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U.S. Cancer Rate-Death Rate Combo Drops for 1st Time
Date:11/25/2008

But smoking-related cancers continue to rise in some regions of country, report finds

TUESDAY, Nov. 25 (HealthDay News) -- For the first time since such statistics were released in 1998, the number of men and women in the United States getting and dying from cancer has dropped.

The drop in cancer rates is mostly due to fewer cases of lung, prostate and colorectal cancer among men, and fewer cases of breast and colorectal cancer among women. Also, death rates from lung cancer have leveled off among women since 2003, a new report found.

Still, large state and regional differences in lung cancer trends among women highlight the need to increase many state tobacco-control programs, said the study's authors.

"We are making progress in the fight against cancer," said report co-author Dr. Ahmedin Jemal, director of the American Cancer Society's Cancer Occurrence Office. "There is a decrease in incidence and death rate for all cancers combined in both men and women and in almost all racial and ethnic groups."

Still, the progress could have been better, Jemal said. "If we were to insure all Americans to have access to care, then we could have applied cancer prevention and treatment to all segments of the population, he said.

By paying more attention to healthful behaviors such as not smoking, the cancer rate would drop even more, Jemal said. "There are 43 million Americans who smoke, and that's unacceptable. Smoking is the single most preventable cause of cancer. A third of all cancers are due to smoking," he said.

The report, titled the "Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use and Tobacco Control," is issued annually by the American Cancer Society, the U.S. Centers for Disease Control and Prevention, the U.S. National Cancer Institute, and the North American Association of Central Cancer Registries. It was published in the Dec. 3 issue of the Journal of the National Cancer Institute.

The report found that from 1999 to 2005, the rate for all cancers among men and women dropped 0.8 percent a year. Among men the drop was 1.8 percent a year and for women it was 0.6 percent annually.

The decline included all racial and ethnic groups except for American Indians and Alaska Natives, whose rates remained stable. Cancer death rates were highest for blacks and lowest for Asian American/Pacific Islanders, according to the report.

For men, the rates of prostate cancer decreased by 4.4 percent a year from 2001 to 2005. But, rates of cancer of the liver, kidney, esophagus, as well as melanoma, non-Hodgkin lymphoma, and myeloma increased. Rates remained stable for bladder, pancreatic, and brain/nervous system cancers and leukemia.

Among women, rates of breast, colorectal, uterine, ovarian, cervical, and oral cancers dropped. But, there were increases in rates of cancers of the lung, thyroid, pancreas, brain/nervous system, bladder, and kidney, as well as for leukemia, non-Hodgkin lymphoma, and melanoma, the report said.

The report authors also found a difference in lung cancer and lung cancer death rates in different regions of the country. "Lung cancer rates, especially in women, are increasing in 13 states in the South and Midwest," Jemal said.

These states have more female smokers, low excise taxes, and local economies that are traditionally dependent on tobacco farming and production, he said.

Besides lung cancer, smoking also causes cancers of the mouth, pharynx, larynx, esophagus, stomach, bladder, pancreas, liver and kidney, as well as the uterus, cervix and myeloid leukemia, he said.

Dr. David L. Katz, director of the Yale University School of Medicine Prevention Research Center, agreed that progress has been made, but there is still much to do.

"For those of us who have long argued that cancer, like heart disease, is by and large predictable and preventable, this is a very gratifying report," he said. "We have here proof that both the incidence and mortality of cancer overall have trended downward over recent years. This means that we are treating cancer more effectively when it occurs, but also preventing it outright more often."

Yet there is some discouraging news, Katz said. "Lung cancer death rates in women in the South and Midwest have continued to rise, due to higher rates of smoking. We should note, however, that after smoking rates fall, it takes some time to see that reflected in less cancer. So we might fix the basis for these disparities, and still see disparities for some time," he said.

"Cancer remains a leading cause of both premature death and misery in our society. And far more of that burden is preventable than progress to date reveals. You can minimize your own risk by taking four steps: Don't smoke, eat well, be active, and get screened," Katz said.

More information

To learn more about cancer, visit the American Cancer Society.



SOURCES: Ahmedin Jemal, D.V.M., Ph.D., director, Cancer Occurrence Office, American Cancer Society, Atlanta; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Dec. 3, 2008, Journal of the National Cancer Institute


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