The Washington Post (pg. A1)  [Printer-friendly version]
January 18, 2007 Thursday


Fewer Smokers, More Screening Credited

By Rob Stein, Washington Post Staff Writer

The number of Americans who died of cancer has dropped for a second
straight year, marking a milestone in the war on the disease,
officials said yesterday.

More than 3,000 fewer Americans died from cancer in 2004 than in 2003,
according to statistics analyzed by the American Cancer Society,
indicating that a much smaller decline in cancer deaths a year earlier
probably was not a fluke but instead marked the start of a trend.

"It's very exciting," said Ahmedin Jemal, a cancer epidemiologist who
prepared the report. "I think it's a turning point in our efforts to
reduce the number of people dying from cancer. It's very good news."

The trend was driven by drops in deaths from three of the four major
forms of cancer -- breast, prostate and colorectal -- and a decline in
deaths among men from the fourth, lung cancer. It was caused by a
combination of factors, including a decrease in cigarette smoking
among men, wider screening for colon, prostate and breast cancer, and
better treatments, Jemal and others said.

"There's a lot of good news in this report," said Linda Pickle of the
National Cancer Institute. "We hope that it's the beginning of a long-
term downward trend and that we've finally turned the corner."

President Bush lauded the news during a visit to the National
Institutes of Health in Bethesda. "This drop was the steepest ever
recorded," he said. "Progress is being made."

Jemal and others noted that although the number of cancer diagnoses
also appears to have plateaued, more than 1.4 million Americans will
still find out they have a form of the disease this year, and 560,000
will die, keeping cancer the second-leading cause of death in the
United States, after heart disease.

"We clearly still have a long way to go," Jemal said.

The death rate from cancer has been dropping by about 1 percent a year
since 1991, but the total number of deaths continued to rise because
the growth of the overall population and the number of elderly
outpaced the declining death rate.

Between 2002 and 2003, the number of cancer deaths dipped for the
first time since officials started tracking data from death
certificates in 1930, dropping by 369 deaths. But that number,
reported last year, was too small to be sure it was not an aberration.

When Jemal and his colleagues examined the 2004 data, the latest
available, they found that the rate dropped by more than 2 percent and
that the overall number of deaths fell more steeply, from 556,902 in
2003 to 553,888 in 2004, a decline of 3,014. Deaths from some cancers
increased, however.

"It's not only continuing, it's much larger," Jemal said. "This shows
that what we reported last year really was not a fluke. We really are
making progress."

The biggest drop occurred in colorectal cancer, with 1,110 fewer men
and 1,094 fewer women dying from the disease. The decline was
attributed to broader screening efforts and improved treatment.

Similarly, 666 fewer women died of breast cancer and 552 fewer men
died of prostate cancer in 2004, probably the result of increased
detection and better treatment.

For lung cancer, the picture was mixed, with 333 fewer men but 347
more women dying -- reflecting that women were slower to take up
smoking and started quitting later. But the death rate among women has
been dropping sharply, and the absolute number should begin declining
soon if trends continue, Jemal said.

"Women lag about 10 to 20 years behind men in their smoking patterns,"
he said.

Several advocates and cancer experts said, however, that the good news
is tempered by cuts by the White House and Congress in funding for
health research that has helped fight cancer.

"The government's investment in the war on cancer has fueled the
progress we've made against this disease," said Daniel E. Smith,
president of the cancer society's Cancer Action Network. "We risk
jeopardizing those gains if we retreat from the fight."

Other experts hailed the decline but said it resulted primarily from
preventing cancer through lifestyle changes such as quitting smoking
and from more aggressive screening, rather than from major advances in

"This is largely the payoff from increased attention in recent years
to cancer prevention and early detection," said John Bailar III, who
studies cancer trends at the National Academy of Sciences. "Treatment
results remain disappointing. I think we need to continue to shift
research resources into prevention and early detection. This shows
that's where we get results."

Others noted that even when people survive cancer, they often suffer
terribly with the aftermath of the disease.

"Cancer is still one of the most feared, if not the most feared,
diagnosis anyone can receive," said Ellen Stovall of the National
Coalition for Cancer Survivorship, an advocacy group. "Just because
people are surviving isn't sufficient."