Cancer incidences on decline
The US Annual Report to the Nation on the Status of Cancer has this month reported that deaths from some of the most common cancers in the United States have declined over the last decade, and that fewer people today are being diagnosed with cancer—signs that prevention efforts, earlier detection and improved treatments are paying off.
However, the authors of this important report have cautioned that major public health challenges continue to lie ahead as the population ages.
“Even with declining cancer incidence rates, the absolute number of individuals diagnosed with cancer will continue to increase because of population changes, leading to increased demand for cancer-related medical services through the spectrum of diagnosis, active treatment and post-treatment medical management,” the authors wrote in the May 4 issue of the Journal of the National Cancer Institute.
The authors concluded that management of the cancer burden will require “sound cancer control strategies in prevention, detection, treatment, and survivorship, as well as resources to provide good quality of care.”
Overall, cancer incidence fell by approximately 1% per year, a decrease that was statistically significant in women (P<0.05) but not in men, owing to a recent increase in prostate cancer incidence.
Deaths from cancer fell for both women and men, with the largest decrease seen in black and Hispanic men at approximately 2.5% per year. Notably, lung cancer incidence and death rates declined significantly in women of all ethnicities between 2003 and 2007, the first time lung cancer rates have dropped in women since 1975. The decline in women comes more than a decade after the rates began to decrease in men.
Mortality rates dropped in seven of the remaining 14 most common cancers, including cancers of the colorectum, kidney, stomach, brain, leukemia, non-Hodgkin’s lymphoma and myeloma, as well as prostate and oral cancer among men and cancers of the breast, ovaries and bladder among women. Mortality from other cancers—kidney, thyroid, pancreatic, liver, melanoma and uterine cancers—in women increased but not enough to offset the overall decline.
“These decreases indicate real progress in cancer control,” wrote Betsy A. Kohler, MPH, executive director of the North American Association of Central Cancer Registries, and co-authors.
The report also revealed that colorectal cancer rates decreased for both men and women, but the decrease was not statistically significant for American Indian/Alaska Native women. Incidence dropped 3% in men between 1998 and 2007 and 2.3% in women.
Investments in preventing, diagnosing and treating cancer are paying off but more research dollars are needed to help more patients survive what was once an incurable disease, said George Sledge Jr., MD, Ballve-Lantero Professor of Oncology at the Indiana University Melvin and Bren Simon Cancer Center, and president of the American Society of Clinical Oncology.
“In spite of the progress, much more research needs to be done,” Dr. Sledge said in a statement. “Current federal budget restraints threaten our ability to build on the new, innovative and personalized treatments that are being researched [and] that are leading to longer and more productive lives for cancer patients.”
Jeffrey M. Weber, MD, the director of gastroenterology and metabolism at Cancer Treatment Centers of America at Western Regional Medical Center, Goodyear, Ariz., called the report “encouraging.”
“As a gastroenterologist, I’m very pleased to see a decrease in deaths from colorectal cancer,” he said, adding that the drop likely reflects improvements in screening.
He noted, however, that there is clearly a need for greater emphasis on childhood cancers, along with more cooperation between medical centres and greater use of tissue banking.
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