What the Future Looks Like for Cancer in the US

Some Good News

In spite of the aging of the population, overall mortality rates from cancer have stabilized. This is true in all groups of our population except black males. Not only has the death rate stabilized, but the incidence of most cancers in our population is also declining; only a few have increased. According to www.cancercontrol.com, cancers of the breast, prostate, lung, and colon/rectum accounted for more than half of all cancer deaths in the United States in 2003, and lung cancer accounted for more than a quarter of all deaths.

Why the Change in Cancer Incidence and Mortality Rates?

In a word, screening. Because some cancers, including those of the breast, colon, cervix and prostate are being detected earlier, they have a higher rate of being cured.

• Breast cancer: annual screening mammograms have made a difference; the mortality rate has declined in white women, but not in black women.
• Colon cancer: screening colonoscopies have had a positive impact on survival through earlier diagnosis and treatment.
• Cervical cancer: the Pap smear has detected and been responsible for increasing the earlier diagnosis and ultimate curability of cervical cancer.
• Prostate cancer: incidence and overall death rates have been declining, which I believe is due to screening with prostatic specific antigen.

Unfortunately, no good screening test has been identified for lung cancer, pancreas cancer, brain tumors and some others. For these cancers, our treatments are curative only in the earliest cases. A recent article on www.cancercontrol.com suggests that screening high-risk people (e.g., heavy smokers) for lung cancer is beneficial in detecting lung cancer earlier. This expensive screening test is not presently the formal recommendation of the national societies. In spite of this, the incidence and mortality from lung cancer has improved overall.

Cancers in Decline: Which Ones and Why

• Head and neck: treatment and oral screening by dentists
• Uterus: treatment and awareness
• Ovary: treatment and awareness
• Thyroid: treatment and awareness
• Testis: treatment related
• Vagina: treatment and awareness

Cancers in Limbo: Minimize Your Risk Factors

• Esophagus: death rates may be increasing for adenocarcinoma.
• Stomach: death rates may be increasing.
• Lymphoma: decreasing death rates in whites, but increasing in blacks. Probably treatment related.
• Lung cancer: decreasing death rates in whites but not in blacks. Primarily due to a decline in smoking. Some extent due to treatment-related issues.

How to Stay on Top of Your Cancer Risk

• Adopt a healthy lifestyle. This includes a diet rich in vegetables, fruit, beans and legumes. Incorporate some form of physical activity into your life every day.
• Get screened. Early cancer detection increases the cure rate for many cancers.
• Consider your risk factors, including your family history of certain cancers. If you are at a higher risk, you may benefit from genetic testing.

Posted in Cancer Studies, Cancer Treatment, Senior Health