CANCER: Incidence, Death Rates On Decline
For the first time since data were collected in the 1930s, government epidemiologists announced yesterday the number of new cancer cases among Americans is declining. In addition, the number of deaths from cancer is dropping, continuing a trend first identified in November 1996. "The incidence of cancers -- the number of reported cancer cases per 100,000 Americans -- slipped an average 0.7% a year during the 1990 to 1995 period, a significant change from the average 1.2% a year rise in cases reported between 1973 and 1990," the Wall Street Journal reports (Waldholz, 3/13). Further, the Los Angeles Times reports, "preliminary findings from 1996 show that declines in both incidence and death rates are continuing." The study was compiled by the American Cancer Society, the National Cancer Institute and the Centers for Disease Control and Prevention (Cimons, 3/13). Although cancer still kills more than 1,500 Americans each day, the CDC's James Marks said, "The burden of fear the public has been feeling should begin to lift." Yesterday's announcement represents a sharp reversal and offers "new hope that 27 years after President Richard Nixon declared 'war on cancer,' the nation may have reached a turning point."
Tempered Joy
Yesterday's news was not uniformly good for all types of cancer, all races or both sexes. The study examined data on 23 types or "sites" of cancer and focused on lung, prostate, breast and colon-rectum cancer, the four leading cancer killers between 1990 and 1995. The New York Times notes that "men benefitted more from the recent declines than did women. And among Asian and Pacific Islander women, death rates are up." Black men continued to show "the highest cancer rates of any group in the nation, mainly because of a sharp rise in new cases of prostate cancer" (Stolberg, 3/13). The Los Angeles Times reports that lung cancer incidence and death rates rose for women, in contrast to a decline among men, likely due to recent increases in smoking among women, according to health officials. And both the incidence and mortality from melanoma and non-Hodgkin's lymphoma are increasing, while a recent decline in the incidence of uterine cancer has leveled off (3/13). The Washington Post reports that breast cancer "declined slightly for whites, and more markedly for Asians and Hispanics, while it rose for blacks" (Brown, 3/13).
Don't Let Up
Experts are attributing the decline in new cancer incidence to behavioral changes, particularly dietary improvements and drops in smoking. They attribute the drop in deaths to more accurate and comprehensive screening and therapies. Health officials warned, however, that "the large number of children who are still taking up smoking -- estimated at 3,000 every day -- could reverse the statistics unless efforts to curb tobacco use are stepped up" (Los Angeles Times, 3/13). The full study will be published in the March 15 issue of the journal Cancer (multiple sources, 3/13).
Criticism
USA Today reports that "John Bailar, author of a New England Journal of Medicine study critical of the cancer war, says the report card is misleading." Bailar said, "Progress has been overstated. The change is tiny" (Davis, 3/13). Lovell Jones, a professor at the University of Texas' M.D. Anderson Cancer Center also questioned the report's value. "How is this a national report card? By giving this information, you give a sense of false hope to individuals who are really suffering," he said. The Boston Globe reports that critics "said the study paints an overly rosy picture because it undercounts cancer among members of minority groups and the poor, in whom several cancers are still climbing sharply" (Kong, 3/13).