Every year around this time the American Cancer Society publishes its annual “Cancer Facts and Figures.” This year, the report is being released today, February 20th.
You may not know the name of the publication, but you may well be familiar with its content. This is the report that is so frequently quoted in the media as the source of a statement which is something to the effect, “According to the American Cancer Society, “x” number of people will be diagnosed with (type of cancer) in the United States in 200x, and “y” number of people will die from that disease.”
The reason this report is so important is that it provides us with an update in how we are doing in our nationwide fight against cancer. It provides an estimate of the incidence and deaths of cancer in 2008, based on the best available information from years past.
This report also provides us an opportunity to get a sense of where we are headed in our efforts to eradicate cancer as a fatal disease. And, each year, we select a particular topic to focus on which will provide us an in-depth analysis of a particular problem related to cancer, such as pain or the relationship of infections to the causation of various cancers.
Perhaps the most watched statistic in Cancer Facts and Figures is our assessment of the number of cancer deaths year to year.
You may recall that for the past two years we reported there were actual declines in the number of people who died from cancer from 2002 to 2003, and 2003 compared to 2004. In fact, last year we reported that there were over 3000 fewer cancer deaths when comparing 2004 to 2003. (The reason for the delay in determining the number of cancer deaths 3 years previously has to do with the time it takes to get accurate information.)
At the time, we said we hoped the trend would continue. But we also cautioned it may not. After all, it takes many years to define a continuing trend, and variations from year to year can be hopeful or disappointing, but they may not define on ongoing direction.
This year, we report that from 2004 to 2005, there was an increase of 5,424 deaths from cancer in the United States.
What that means is that there was a smaller decline in the cancer death rates during 2005 which were not enough to overcome the large increase in the number of people at risk of dying from cancer.
That may sound a bit confusing, so let me try to explain.
The population of older people is rapidly increasing in this country as baby boomers age. Age is probably the most significant risk factor for cancer. When we have more people at risk, we would expect to see larger numbers of deaths.
That is counterbalanced by the rate of cancer deaths. If the decline in death rates is large enough, it can overcome the negative effects of the larger, older adult population.
In two previous years (2002 to 2003 and 2003 to 2004), that was the case. The rate of decline in cancer deaths was large enough to overcome the increase in the number of people at risk of developing and dying of cancer. For those years, the rate of decline for each year was about 2%. From 2004 to 2005, however, that was not to be. For that year, the rate of decline slowed to 1%.
But that doesn’t mean we have not been making progress, nor does it mean that in years to come we won’t once again see an absolute decline in the number of cancer deaths.
Take a look again at the rate of decline and what you see is that the rate of cancer deaths declined by more than 5% over that period of time from 2002 through 2005. To me, that is a remarkable number.
For example, colorectal cancer death rates declined about 6% from 2003 to 2004, and another 3% from 2004-2005.
Here is another way to look at the progress we have made:
When you look at the rates of cancer deaths from 2004 and compare it to those that were seen in 1990-1991, the estimate is that over half a million deaths from cancer were averted during that time period. Over that interval, death rates from cancer decreased by 18.4% among men and by 10.5% among women.
To me, that is an astounding number. If we were not doing anything different for the prevention, early detection and treatment of cancer, we would have lost an additional one-half million people during those 15 years.
There are some other numbers worth noting in this report. Unfortunately, not all of them are good numbers. But we should never ignore the fact that there is much we could be doing better and more effectively.
In men, prostate, lung and colorectal cancer account for ½ of all cancer diagnoses.
For women, breast, lung and colorectal cancer make up 50% of new cancer diagnoses.
We have much to learn about the detection and treatment of men with prostate cancer, and we don’t know much about how to prevent the disease.
We do know how to prevent some breast cancers in women at high risk, and we certainly know a considerable amount about how to find the disease early.
We know how to prevent lung cancer, are learning whether or not early detection is a real possibility, but we can’t do much to treat the disease in most people once it has been diagnosed at an advanced stage or spread through the body.
Colorectal cancer is to me the leading example of our frustration at truly decreasing the burden of cancer, when you consider the real and almost immediate impact we could have on deaths from this disease if we only did what we know works. Literally thousands of lives could be saved every year if people got screened for this disease in accordance with American Cancer Society guidelines.
I have previously reported on our Annual Report to The Nation, where we discussed the dramatic decline in breast cancer deaths from 2001 to 2004. And I also pointed out that although there is some hope regarding lung cancer in women, the sad reality is that deaths from this disease have increased slightly each year from 1995 through 2004.
In African-Americans, the toll of cancer remains overwhelming. African-American men have a 19% higher incidence rate and 37% higher death rate from all cancers combined when compared to white men.
On the other hand, although African-American women have a 6% lower incidence of cancer compared to white women, but their death rate is 17% greater.
Some of this disparity is undoubtedly due to the focus topic of this year’s Cancer Facts and Figures, namely the role that insurance (or lack thereof) plays in delayed diagnosis and treatment of cancer in this country.
Again, this is not a new topic. Even as recently as this Monday my colleagues at the American Cancer Society have published another of several articles demonstrating how lack of insurance or adequate insurance adversely impacts the outlook of many people in this country with cancer.
Access to care impacts prevention, early detection, diagnosis, treatment and outcome of people with cancer. We cannot ignore that fact, and this year’s Cancer Facts and Figures once again outlines the enormity of the problem that faces us in this country.
So, as is often the case we have some news to celebrate, and some news that is not so good. We have areas were we have excelled, and areas where we have not.
But, as always, we must keep looking forward, improving on our successes and turning around our failures.
By constantly striving to improve—through more research, better application of what we know, and making certain that every citizen in this country has access to a health care system that is the most technologically advanced in the world—we will eventually achieve success in reducing the suffering and burden of cancer.
This is not an easy task, and it is not a simple or quick one. But I remain an optimist that we can achieve our goals, continue to see declines in cancer incidence and death rates, and continue to present annual Cancer Facts and Figures reports that document our progress.