Last February I wrote a blog about the decrease in the number of people dying from cancer in the United States from 2002 to 2003.
This was the first time since records have been kept that such a decline was ever seen, despite the fact that we have a population in this country that is growing and becoming older.
One of my conclusions from that posting was the following:
“Probably the most important ‘next question’ is whether we believe this decline in the number of cancer deaths will continue. The obvious answer is that we hope so. The honest answer is we don’t know.”
Now we do know the answer to that question, and we can say with certainty that, for the second consecutive year, the absolute number of people dying from cancer in this country has continued to decrease.
And, my friends, that is wonderful news.
Every year the American Cancer Society publishes an article titled “Cancer Statistics.”
In that publication, we do two things:
First, we estimate what the number of new cancer cases and cancer deaths will be in the United States for the coming year using sophisticated statistical models. You frequently see that information quoted in the media as, “The American Cancer Society estimates that “x” number of cases of a particular cancer will occur in the United States this year.”
The other part of the annual report is to provide an update on the actual number of cancer deaths that occurred for the latest year when the information is available for analysis. That data usually lags several years because of the need to collect accurate statistics.
Last year in our Cancer Facts and Figures 2006 report, we announced there were 369 fewer deaths from cancer in 2003 than 2002. Most of this was due to fewer deaths in men; there actually had been an increase in the number of women who died from cancer.
This year, when the data from 2004 and 2003 were analyzed, we found there was a decrease of 3,014 deaths from cancer in 2004 compared to the previous year. This included 1,160 fewer deaths in men, and 1,854 fewer deaths in women.
The authors of the report also noted that the largest change in the number of deaths was from colorectal cancer, decreasing by 1,110 in men and 1,094 in women. Also contributing to the decline was a decrease of 333 deaths from lung cancer in men, 666 breast cancer deaths in women, and 552 deaths from prostate cancer in men.
When the authors of the article looked to see which cancers showed the greatest decline in death rates from 1990 to 2003, they found that for men most of the decrease was in lung cancer (down 38.4%), prostate cancer (down 24.8%) and colorectal cancer (down 16.1%).
For women, the greatest decline in death rates from cancer was in breast cancer (down 39.4%) and colorectal cancer (down 22.3%).
Unfortunately, not all of the news is good.
Although many cancers death rates in men and women have been declining from 1990 to 2003, there are some that are increasing, including primarily cancers of the esophagus, liver and bile ducts in men (accounting for about 75% of the increase in men), and lung cancer in women (accounting for about 86% of the increase in women).
If there is any good news about lung cancer and women, it is that the death rates appear to be leveling off and hopefully will begin to decline within the next several years as women start catching up to the significant decreases in lung cancer death rates that men began to experience in the 1990’s.
No doubt, we still have a long way to go.
There will be an estimated 1.44 million new cases of cancer diagnosed in this country in 2007. And that doesn’t include the more than 1 million new cases of “benign” squamous and basal cell cancers of the skin, or the estimated 62,030 “in situ” (non-invasive) cases of breast cancer in women, or the 48,290 “in situ” cases of melanoma.
And, despite our progress, an estimated 559,650 Americans will lose their lives to cancer in 2007, which is over 1500 deaths every day of the year.
Common cancers are still common:
- In men, prostate cancer alone will account for 29% of new cancer cases, lung cancer 15% and colorectal cancer 10% in 2007.
- For women, breast cancer will represent 26% of new cancer cases, lung cancer 15%, and colorectal cancer 11% this year.
- Many women are not aware that lung cancer is the leading cause of death for women in this country, accounting for 26% of cancer deaths. In contrast, but still too high, breast cancer is responsible for 15% of cancer deaths in women, followed by colorectal cancer with 10% of all cancer deaths in women.
Cancer still remains—unfortunately—the leading cause of death in this country of people under the age of 85. In that group, approximately 59,000 more people died in this country from cancer than heart disease in 2003.
And the news is not acceptable when we consider race and ethnicity as the defining factor.
The report indicates that for all cancer sites combined, African American men have a 15% higher incidence rate and a 38% higher death rate compared to white men.
African American women actually have a 9% lower incidence rate of cancer compared to white women, but their death rate is 18% higher for all cancer sites combined, according to the study.
Although there may be a number of factors that explain these sad differences, the reality is that access to screening and access to timely diagnosis and treatment for many cancers for African Americans in this country is thought to be responsible for much of the discrepancy.
What we do know is that, for several cancers that have been studied, equal access means equal outcome.
As our population in the United States becomes more diverse, there can be little question but that we must address these issues directly. To not do so may mean that, at some time in the not too distant future, we will inevitably see cancer deaths resume climbing.
My conclusions this year are not that dissimilar to my comments last year:
- We have seen a significant decline in the number of cancer deaths in this country for the second consecutive year. Although we hope that this decline will continue (and possibly accelerate) in future years, we can’t be certain until the data is available.
- Much of that decline is due to better screening and better treatment, as well as a decrease in the number of people who smoke.
- We still have much we could do to improve these successes, as reflected in the decline in the number of colorectal cancer deaths. Many people who need to be screened for cancer, whether it be mammography, cervical cancer screening or colorectal cancer screening, for example, either aren’t taking advantage of the opportunity or don’t have the opportunity. We need to do better.
- We must solve the access issue. We spend over $2 trillion dollars on health care in this country every year, and yet lives are being lost for the most simple and basic lack of medical care. For example, can we take pride in our health care delivery system when only 1 in 5 eligible women are able to take advantage of the CDC sponsored breast and cervical cancer early detection program for women who lack adequate access to cancer screening, a program that has been shown to save lives?
So, while we congratulate ourselves on our successes, we must not ignore our inadequacies. If anything, we must take note of those problems and redouble our efforts.
This is a journey of sometimes small and sometimes simple steps.
Our research moves forward, developing better understanding of cancer and what we can do to improve our ability to prevent, detect, and treat the many diseases that we call cancer. However, much of our success will be in a succession of small steps, and not huge breakthroughs (although, fortunately, those do happen from time to time).
Simple steps include what you can do for yourself, your family and your community by following straightforward recommendations about nutrition, physical activity, smoking and screening, and by making our environments safe through such actions as eliminating second hand smoke.
We must understand that only through our control of our health, through our investment in research, and through making access to medical care a priority for our nation will we be able to make this successful report on decreasing deaths from cancer in this country an annual event.
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