Star Tribune: Newspaper of the Twin Cities (Minneapolis, MN)
January 18, 2007
HEALTH CARE
CANCER DEATHS DROP
Screening tests given credit for decline in cancer deaths
Fewer deaths for a second straight year signals a trend, experts say, and screening plus fewer smokers are the reason. Colon, rectal cancers down most.
Author: Josephine Marcotty
Richard Meryhew
Staff Writers
The war against cancer is far from over, but it may have reached a turning point. Cancer deaths dropped in 2004 for the second year in a row, a decline even more pronounced in Minnesota than for the country as a whole.
A new report from the American Cancer Society shows that a nationwide decrease of 369 deaths reported for 2003, the first in more than 70 years, appears to be the start of a sustained decline rather than a statistical fluke, the society said.
The trend accelerated in 2004, when cancer deaths fell by 3,014, or 0.5 percent.
In Minnesota, there were 9,091 cancer deaths in 2004, 1 percent less than the previous year.
"What appears to be a sustained trend is very gratifying," said Dr. Mark Wilkowske, chief of oncology services at Park Nicollet Cancer Center. "The sky is the limit for the future."
Much of the change was attributed to smoking cessation and better detection and treatment of three of the most common cancers - colorectal, breast and prostate, the American Cancer Society said.
Cancer is the second leading cause of death in the United States, after heart disease.
By far, the greatest U.S. decrease in mortality in 2004 was in co! lon cancer, with 1,110 fewer deaths in men and 1,094 fewer in women. In fact, Minnesota owes its larger overall decline in cancer deaths entirely to its proportionately larger decrease in deaths from colon cancer.
There were more than 150 fewer such deaths in 2004 than 2003, said Matt Flory, health promotions director for the American Cancer Society in Minnesota.
That's because Minnesotans are better than just about anyone else in stepping up for colon screening tests. The screening methods include stool tests; colonoscopy, which examines the entire large intestine; and sigmoidoscopy, which examines the lower part of it.
Flory said that 60 percent of the people in this state who should have colonoscopies get them. That's a far higher rate than most other states and the national average of about 50 percent, he said.
Doctors and cancer survivors said the numbers are proof the advanced research and treatments they've been seeing for the past several yea! rs are working.
"It's interesting to watch where these doctors' and researchers' minds are going," said Laurie Whitt, 45, of Maple Grove, who was diagnosed with breast cancer 11 years ago. "They are thinking outside the box, which is so cool."
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Treatments extend lives
Although the drop in deaths is noteworthy, it still pales in comparison to the total of 553,888 cancer deaths in 2004.
The death rate from cancer has been falling by slightly less than 1 percent a year since 1991. But until 2003 the actual number of deaths kept rising because the population was growing and aging.
That year, the cumulative drop in death rates finally became large enough to outpace aging and population growth.
"I wasn't sure it would happen in my lifetime," said Tim Church, an expert on prevention and early detection of cancer at the University of Minnesota.
Experts said that in addition to better early detection through screening, new drugs and treatments have extended lives of people who would have died much sooner! .
"There was a revolution in treatment between 1998 and 2000, and revolution is a mild word," said Dr. Alfred Neugut, head of cancer prevention and control at Columbia University Medical Center. "We went from having one drug to having six or seven good drugs. The cure and survival rates have increased dramatically as a result."
And colorectal screening, Neuget said, was comparable to the Pap test, which led to an 85 percent decrease in cervical cancer cases in this country.
"It's a whole different ballgame for a cancer survivor now," said Pat Harwood, 54, of St. Louis Park, who was diagnosed with stage 3 multiple myeloma, a cancer of the bone marrow, in 1996. "Every year you live could be a lifetime because of the new research coming on the market."
Ruth Edstrom, 58, of Minneapolis, credits a colonoscopy in late 1999 with helping to save her life.
Although she had experienced symptoms of colon cancer for several years, she said the disease wasn! 't detected until a doctor performed a colonoscopy. By the time cancer was spotted, it had spread to her liver.
But she had several successful surgeries and six months of chemotherapy. She is cancer free today, and so are her younger siblings. After her experience, she persuaded all four to have colonoscopies. The screening paid off - doctors spotted and removed a precancerous polyp from the colon of her brother.
"Go out and get yourself checked," said Whitt, of Maple Grove. "Go in and get a mammogram. Go get a colonoscopy. We all have to be on top of our game at all times. We cannot let our guard down. Something could sneak up."
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Disparities are troubling
The American Cancer Society said it expects that deaths will continue to decline, and other experts agreed. Church said that there are large studies now underway to test the effectiveness of screening for lung cancer, still the leading cause of cancer deaths.
There are also major studies underway to test the effectiveness of advance screening tests for pr! ostate cancer, he said.
One area of great concern, said Dr. Elizabeth Ward, the cancer society's managing director in epidemiology and surveillance, are the considerably higher cancer death rates among African-Americans for nearly every type of cancer. Researchers do not fully understand why.
Disparities in income, education and access to health care could account for much of the difference, but not all of it, researchers say.
"If we really want to continue to make progress by applying what we know," Ward said, "we have to figure out a way to make sure to reach all populations with the information they need to prevent cancer and make sure that all populations have access to early detection and treatment - quality treatment - so that 10 to 20 years from now we don't see the same big differences."
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This report contains material from the New York Times.
Josephine Marcotty- 612 673 7394
Richard Meryhew - 612-673-4425
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268 ! fewer cancer deaths in Minnesota in 2005 than 2004
3,014 fewer c ancer deaths in the United States in 2004 than 2003
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MINNESOTA CANCER DEATHS
Year Total Colon, rectum, anus Breast Prostate
1999 8,876 895 674 565
2000 9,199 923 737 598
2001 8,906 867 695 598
2002 9,205 934 642 601
2003 9,183 960 647 545
2004 9,091 803 656 560
2005 8,823 796 662 491
Source: Minnesota Health Stastics
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U.S. CANCER DEATHS DROP
Cancer deaths in the United States have dropped for a second straight year while more than 1.4 million new cases and 559,000 deaths are projected this year, the American Cancer Society reported.
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Number of cancer deaths, in thousands
Men
Women
(See microfilm for chart.)
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Estimated new cancer cases in 2007
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Men total: 766,860
Prostate: 218,890
Lung & bronchus: 114,760
Colon & rectum: 79,130
Urinary bladder: 50,040
Non-hodgkin: 34,200
Lymphoma: 33,910
Melanoma of the skin: 31,590
Kidney & renal pelvis: 24,800
Leukemia: 24,180
Oral cavity & pharynx: 18,830
Pancreas: 136,530
Estimated deaths
Total: 289,550
Others: 41%
Lung & bronchus: 31%
Prostate: 9%
Colon & rectum: 9%
Pancreas: 6%
Leukemia: 4%
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Women total: 678,060
Breast:! 178,480
Lung & bronchus: 98,620
Colon & rectum: 74,630
Uterine corpus: 39,080
Non-Hodgkin lymphoma: 28,990
Melanoma of the skin: 26,030
Thyroid: 25,480
Ovary: 22,430
Kidney & renal pelvis: 19,600
Leukemia: 19,440
Others: 145,280
Estimated deaths
Total: 270,100
Others: 37%
Lung & bronchus: 26%
Breast: 15%
Colon & rectum: 10%
Pancreas: 6%
Ovary: 6%
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NOTE: Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder
Source: American Cancer Society
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Caption:
CHART;PHOTO
Memo:
See microfilm for chart.
Copyright 2007 Star Tribune: Newspaper of the Twin Cities
Record Number: 070118cancer0118 |