Fewer Americans are dying of cancer, even though the number of people being diagnosed with the disease remains the same, according to the latest figures from the nation’s top cancer groups.
An overall decline in cancer deaths that began in the early 1990s continues, with death rates among men dropping at twice the rate as those among women -- a 1.6 percent annual decline for men from the early 1990s to 2003, compared with a 0.8 percent fall for women.
A reduction in cigarette smoking among adults continues to be one of the biggest driving forces in the drop in cancer deaths, along with earlier cancer detection through screening, and treatment advances.
Smoking rates among American men have declined faster than among women. As a result, lung cancer incidence has been dropping among men and increasing among women from 1975 to 2003.
“Smoking is a big risk factor for many cancers, not just lung cancer,” says Holly Howe, PhD, executive director of the North American Association of Central Cancer Registries, and one of the researchers. “That is why it is so important that we continue smoking cessation efforts aimed at women and teen girls.”
Breast Cancers May Have Stabilized
The new cancer death and incidence report was a joint effort of the registries association, the CDC, the American Cancer Society, and the National Cancer Institute. The figures have been updated annually since 1998.
Among the major findings from 1995 to 2003:
--Men’s death rates for 11 of the 15 most common cancers -- including lung, prostate, colon and rectum, pancreatic, and leukemia -- continue to decline.
--Deaths from esophageal and liver cancer increased, but seem to have stabilized for kidney cancer and melanoma.
--Among women, death rates dropped for 10 of the 15 most common cancers, including cancers of the colon and rectum, kidney, cervix, and bladder.
--Deaths from leukemia, non-Hodgkin lymphoma, and myeloma also declined.
--Death rates were stable for pancreatic, ovarian, and uterine cancer.
--Breast cancer rates stabilized between 2001 and 2003, appearing to end a dramatic increase in the number of women being diagnosed with the disease that began two decades earlier.
Hormone Replacement and Cancer
It has been suggested that fewer middle-aged women are developing breast cancer because a smaller number are taking hormone replacement therapy, which has been linked to an increased risk of breast cancer.
But it remains to be seen if the stabilization in breast cancers is a real trend or a random fluctuation, the report’s authors say.
And while lung cancers among women have climbed for the last three decades, the rate of increase has slowed in recent years.
Between 1995 and 2003, lung cancer rates increased among women 65 years and older, while they decreased among women between the ages of 45 and 65, and remained stable in women younger than 45. During the same period, lung cancer rates declined among men in all age groups.
While smoking cessation efforts have clearly had an impact on cancer deaths, the battle is far from won, says Ahmedin Jemal, PhD, of the American Cancer Society.
“More than 40 million adults in the United States still smoke,” he tells WebMD. “Clearly, we still have a long way to go.”
Cancer Among U.S. Hispanics
This year’s report included a special section on cancer among Latino/Hispanics living in the United States, based on data derived from 90 percent of the U.S. Hispanic/Latino population.
“Latinos are among the largest minority group in this country, and it is encouraging that we now have a comprehensive picture of their cancer risk,” Howe tells WebMD.
Findings for Latino/Hispanics
Among the major findings about Latino/Hispanics:
--Latino/Hispanics in the U.S. have a lower incidence of most cancers than non-Hispanic whites. This is partially explained by the fact that smoking rates among Hispanic women are about half that of white women (10 percent compared with around 20 percent), and men also tend to smoke less, according to Faruque Ahmed, MD, PhD, acting chief of cancer surveillance at the CDC.
--Although fewer cancers are diagnosed overall, those that are tend to be more advanced. Latinos are less likely than whites to be diagnosed with more easily treatable, localized cancers of the lung, colon, prostate, breast, and cervix. These differences may be attributed to less cancer screening, lower income, lower education, language difficulties, increased environmental exposures, and limited access to health care.
--Cancers associated with infections were more common among Latino/Hispanics than among non-Hispanic whites. These include cervical cancer, which is primarily caused by human papilloma virus (HPV) infection; stomach cancer, linked to Helicobacter pylori (H. pylori) bacterial infection; and liver cancer, which has been linked to infection with hepatitis B and C viruses.
--The higher incidence of infection-related cancers among Latinos, and the fact that their cancers tend to be diagnosed later, points to a need for better access to preventive health care, says Ahmed.
He added that public health policymakers must continue to commit health care dollars to cancer prevention and early detection efforts if gains seen in recent years are to be maintained.
“The resources have to be made available to continue the interventions that have led to the decline in cancer death rates,” Ahmed says. “That means providing funds for smoking cessation efforts and preventive screening, among other things.”
By Salynn Boyles, reviewed by Louise Chang, MD
SOURCES: Howe, H. Cancer, Oct. 15, 2006; vol 106: online edition. Holly L. Howe, PhD, executive director, North American Association of Central Cancer Registries, Springfield, Ill. Ahmedin Jamal, PhD, DVM, program director for cancer occurrences, American Cancer Society, Atlanta, Ga. Faruque Ahmed, MD, PhD, acting chief of the cancer surveillance branch, CDC, Atlanta.