What Is patientINFORM?

The cancer death rate in the United States continues to go down, a new report from the nation's leading cancer organizations says. What's more, cancer incidence -- the rate at which new cancers are diagnosed -- also appears to be dropping.

The findings come from the Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use and Tobacco Control.

According to the report, cancer death rates for both sexes combined declined about 1.8% per year from 2002 through 2005, almost double the 1.1% per year decrease seen from 1993 through 2002. And for the first time in the 10-year history of the report, incidence rates for all cancers combined decreased, falling by 0.8% per year from 1999 to 2005.

"The drop in incidence seen in this year's Annual Report is something we've been waiting to see for a long time," said Otis W. Brawley, MD, chief medical officer of the American Cancer Society (ACS). "However, we have to be somewhat cautious about how we interpret it, because changes in incidence can be caused not only by reductions in risk factors for cancer, but also by changes in screening practices. Regardless, the continuing drop in mortality is evidence once again of real progress made against cancer, reflecting real gains in prevention, early detection, and treatment."

The Annual Report to the Nation is a joint report of the American Cancer Society, the US Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACR). It will be published online today and is slated to appear in the December 3, 2008 issue of the Journal of the National Cancer Institute. This year's report includes a special section on lung cancer rates and tobacco control.

Cancer death rates declined for 10 of the 15 most common causes of cancer death among both men and women, but increased for a few individual cancers, such as esophageal and bladder cancers among men, pancreatic cancers in women, and for cancers of the liver in both.

The decline in cancer incidence was largely due to declines in the most common cancers: lung, colorectal, and prostate cancer for men and breast and colorectal cancer for women.

Lung cancer death rates in women leveled off from 2003 through 2005, but incidence rates are still rising, though more slowly than they have risen in the past. Lung cancer death rates have been decreasing in men since the 1990s.

The report shows significant differences in lung cancer deaths in different parts of the United States. In California, for instance, the lung cancer death rate dropped by about 2.8% per year among men between 1996 and 2005. That decline is more than double that seen in some Midwestern and Southern states, and may be due in part to California's strong tobacco control policies.

"We can see that, in areas of the country where smoking and tobacco use are entrenched in daily life, men and women continue to pay a price with higher incidence and death rates from many types of cancer. This type of geographic variation in smoking-related cancers is due to smoking behaviors, not regional environmental factors," said Betsy A. Kohler, MPH, executive director of the NAACCR.

CDC Director Julie Gerberding, MD, said, "We must recommit ourselves to implementing tobacco control programs that we know work if we are truly going to impact the staggering toll of tobacco on our society."

Although the news from the new report is encouraging, more could be done to reduce cancer deaths even further, the study authors point out.

The medical community needs to apply what it knows about prevention, early detection and treatment of cancer much more broadly, they say, so that all segments of the US population benefit from it. Right now, there are still differences among ethnic and racial groups. Cutting tobacco use is another important avenue for reducing cancer deaths. And, there needs to be more research into better methods of prevention, early detection and treatment, they write.

Citation: Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use and Tobacco Control. Published in the December 3, 2008 Journal of the National Cancer Institute (Vol. 100, No. 23: 1672-1694). First author, Ahmedin Jemal, PhD, American Cancer Society.