U.S. Cancer Rates Still Falling - Annual Report...05/15/00
By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - U.S. cancer rates are falling faster than ever and death rates are also down -- due mostly to a decline in cigarette smoking among men, researchers said on Sunday

And despite Americans' bad eating habits and reluctance to undergo cancer screening, rates of colon cancer are also down, the annual report on cancer incidence in the United States found.

The report, compiled by the National Cancer Institute (NCI), the American Cancer Society (ACS), the North American Association of Central Cancer Registries (NAACCR), the Centers for Disease Control and Prevention (CDC) and the CDC's National Center for Health Statistics (NCHS), showed that the number of new cancer cases declined on average 0.8 percent per year between 1990 and 1997.

``The mortality rates looked as though they peaked in around 1991,'' Lynn Reis, a statistician at the NCI who helped write the report, said in a telephone interview.

``They went down 1.7 percent per year in 1995 to 1997.''

That was the biggest drop ever.

``These findings underscore the remarkable progress we've made against cancer,'' NCI Director Dr. Richard Klausner said in a statement.

``It's prevention and that, coupled with early detection and better treatment, are in fact having the desired impact,'' Dr. Harmon Eyre, chief medical officer of the American Cancer Society in Atlanta, said in a telephone interview.

``Because many men have stopped smoking now for a number of years, lung cancer incidence and death rates are dropping in men. There is a declining rate of increase in lung cancer deaths in women but it hasn't turned down yet,'' he added.

That is because women have trailed men in kicking the smoking habit.

The report found that breast cancer incidence rates changed little in the 1990s, while breast cancer death rates declined about 2 percent per year since 1990 and have dropped sharply since 1995. Prostate cancer death rates were ``dramatically'' down, Eyre said, mostly due to better treatment and perhaps screening, which catches cancer early.

The bad news was that death rates for non-Hodgkin's lymphoma were on the rise. ``We don't know why this is occurring but it now appears the rate of increase is beginning to lessen,'' Eyre said.

The worst kind of skin cancer, melanoma, was also on the increase although death rates have leveled off.

``The country needs to continue to be aware that sun exposure is harmful,'' Eyre said.

Colon cancer was the third most common cancer for both men and women, after lung cancer and breast cancer for women, and lung cancer and prostate cancer for men. The report showed that incidence increased until 1985 and then began decreasing steadily at an average rate of 1.6 percent per year.

The drop occurred even though Americans remained reluctant to get screened for colon cancer, either by fecal occult blood tests, sigmoidoscopy, or proctoscopy. Only 35 percent of men had either a sigmoidoscopy or proctoscopy, which involve inserting a tube to inspect the bowel, and 26.8 percent of women did.

Eyre said he believed some Americans were also starting to eat a better diet, with more fruits and vegetables, which has been linked to a decrease in colon cancer.

``If you look over the last 10 years, there has been a statistically significant increase in the number of individuals who are eating more fruits and vegetables,'' Eyre said.

``But the population is divided into a group of people who actually care about their diets, and they eating more fruits and vegetables and less animal fat, and a population that doesn't care and that is usually the obese people who eat fast foods.''

A study published last month showed that people who ate more fruits and vegetables over a period of four years did not have fewer of the little colon growths called polyps that can lead to cancer, but Eyre said that did not mean that a lifetime of eating fruits and vegetables does not prevent colon cancer.

``We do know that a diet over 20 years can negatively impact your colon cancer rates,'' he said.

Wider use of drugs such as aspirin, which also seemed to somehow prevent colon cancer, may also be responsible.

The report estimated that 1.2 million Americans would be diagnosed with cancer in 2000, and that 560,000 would die of the disease.

A man had a 42.8 percent risk of being diagnosed with cancer sometime in his life and a 24 percent chance of dying from it. A woman had a 37.5 percent risk of developing cancer and a 20 percent risk of dying of it.

From 1993 to 1997, 400 Americans per 100,000 developed cancer and 168 per 100,000 died of it, according to the report. About 475 per 100,000 males developed cancer in those years and 348 per 100,000 females.

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