Long-Term Declines in Cancer Incidence, Mortality Rates Seen for First Time, Analysis Finds

The rate of cancer incidence in the U.S. has begun to decrease in recent years and cancer mortality rates have continued to decline, marking for the first time the downward trend in both, according to an analysis published Wednesday in the Journal of the National Cancer Institute, the Washington Post reports. The analysis showed that the overall incidence of cancer began falling in 1999, and the long-term decline became apparent after data were analyzed from 2005. Cancer mortality rates have been falling since the early 1990s.

For the study, researchers from the National Cancer Institute, the American Cancer Society, CDC and the North American Association of Central Cancer Registries -- led by ACS strategic director for cancer surveillance Ahmedin Jemal -- examined data from surveys conducted between 1975 and 2005 and from cancer registries. According to the report, the overall incidence of the disease has fallen by 0.8% annually since 1999. The rate dropped by 1.8% annually in men between 2001 and 2005, compared with 0.6% for women from 1998 through 2005. The analysis also showed that cancer deaths have dropped by about 2% in men every year since 2001 and by 1.6% in women since 2002. Jemal said, "This is really the first year that rates decreased in both women and men" (Stein, Washington Post, 11/26).

The decline primarily is a reduction in mortality rates for certain common cancers, including prostate and lung cancers in men, breast cancer in women and colorectal cancer in both sexes (Rabin, New York Times, 11/26). Researchers say that colorectal screenings have helped prevent many new cancer cases and that declines in smoking rates also have contributed to the trend (Szabo, USA Today, 11/26). The report also highlights the variation in lung cancer mortality rates among states with strict anti-smoking laws.

Jemal said that it is not clear whether the decline in new cancer diagnoses shows an actual decrease in cancer rates or people forgoing screenings that would have detected the disease (Neergaard, AP/Kansas City Star, 11/26). He said, "It's very difficult to say this is good news or bad news." He added, "The fact that you have lower detection rates is not necessarily good news. The reduction of lung cancer and colorectal cancer is clearly good news," but "it's not so clear for breast and prostate cancer" (Washington Post, 11/26).

The rate of new cancer diagnoses for myeloma, non-Hodgkin lymphoma, melanoma and cancers of the liver, kidney and esophagus have increased (Graham, McClatchy/Houston Chronicle, 11/25).

Reaction
John Niederhuber, director of NCI, said the decline is considerable when considering that the U.S. population is aging and cancer risk increases with age. He said, "Some of the things we're doing, we're doing right" (AP/Kansas City Star, 11/26). "Each year that you see these steady declines it gives you more confidence that we're moving in the right direction," Niederhuber said, adding, "This is not just a blip on the screen" (New York Times, 11/26). Jemal said that rates could decrease further if more people had access to screening and treatment. "We discover breakthroughs, but we don't deliver them to everyone. We need to make sure all Americans have timely access to prevention, so the entire population can benefit," Jemal said (USA Today, 11/26).

Broadcast Coverage
CBS' "Evening News" on Tuesday reported on the report. The segment includes comments from Charles Lightdale, professor of clinical medicine at New York Presbyterian Hospital and Columbia University Medical Center, as well as a cancer patient (LaPook, "Evening News," CBS, 11/25).

NPR's "All Things Considered" on Tuesday also covered the report (Knox, "All Things Considered," NPR, 11/25).