The latest American Cancer Society’s annual report on cancer statistics shows that the nation’s overall death from cancer continues to fall, but in 2004 to 2005, the last period for which full data is available, actual deaths went up by over 5,000, prompting suggestions that two other significant trends, a growing and aging population, could be slowing the rate down.

The report, titled Cancer Statistics 2008, is to be published in the March/April issue of CA: A Cancer Journal for Clinicians, and in the 57th edition of its companion publication, Cancer Facts & Figures 2008.

For the number of deaths to decrease, said the report, it is important to realize that the overall rate of death has to be large enough to offset two other rising trends: an aging population and an increasing population.

CEO of ACS, Dr John R. Seffrin, highlighted that:

“The increase in the number of cancer deaths in 2005 after two years of historic declines should not obscure the fact that cancer death rates continue to drop, reflecting the enormous progress that has been made against cancer during the past 15 years.”

Since the 1990s, when they first began to fall, the death rates from cancer in the US have gone down by 18.4 per cent in men and 10.5 per cent in women. This equates to more than half a million people that have not been killed by the disease, said the report. The actual figure is 534,500 deaths averted.

“While in 2005 the rate of decline was not enough to overtake other population factors, the fact remains that cancer mortality rates continue to drop, and they’re doing so at a rate fast enough that over a half million deaths from cancer were averted between 1990/1991 and 2004,” said Seffrin.

Despite a continuing fall in the overall cancer death rate from 2004 to 2005, the actual number of deaths went up from 559,312 in 2005 to 553,888, an increase of 5,424. The previous two years had seen a decrease in the actual number of deaths.

From 2004 to 2005, the overall cancer death rate fell by 1 per cent. This compares to a 2 per cent fall in both previous years, 2003 to 2004 and 2002 to 2003.

Broken down by the four major cancers, the latest report shows that death rates for colorectal cancer dropped by about 3 per cent in 2004 to 2005, compared to about 6 per cent in 2003 to 2004. Death rates for breast cancer in women, and cancers of the lung and bronchus, and also prostate in men, were also smaller in 2004 to 2005 compared to 2003 to 2004.

The ACS epidemiologists that compiled the report got their base data from the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), the North American Association of Central Cancer Registries, health agencies at state and local level, and thousands of cancer registrars throughout the US.

From its humble beginnings in the 1950s, when the report comprised four typewritten pages, the ACS annual statistics is a hefty volume that is used throughout the world. Scientists from the ACS and the National Center for Health Statistics use the actual previous incidence statistics to predict cancer incidence and mortality, both nationally and state by state, for the current year.

They predict, for example, that in 2008, the US will see a total of 1,437,180 new cases of cancer (745,180 in men and 692,000 in women) and 565,650 deaths from the disease (294,120 among men and 271,530 among women).

The report breaks this down as follows:

  • One in two new cases (50 per cent) of cancer in men will be for cancers of the prostate, lung and bronchus, and colon and rectum.
  • Prostate cancer will account for 1 in 4 of all new cancer cases in men.
  • In women, the three most commonly diagnosed cancers will be of the breast, lung and bronchus, and colon and rectum.
  • These will account for half (50 per cent) of new cancers in women.
  • Breast cancer will account for 1 in 4 new cancer cases in women.
  • Lung cancer overtook breast cancer as the leading cause of cancer death in women in 1987. It is expected to account for 26 per cent of all cancer deaths in women in 2008.
  • Lung cancer rates are falling in men and appear to be leveling off in women, after increasing for several decades.
  • Colorectal cancer rates went down from 1998 to 2004 in both men and women.
  • Breast cancer rates in women went down by 3.5 per cent a year from 2001 to 2004, after increasing since 1980.
  • In men under 40, leukemia is the most common fatal cancer.
  • In men over 40, lung cancer is the most common fatal cancer.
  • Leukemia is also the leading cause of cancer death in women under 20.
  • Breast cancer is the leading cause of cancer death in women aged 20 to 59.
  • Lung cancer is the leading cause of cancer death in women aged 60 and over.
  • For children aged between 1 and 14, cancer is the second leading cause of death, after accidents.
  • The 5-year relative survival among children for all cancers combined, went up from 58 per cent for cases diagnosed between 1975 to 1977 to 80 per cent for cases diagnosed between 1996 and 2003.

The ACS urge caution in the interpretation of these figures. They may vary significantly from year to year, particularly for the rarer cancers, and in states with smaller populations.

However, in spite of such limitations, such figures help policy makers to implement measures to fight and hopefully reduce the cancer burden of the nation, said the ACS in a press statement.

The report also contains a comprehensive section on prevention, detection and treatment, which in recent years has focused on tobacco, obesity, infectious causes, pollution, and pain. Another section contains a report on potential barriers to care, such as lack of insurance, being on low income, and minority populations.

Chief medical officer of the American Cancer Society, Dr Otis W Brawley, commenting on these sections, said:

“The progress that has been made in reducing cancer death rates is a direct result of investment in approaches that we know work, such as comprehensive tobacco control and screening for breast, cervical, and colorectal cancers, as well as research that has identified more successful treatments.”

“However, we believe that lack of health insurance and inadequate health insurance is one of the most important barriers to continued progress.”

“A growing body of data shows that compared to those with private insurance, those without health insurance are less likely to receive smoking cessation advice and treatment, about half as likely to receive cancer screening, more likely to be diagnosed at late stage, and less likely to survive after a cancer diagnosis. We are committed to addressing this critical issue,” he added.

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Source: American Cancer Society press statement.

Written by: Catharine Paddock, PhD