Diagnoses Of Cancer Decline in The U.S.

By Rob Stein
Washington Post Staff Writer
Wednesday, November 26, 2008

The pace at which Americans are getting cancer has started to decline, marking what could be a long-awaited turning point in the battle against the disease, according to an annual report that tracks progress in the war on cancer.

Cancer deaths have also continued a decline that began in the early 1990s, meaning that for the first time both trend lines are dropping.

"It is a significant milestone," said Otis W. Brawley, chief medical officer at the American Cancer Society, which produces the report with the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries.

The drop in new cancer diagnoses has been driven largely by declines in many of the leading forms of cancer: lung, prostate and colorectal cancer in men, and breast and colorectal cancer in women.

The analysis found that the overall incidence of cancer began inching down in 1999, but not until the data for 2005 were analyzed was it clear that a long-term decline was underway.

"The take-home message is that many of the things we've been telling people to do to be healthy have finally reached the point where we can say that they are working," Brawley said. "These things are really starting to pay off."

Brawley and others cautioned, however, that part of the reduction could be the result of fewer people getting screened for prostate and breast cancers. In addition, the rates at which many other types of cancer are being diagnosed are still increasing, he said, and overall far too many Americans are still getting and dying from cancer.

Cancer is still being diagnosed in about 1.4 million Americans each year, and 560,000 die from it.

"We still have a lot to do," Brawley said. "If you look at the data, it's clear that we could still do much better -- much, much better."

Some experts said the drop was not surprising, noting that it was primarily the result of a fall in lung cancer because of declines in smoking that occurred decades ago. They criticized the ongoing focus on detecting and treating cancer and called for more focus on prevention.

"The whole cancer establishment has been focused on treatment, which has not been terribly productive," said John C. Bailar III, who studies cancer trends at the National Academy of Sciences. "I think what people should conclude from this is we ought to be putting most of our resources where we know there has been progress, almost in spite of what we've done, and stop this single-minded focus on treatment."

Bailar and others argue that research should emphasize identifying the underlying causes of cancer, such as environmental exposures, to prevent it from occurring in the first place.

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