Reducing the Burden of Cancer

ABSTRACT: Collaborative annual report to the nation finds the cancer death rate decline doubling Report from the CDC, ACS, NCI, and NAACR, in collaboration with the Indian Health Service and Mayo Clinic College of Medicine

A new report from the nation's leading cancer organizations shows cancer death rates decreased on average 2.1% per year from 2002 through 2004, nearly twice the annual decrease of 1.1% per year from 1993 through 2002. The findings are in the "Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives," published online October 15, 2007 (www.interscience.wiley.com/cancer/report2007) and appearing in the November 15, 2007, issue of Cancer.

Among the general population, the report shows that long-term declines in cancer death rates continued through 2004 for both sexes and, despite overall higher death rates for men, the declines from 2002 through 2004 were 2.6% per year among men and 1.8% per year among women. Death rates decreased for the majority of the top 15 cancers in men and women. Important declines were noted for the three leading causes of cancer deaths in men: lung, prostate, and colorectal cancers. In women, deaths rates from colorectal cancer and breast cancer decreased, while the rate of increase for lung cancer deaths slowed substantially.

"The significant decline in cancer death rates demonstrates important progress in the fight against cancer that has been achieved through effective tobacco control, screening, early detection, and appropriate treatment," said Centers for Disease Control and Prevention (CDC) Director, Julie L. Gerberding, md. "As a nation, we must commit to continuing and enhancing these important public health efforts."

"The evidence is unmistakable: We are truly turning the tide in the cancer battle," said John R. Seffrin, phd, chief executive officer of the American Cancer Society (ACS). "The gains could be even greater if everyone in the US had access to essential health care, including primary care and prevention services."

Overall cancer incidence rates for both sexes and all races combined declined slightly from 1992 through 2004. Incidence rates for female breast cancer dropped substantially from 2001 through 2004. This drop is possibly related to declining use of hormone-replacement therapy as well as the recently reported decline in use of screening mammography. Also, lung cancer incidence rates in women stabilized from 1998 through 2004 after long-term increases, and in men the rate declined 1.8% per year from the period 1991 through 2004. Colorectal cancer incidence rates decreased by more than 2.0% per year for men and women, likely due to prevention through the removal of precancerous polyps.

A featured special section provides the most comprehensive cancer data to date for American Indians and Alaska Natives (AI/AN) across the United States. Cancer incidence rates among AI/AN men and women varied two-fold among six geographic regions of the country. From 1999 through 2004, AI/AN men from the Northern Plains region and AI/AN women from Alaska and the Northern and Southern Plains regions had higher cancer incidence rates than non-Hispanic white men and women in the same areas.

"We are firmly committed to addressing cancer health disparities so that the benefits of decades of research can reach all Americans," said National Cancer Institute (NCI) Director John E. Niederhuber, md. "The fact that lung and colorectal cancers rates were higher in some American Indian and Alaska Native populations points to the work we still have to do."

"We now have an infrastructure in this country for obtaining high-quality information about new cases of cancer and we can now describe the successes in cancer interventions and treatment as well as uncover populations with varying risks and outcomes," said Holly L. Howe, phd, executive director of North American Association of Central Cancer Registries (NAACCR). "Without this surveillance, we would be ill-equipped to address the challenges we face in further reducing the cancer burden."

The authors report that earlier detection of disease through screening, improved prognosis through more effective treatment, tobacco control, and reduction in inequalities in cancer care all point to the success of the nation's dedication and focus on reducing the burden of cancer in the US.

The study was conducted by scientists at the CDC, ACS, NCI, which is part of the National Institutes of Health, and NAACCR, in collaboration with scientists from the Indian Health Service and Mayo Clinic College of Medicine.