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U.S. Cancer Deaths Still Dropping

Posted on: Saturday, 8 October 2005, 12:00 CDT

By ASSOCIATED PRESS

WASHINGTON -- Liver cancer seems to be on the rise, a blip of bad news in the nation's otherwise optimistic annual report on cancer that shows survival continuing to improve.

Overall, Americans' death rates from cancer have dropped 1.1 percent a year since 1993, a trend that continued in 2002 -- the most recent figures available -- researchers reported Tuesday in the Journal of the National Cancer Institute.

Rates of new cases are holding steady for men. But a small but stubborn increase in female diagnoses continues -- 0.3 percent a year since 1987 -- fueled mostly by steadily rising rates of breast and thyroid cancer, melanoma and lymphoma.

Another fairly rare malignancy is becoming more common: liver cancer. The report found annual increases of 3 percent among white men, 4.5 percent among black men, 3.7 percent among white women and 5 percent among Hispanic women.

It's not clear what's spurring the rise; one factor may be hepatitis infections.

"It's a concern worldwide," said Brenda Edwards of the NCI, who co-wrote the report with scientists from the Centers for Disease Control and Prevention, American Cancer Society and North American Association of Central Cancer Registries.

Deaths from breast cancer, the most common malignancy among women, fell 2.3 percent a year from 1990 to 2002. The decrease probably is a result of better treatments and early detection, says Elizabeth Ward, the American Cancer Society's director of surveillance research.

The number of new cases of breast cancer, however, increased by 0.4 percent a year from 1987 to 2002, according to the report. Breast tumors were diagnosed in more than 200,000 women in 2002.

The growth in breast cancer diagnoses is probably too great to be caused solely by the wider use of screening mammograms, says Brenda Edwards, an associate director of surveillance research programs at the National Cancer Institute. Breast cancer rates rose steeply in the 1980s because mammograms helped detect many early tumors.

Another concern is ensuring that patients receive care based on the latest expert guidelines. The report shows that growing numbers of patients do, which is considered a significant reason why deaths are dropping. But there are gaps, including:

More breast cancer patients are getting just the tumor removed instead of the entire breast, but a significant number skip the radiation recommended to kill leftover cancer cells.

Patients 65 or older are less likely to receive recommended chemotherapy after surgery for advanced colorectal cancer.

Only 34 percent of female Medicare beneficiaries had their ovarian cancer removed by a gynecologist oncologist, a specialist considered to have better outcomes than general surgeons.

Although there is a dispute over what is the most appropriate prostate cancer treatment, in general black men receive less aggressive care than white men.

USA Today contributed to this report.

Source: Tulsa World

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