010623 Some Progress, But War on Cancer Is Not Won

Washington - The toll cancer takes on America has moderated in the past decade, but the war against the group of diseases that kills 550,000 people annually in the United States is far from won, experts say.

One in four deaths in the United States is due to cancer, a category of ailments marked by uncontrolled growth and spread of abnormal cells. Only heart disease claims more lives.

There was plenty of good news in the annual report on cancer in America published on Tuesday in the Journal of the National Cancer Institute. The overall death rate and the rate of diagnosis of new cases of most types of cancers continued their decline from peaks registered in 1991 and 1992.

“We're headed in the right direction, but we have a long way to go,” said Dr. Michael Thun, who heads epidemiological research for the American Cancer Society and was a co-author of the report.

“The good news is that with respect to cancer death rates, there is this continued decline in all cancers combined, both men and women -- cancers of the breast and of the prostate, of the colon and rectum and of the lung in men.”

Thun cited wider use of improved screening methods, better treatment and reduced smoking as key factors.

On the “bad news” side of the equation, the report cited rises in new breast cancer cases and in the female mortality from lung cancer. It also identified 10 other cancers for which incidence or mortality has grown in either men or women.

Most are relatively uncommon, including: Non-Hodgkin's lymphoma (accounting for 4.4% of overall U.S. cancer deaths and 4% of cases in 1998, the last year for which figures were available); liver cancer (2.3% of deaths, 1.2% of cases); esophagus cancer (2.2% of deaths, 0.9% of cases); and the skin cancer melanoma (1.4% of deaths, 3.5% of cases).

Cancer of the lung, prostate, breast and colon represented 56% of all new cancer cases and were the leading causes of cancer deaths for every racial and ethnic group.

BAD CHOICES, BAD CONSEQUENCES

One frustration to experts is how many cancer cases are completely preventable. The American Cancer Society estimates that about 171,000 cancer deaths a year are caused by smoking, and another 19,000 cancer deaths may be related to excessive alcohol use, frequently in combination with tobacco use.

Experts said only a fraction of cancer cases can be blamed on genetics, saying personal choices about smoking, drinking, diet and exercise are far more relevant.

The American Cancer Society said nutrition -- particularly a fatty diet -- plays a role in a third of cancer deaths. It recommends a diet rich in fruits, vegetables, grains and beans, with limited amounts of meat, dairy and other high-fat foods.

“When you think of the percent of folks who take up smoking every year and you look at youth who take up smoking, that's a concern,” said Dr. Phyllis Wingo of the U.S. Centers for Disease Control and Prevention, a co-author of the annual cancer report. “Diet, physical exercise are important. And screening is important.”

Experts said regular screening examinations can detect breast, colon, rectum, prostate, cervix and other cancers at early stages when treatment is more likely to be successful.

Breast cancer has become a much bigger problem for American woman in the last quarter century. New diagnoses surged by 40% from 1973 to 1998, the report said. About 40,000 American women die of breast cancer annually.

Experts said the gradual rise in breast cancer cases in the 1990s stemmed in large part from more screening, particularly with mammography, among women in the age groups at the highest risk (age 50 to 64).

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