Cancer Death Rates Cease Decline
< Apr. 23, 2008 > --
Declining cancer death rates in the US appear to have halted, according to a new
annual report from the American Cancer Society (ACS).
The report, Cancer Prevention & Early
Detection Facts and Figures 2008 (CPED), points out that drops in smoking
appear to have leveled off and that mammography rates have been stable or
slightly declining since 2000 after increasing for more than a decade.
"We've run into plateaus in terms of people smoking and
getting necessary screening. The next big barrier is the obesity epidemic," says
Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in
Baton Rouge, La.
Nevertheless, Dr. Brooks stresses, the progress already
made is substantial. "When you step back and think about where we've come in
this country, it's phenomenal," he says.
"The report is a tremendous example of the work that's been
done over the past 20 years in showing that the efforts to reduce smoking and
increase screening have been tremendous in terms of decreasing death rates from
cancer," he continues.
CPED, published annually since
1992, is the most comprehensive annual report on factors that affect cancer
risk, including behavior and early detection. It details the challenges and
opportunities in preventing cancer and cancer death, and outlines lifestyle
changes and medical care changes that have the potential to prevent about half
of cancer deaths.
Some findings from the report include:
About 40 percent of the reduction in cancer deaths in males
between 1991 and 2003 can be attributed to declines in smoking that have taken
place over the last century. But efforts have stalled: Almost 24 percent of men
and 18 percent of women smoke, a rate that has remained unchanged for the past
two years.
The percentage of high school students who smoke (currently
23 percent) has also leveled off since 2005.
According to the US Centers for
Disease Control and Prevention (CDC), if all state tobacco control
programs were funded at their recommended level for five years, there would be
about 5 million fewer smokers in the United States. But in 2008, only three
states (Maine, Colorado and Delaware) met or exceeded CDC
minimum recommended levels for funding of these programs.
The rate of mammography screening has remained stagnant
since 2000. In 2005, about two-thirds of women aged 40 and older reported having
had a mammogram within the past two years (four percentage points lower than in
2000) and only 51.2 percent reported having had a mammogram within the past
year. Women without health insurance and recent immigrants had the lowest levels
of screening.
Rates of colorectal cancer screening are improving, but
still leave ample room for improvement. Less than half (46.8 percent) of
American men and women aged 50 and over have had a recent colorectal cancer
screening test, up from 42.5 percent in 2000. So far, 22 states plus the
District of Columbia have legislation in place that requires coverage for all
colorectal cancer screening tests. Again, the uninsured and recent immigrants
were least likely to have been screened.
Exposure to sunlight (outside or in the tanning booth)
remains a major risk factor for different types of skin cancer. According to the
report, 68.7 percent of youth reported getting sunburned during the summer,
although only one-third reported using sunscreen all the time or often, not to
mention other forms of protection (such as seeking shade or wearing long-sleeved
clothing).
Overweight and obesity are significant risk factors for
different types of cancer. Currently, 17.1 percent of adolescents and 35.2
percent of adults are considered obese. These startling figures go hand-in-hand
with relatively low levels of physical activity (less than 36 percent of U.S.
residents were physically active for at least 60 minutes on most days of the
week, while 23.9 percent of adults reported no leisure-time physical activity)
and poor eating habits (only one in five U.S. high school students and less than
one-quarter of adults ate vegetables and fruits five or more times a day in
2005).
The trends, detailed in the CPED,
do point to a need for more effort.
"If we see sustained declines in prevention and early
detection efforts that could really have, down the road, an impact on [cancer
deaths], that's why we're picking up the pace now and emphasizing the importance
so we can correct this," says study co-author Vilma Cokkinides, Ph.D., strategic
director in risk factor surveillance, department of epidemiology and
surveillance at the ACS in Atlanta.
Earlier this year, the ACS
reported that death rates in the United States had dropped by 18.4 percent in
men and 10.5 percent in women since the early 1990s, when mortality rates first
began to decline. This means a total of more than half a million deaths from
cancer have been averted in those years.
Dr. Otis W. Brawley, national chief medical officer of the
ACS says, "If we want these gains to continue, we
need comprehensive, systematic efforts to reduce tobacco use, to address the
epidemic levels of obesity in this country, and to make sure all Americans have
access to and receive established cancer screening tests."
Always consult your physician for more information.
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Cancer is not just one disease but rather a group of
diseases, all of which cause cells in the body to change and grow out of
control. Cancers are classified either according to the kind of fluid or tissue
from which they originate, or according to the location in the body where they
first developed. In addition, some cancers are of mixed types.
There is no one single cause for cancer. Scientists believe
that it is the interaction of many factors together that produces cancer. The
factors involved may be genetic, environmental, or constitutional
characteristics of the individual.
Diagnosis, treatment, and prognosis for childhood cancers
are different than for adult cancers. The main differences are the survival rate
and the cause of the cancer.
The survival rate for childhood cancer is about 79 percent,
while in adult cancers the survival rate is 66 percent. This difference is
thought to be because childhood cancer is more responsive to therapy, and a
child can tolerate more aggressive therapy.
Childhood cancers often occur or begin in the stem cells,
which are simple cells capable of producing other types of specialized cells
that the body needs. A sporadic (occurs by chance) cell change or mutation is
usually what causes childhood cancer.
In adults, the type of cell that becomes cancerous is
usually an "epithelial" cell, which is one of the cells that line the body
cavity, including the surfaces of organs, glands, or body structures, and cover
the body surface. Cancer in adults usually occurs from environmental exposures
to these cells over time. Adult cancers are sometimes referred to as "acquired"
for this reason.
Some cancers, particularly in adults, have been associated
with certain risk factors. A risk factor is anything that may increase a
person's chance of developing a disease. A risk factor does not necessarily
cause the disease, but it may make the body less resistant to it.
Persons who have an increased risk of developing cancer can
help to protect themselves by scheduling regular screenings and check-ups with
their physician and avoiding certain risk factors. Cancer treatment has been
proven to be more effective when the cancer is detected early.
The discovery of certain types of genes that contribute to
cancer has been an extremely important development for cancer research. Over 90
percent of cancers are observed to have some type of genetic alteration. A small
percentage (5 percent to 10 percent) of these alterations are inherited, while
the rest are sporadic, which means they occur by chance or occur from
environmental exposures (usually over many years).
Usually the number of cells in any of our body tissues is
tightly controlled so that new cells are made for normal growth and development,
as well as to replace dying cells. Ultimately, cancer is a loss of this balance
due to genetic alterations that "tip the balance" in favor of excessive cell
growth.
Always consult your physician for more information.
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