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U.S. Cancer Deaths Drop for First Time in More Than 70 Years
Experts point to lifestyle changes, earlier screening and better therapies

By Amanda Gardner
HealthDay Reporter

The number of cancer deaths in the United States dropped slightly in 2003, the first such decline since 1930.

"It's an important milestone that the number of Americans dying from cancer is decreasing," said Dr. Michael Thun, vice president of epidemiology and surveillance research at the American Cancer Society. "We are making progress, and we have a very long way to go."

The estimates appear in a report released Thursday called Cancer Facts & Figures, which has been published annually by the American Cancer Society since 1952.

The report projects that 564,830 Americans will die of cancer this year, or more than 1,500 people each day. And about 1.4 million Americans will be diagnosed with the disease. Cancer is second only to heart disease as the most common killer in the United States.

The death rate, as opposed to number of deaths, has been declining in the United States since 1991. But, until 2003, the aging and growth of the population conspired to increase the actual number of deaths.

Now, the numbers are actually dropping. The report found that from 2002 to 2003 the number of U.S. cancer deaths fell by 369 -- from 557,271 in 2002 to 556,902 the following year.

There are a number of explanations for the good news, including lifestyle changes, earlier detection and advances in treatment.

"Quitting smoking has been tremendous in men and is slowly beginning to be seen in women," said Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in Baton Rouge, La.

"Screening for breast cancer has made a dramatic difference in death rates. Detection at much earlier stages is also important. Treatment for those already diagnosed has begun to make a major impact," he added.

"It's a combination of things," Thun said. "For tobacco-related cancers, it's due to a reduction in tobacco use. For breast cancer, it's a combination of early detection and improvement in treatment. For prostate cancer, we don't have a definitive answer but it's also likely to be a combination. And for colon cancer, the one important factor is an increase in screening."

Some other highlights from the report:

Cancer survivors are living longer. The five-year relative survival rate for all cancers diagnosed between 1995 and 2001 is 65 percent, up from 50 percent for the period 1974 to 1976.
Both incidence and death rates from lung cancer continue to decline in men. In women, the incidence rate has stabilized but death rates continue to climb. Lung cancer is the leading cancer killer in the United States, with 162,460 deaths -- and 174,470 new cases -- expected in 2006.

Kentucky has the highest lung cancer death rate with expected deaths in 2006 projected at 3,500.

After skin cancer, breast cancer is still the most common cancer among women. Some 212,920 new cases will be diagnosed in 2006, and 40,970 women will die of the disease. The death rate has declined by an average of 2.3 percent each year from 1990 to 2002.
Prostate cancer is the most frequently diagnosed cancer in men -- after skin cancer -- with 27,350 deaths and 234,460 new cases expected in 2006. Death rates have been declining but remain more than twice as high in African-American men than in white men.

Colorectal cancer is the third most common cancer in men and women. An estimated 55,170 deaths are expected to occur in 2006. Overall mortality rates have declined at an average of 1.8 percent a year over the past two decades.
An estimated 20,180 new cases of ovarian cancer are expected in 2006, along with 15,310 deaths.
More than 1,000,000 Americans are diagnosed with basal cell or squamous cell skin cancer each year, most of which are curable. About 62,190 people will be diagnosed with the more severe type of skin cancer, melanoma, in 2006. Overall, 2006 will see 10,710 skin cancer deaths, 7,910 of them from melanoma.
Although still rare, cancer is the second-leading cause of death among children. An estimated 1,560 children, from newborns to 14 years of age, are expected to die of cancer in 2006, one-third of them from leukemia. Since 1975, childhood cancer death rates have declined by about 48 percent. The five-year survival rate increased from less than 50 percent before 1970 to nearly 80 percent in the late 1990s.

In addition, this year's report includes a special section on environmental pollutants, particularly air pollutants, including asbestos, radon, secondhand tobacco smoke, vehicle emissions and more.

Exposure to environmental pollutants in occupational, community and other settings is responsible for an estimated 4 percent of cancer deaths (occupational exposures) and 2 percent of deaths (environmental pollutants). That six percent translates into 33,900 U.S. deaths annually, according to the report. (external - login to view)
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