Progress Lagging Against Many Cancers
More than a decade ago the American Cancer Society set a goal of cutting the cancer rate by 25% by the year 2015. A new report published by the Society analyzes data from 1982 through 2004, the mid-point of the campaign.
Between 1992 and 2004, the overall cancer rate in this country fell by eight percent, but that represents both good and bad news, according to Dr. Ezekiel Emanuel, a cancer specialist and head of the Department of Clinical Bioethics at the National Institutes of Health.
"The good news is it did fall by 8%, and that's an important decline," he told Saturday Early Show anchor Maggie Rodriguez. "The bad news part of the story is that the American Cancer Society had this goal of 25% decline over 25 years, and it looks like we're going to be shy of that because it's not declining fast enough."
Can that goal be reached if we continue at this rate?
Emanuel: "No. If we continue at this rate we certainly won't reach it. Even if we speed up a little bit, we're unlikely to reach it. So we're not going to make that goal. But the American Cancer Society set a pretty aggressive goal - a quarter decline in all of cancers."
The greatest declines that were found were among men and people over the age of 65. Why do you think that is?
Emanuel: "Most of this is the decline in smoking. Between 1965, roughly, and today, we've had a more than 50% decline in smoking. This country really has changed its attitude toward smoking, and now only 1 in 5 Americans smoke. That has had a big effect on lung cancer, cancer of the mouth and pharynx, and in other cancers. So that's the big, big factor here. There are some other changes in lifestyle and pick up of screening that has had an impact."
Speaking of screening, we've also seen a reduction in the cases of breast and colorectal cancer. There are such aggressive campaigns for early testing. Has that played a role?
Emanuel: "Absolutely true. Breast is a little complicated because we've had mammography and women have used mammography, although that has stabilized - about 3 out of every 4 women have used mammography, but still a quarter who seem not to get the screening test. Also, the stopping of using of hormones after menopause seems to have had a big impact on decreasing breast cancer.
"On the colon cancer side, the upside is screening. Katie Couric went on TV and did a cancer screening and that had a big impact on the people in this country, and now more than half of people are getting screened and that's also probably a very big impact on colon cancer.
"I have a friend at one of the cancer centers who said no one should die of colon cancer because we can see it and take out all the early precancerous lesions. People just really need to be screened for that."
Interesting, too, that some cancers are going down, others are not. For example, with brain, pancreatic, uterine and leukemia, there are no changes.
Emanuel: "It shows you we need a lot more thinking and research about those. Brain cancer, we don't have a good idea as to what causes brain cancer. It's a tragic cancer because it affects people in the prime of life - 50, 55 or 60. Uterine cancer, that's a cancer probably a result of the increase in obesity in this country; fat cells produce more hormones that stimulate the uterus. And the story on pancreas is also a little complicated because smoking causes paneas cancer, and one would have thought that the decrease in smoking would have led to a decline in pancreas, but there may be other factors we don't fully understand."
Dr. Emanuel's Five Recommendations For Reducing Cancer Risks:
1. Seek Medical Prevention
2. Exercise
3. Eat Fruits & Veggies
4. Stay Out of the Sun
5. Don't Smoke
The report appears in the November/December issue of CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society.