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Corner turned in cancer battle?

By WASHINGTON POST
Published January 18, 2007


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WASHINGTON - The number of Americans who died of cancer has dropped for a second straight year, marking a milestone in the war on cancer, officials said Wednesday.

More than 3,000 fewer Americans died from cancer in 2004 than in 2003, according to statistics analyzed by the American Cancer Society, indicating that a much smaller decline in cancer deaths a year earlier was likely not a fluke but instead marked the start of a trend.

"It's very exciting," said Ahmedin Jemal, a cancer epidemiologist who prepared the report. "I think it's a turning point in our efforts to reduce the number of people dying from cancer. It's very good news."

The trend was driven by drops in deaths from three of the four major forms of cancer - breast, prostate and colorectal - and a decline in deaths among men from the fourth, lung cancer. It was caused by a combination of factors, including a decline in cigarette smoking among men, wider screening of men and women for colon cancer, prostate and breast cancer, and better treatments, Jemal and others said.

"There's a lot of good news in this report," said Linda Pickle of the National Cancer Institute. "We hope that it's the beginning of a long-term downward trend and that we've finally turned the corner."

President Bush lauded the news during a visit to the National Institutes of Health. "This drop was the steepest ever recorded," Bush said. "Progress is being made."

Jemal and others noted that while the number of Americans being diagnosed with cancer also appears to have plateaued, more than 1.4-million Americans will still find out they have a form of the disease this year and some 560,000 will die, keeping cancer the second leading cause of death in the United States, after heart disease.

"We clearly still have a long way to go," Jemal said.

The death rate from cancer has been dropping by about 1 percent a year since 1991, but the total number of deaths continued to rise because of the growth of the overall population and the number of elderly.

From 2002 to 2003, the number of cancer deaths dipped for the first time since officials started tracking data from death certificates in 1930, dropping by 369 deaths. But that number, reported last year, was too small to be sure it was not an aberration.

When Jemal and his colleagues examined the latest data from 2004, they found the rate dropped by more than 2 percent and the overall number of deaths fell more steeply, from 556,902 in 2003 to 553,888 in 2004, a decline of 3,014.

"It's not only continuing, it's much larger," Jemal said. "This shows that what we reported last year really was not a fluke. We really are making progress."

The biggest drop occurred in colorectal cancer, with 1,110 fewer men and 1,094 fewer women dying from the disease. The decline was attributed to broader efforts to screen for the disease and improved treatment.

Similarly, 666 fewer women died of breast cancer and 552 fewer men died of prostate cancer in 2004, probably the result of increased detection and better treatment.

For lung cancer, the picture was mixed, with 333 fewer men dying but 347 more women - reflecting the fact that women were slower to take up smoking and started quitting later. But the death rate among women has been dropping sharply and the absolute number should begin declining soon if current trends continue, Jemal said.

Several advocates and cancer experts said, however, that the good news is tempered by cuts by the White House and Congress in funding for health research that has helped fight cancer.

"The government's investment in the war on cancer has fueled the progress we've made against this disease," said Daniel E. Smith, president of the cancer society's Cancer Action Network. "We risk jeopardizing those gains if we retreat from the fight."

Other experts hailed the decline but said it resulted primarily from preventing cancer through lifestyle changes such as quitting smoking and from more aggressive screening, rather than from major advances in treatment.

"This is largely the payoff from increased attention in recent years to cancer prevention and early detection," said John Bailar III, who studies cancer trends at the National Academy of Sciences. "Treatment results remain disappointing. I think we need to continue to shift research resources into prevention and early detection. This shows that's where we get results."

Others noted that when people survive cancer, they often suffer with the disease's aftermath.

"Cancer is still one of the most feared, if not the most feared, diagnosis anyone can receive," said Ellen Stovall of the National Coalition for Cancer Survivorship. "Just because people are surviving isn't sufficient."

[Last modified January 18, 2007, 00:32:02]


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