National study showing steady decline among ‘big four’ U.S. cancer killers

The National Institute of Health, along with the American Cancer Society, National Cancer Institute, Centers for Disease Control and be safePrevention and North American Association of Central Cancer Registries published the study last week showing the declines in deaths and diagnosis from numerous cancers.

Among those cancers on the decline were what Dr. Tim Byers, interim director of the University of Colorado Cancer Center at the Anschutz Medical Campus in Aurora, calls the “big four.”

Those include breast, lung, colorectal and prostate cancers.

Byers said the decline in incidence and mortality is unprecedented.

“We’re on a really historic downward trend,” he said.

Byers attributes that decline to numerous efforts in three key areas that are leading to the drop in rates.

Those areas; tobacco use, early detection, and improvements in drug therapies have lead to a decrease of diagnosis and death up to about 1/3 since 1990.

“We’re smoking less … we’re finding cancers earlier, and in more detectable and treatable stages,” he said. “And there are better drugs and better treatment so people are living longer.”

The study determined that new diagnoses for all types of cancer combined in the U.S. dropped, on average, by about 1 percent per year from 1999 to 2006. Cancer deaths dropped by a larger rate, 1.6 percent, over the same time period.

Overall, the study shows, men are diagnosed with cancer more often than women. However, the mortality rate and incidence rate dropped more in men than it did in women.

Byers said the study shows that while progress is being made in a number of areas for men and women, a lot of work still lay ahead.

“For other cancers, we’re not making as much progress,” he said. “We still haven’t figured out how to detect (other cancers) early, we still haven’t figured out risk factors.”

Leaders at the NCI agreed.

“The continued decline in overall cancer rates documents the success we have had with our aggressive efforts to reduce risk in large populations,” NCI Director Dr. John E. Niederhuber, said in a statement. “Yet we cannot be content with this steady reduction in incidence and mortality. We must, in fact, accelerate our efforts to get individualized diagnoses and treatments to all Americans and our belief is that our research efforts and our vision are moving us rapidly in that direction.”

The types of cancer that did not decline in the studey; liver, kidney, pancreas and others, Byers said, have a limited scope of work that can be done. Those cancers are hard to detect, he said, and while future research may uncover different protein strains that may indicate the likelihood that someone may get that cancer, much more research is needed.

“The continued decline in incidence and death rates for all cancers combined is extremely encouraging, but progress has been more limited for certain types of cancer, including many cancers that are currently less amenable to screening, such as cancer of esophagus, liver and pancreas,” said Executive Eirector of NAACCR Betsy Kohler in a statement.

“I think that what’s going to happen is by 2015, we’re probably going to be around half the death rate from those four cancers (breast, prostate, colon and lung) that we were at 25 years ago,” Byers said. “That’s really historic and an important start, but at that point I don’t see much of a reason to believe that the downward declines will continue that steeply.”

Byers said that while the numbers may shrink, rates won’t hit zero for those cancers because early screening and education is reaching its full potential.

“The yield that we’ve gotten from early detection, we’ve mostly seen the benefits from that,” he said. “We need to sustain those efforts, but we won’t see steep downward declines.

“Around 2015, we’ll be at a threshold where able to say ‘We’ve done well and now we need some new tools for the future,’” he said.

“We’re making small progress across the board on many cancers, but big progress on the big cancers — we know how to prevent them, diagnose them early and better treatments.”

The Aurora Sentinel
December 18, 2009

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