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Overall US Cancer Mortality Rate Falls for the First Time

Overall US Cancer Mortality Rate Falls for the First Time

BIRMINGHAM, Ala--After 60 years of steadily increasing cancer
mortality, the tide appears to have turned. From 1990 to 1995,
age-adjusted cancer mortality declined by a total of 3.1%, say
Philip Cole, MD, and Brad Rodu, DDS, of the University of Alabama
at Birmingham School of Public Health and School of Dentistry.

Mortality from all cancers peaked at 135 deaths/100,000 patient-years
in 1990 and declined in each subsequent year to 130.8 in 1995,
representing an average reduction of 0.6% per year (see table
on page 10). The bulk of this decline (40%, or 1.6 deaths/100,000
person-years) stems from the fall in lung cancer mortality (Cancer
78:2045-2048, 1996).

This is the news we've been waiting for," NCI director Richard
Klausner, MD, said of the finding. "We are on the eve of
the 25th anniversary of the National Cancer Act, the legislation
that made cancer research a high national priority. Now our nation's
investment is paying off by saving lives."

The UAB researchers drew on three sources for their analysis:
Vital Statistics of the United States for cancer mortality rates
for 1970 to 1990; CDC's Monthly Vital Statistics Reports for the
1991 to 1995 mortality figures; and the Current Mortality Sample
for 1994 and 1995 statistics. [See page 27 for a report of the
NCI's analysis of US cancer mortality rate trends based on SEER
data.]

Smoking prevalence began a steady decline in 1965, so "it
was inevitable that lung cancer incidence and mortality rates
would begin to decline some 20 or so years later," Drs. Cole
and Rodu say. They note that reductions in smoking lead to reduced
mortality from other cancers as well, such as bladder cancer.

Cancer prevention efforts, other than those aimed at smoking cessation,
including cancer prevention programs in the workplace, also have
had an impact on cancer mortality, they say, as well as lower
case fatality rates due to earlier detection of disease and more
effective treatments.

Unless there is a surge in incidence rates, the investigators
believe the decline will likely continue for at least 20 years
and may accelerate. "It will continue," they say, "because
we are just beginning to see the effects of long-term reductions
in smoking and of reduced exposure to other lifestyle carcinogens
(eg, alcohol and solar radiation) and to some industrial agents."

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