Cancer deaths fell over two-year period

January 18, 2007|By Chris Emery and Jonathan Rockoff | Chris Emery and Jonathan Rockoff,SUN REPORTERS

Cancer deaths have declined in the United States for the second year in a row, suggesting that decades of research into the prevention, diagnosis and treatment of the disease are paying off.

A study by the American Cancer Society, released yesterday, found that at least 3,000 fewer people died of cancer in 2004 than in the previous year, a decrease that continues despite a population growing in numbers and in age.

According to the ACS, 553,888 people died from cancer in 2004, or more than 1,500 a day.

"We are clearly on the right path," Dr. Martin D. Abeloff, director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, said, commenting on the results. "We are seeing that cancer is really beginning to convert to a chronic disease."

Among men, deaths from lung cancer, prostate cancer and colorectal cancer dropped the most. In women, the greatest decline was recorded in breast and colorectal cancers.

Experts attributed the progress to a variety of forces, including improved screening, a decline in smoking and the development of better drugs and therapies.

"We always want to see the grand-slam home run," said Abeloff. "But what we are seeing are incremental gains."

The absolute drop in the number of cancer deaths continues a trend that started in the 1990s, when cancer death rates started to level off and then decline, said Elizabeth M. Ward, director of surveillance for the American Cancer Society and a co-author of the study released yesterday.

An ACS report last year found that in 2003 the number of cancer deaths dropped by 369 compared with the previous year, the first drop in actual mortality since national death statistics were first recorded in the 1930s.

Before that, the growth and aging of the population offset the decline in cancer death rates, expressed in deaths per 100,000 people. Thus the number of people dying from cancer continued to increase, even though the rate of deaths was decreasing.

Ward said the absolute declines in 2003 and 2004 are important benchmarks. "This really convinces us that this is a real effect that is likely to continue," she said.

However, the study also highlighted racial disparities, finding that African-Americans were more likely than any other group to develop and die of cancer. African-American men, for example, are 38 percent more likely to die from cancer than white men are.

Although there might be some underlying genetic causes for the disparity, experts said, socio-economic factors probably play the largest role. "We think much of this gap is due to lack of access to health care and information," Ward said. "African-Americans are less likely to get screening and treatment in a timely way."

Although lung cancer has declined among men, the study found that it continues to grow among women. "Women began smoking later than men and stopped later," Ward said. "Lung cancer in women will start to decline in coming years."

Experts expect the overall number of deaths to keep falling as new drugs and tests are developed.

"This started many years ago with basic science discoveries," said Dr. Gary I. Cohen, director of the cancer center at Greater Baltimore Medical Center. Research has continued, he said, and patients will "see some impact down the road."

President Bush visited the National Institutes of Health yesterday to trumpet the decline in cancer deaths, along with research at the institutes that has led to better cancer treatments.

Bush toured a cancer lab at NIH and met with patients before presiding over a round-table discussion in which he lauded the decline.

"The reason I bring that statistic up is that progress is being made," he said.

NIH Director Dr. Elias A. Zerhouni said the agency is trying to usher in a "new era in medicine" in which doctors don't respond to cancer and other diseases at late stages, but pre-empt them.

"We will strike the disease before it strikes us," Zerhouni said.

NIH is doing that, in part, by mapping the cancer genome. Researchers hope to use a map of the mutations that give rise to cancers in order to learn more about how cancers develop and, as a result, how best to predict, prevent and treat them.

Dr. John Niederhuber, director of the National Cancer Institute, said researchers recently completed a genetic map of prostate cancer, are well into a breast cancer project and are about to start a pancreatic cancer effort.

On the downside, experts also warned that recent cuts in NIH funding might jeopardize future research.

The overall NIH budget doubled between 1998 and 2003, but funding has since declined, according to the American Association for the Advancement of Science.

"There is no doubt that there has been a substantial investment in this research," said Hopkins' Abeloff. "What is ironic about [the drop in cancer deaths] is that at exactly this time the federal funding is not only flat, but it's decreasing. That is something of great concern to those of us who are looking at what we can do with advances in the future."

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