Cancer in retreat: cases drop and fewer lives are lost in US

IN A FIRST unmistakable sign that both new therapies and changes in lifestyle are having a beneficial impact, the numbers of cases of cancer have begun to retreat in the United States, as have the numbers of deaths from the disease.

"Cancer is conquerable and progress is being made," Dr James Marks of the Centers for Disease Control and Prevention, said, unveiling the most recent report on cancer in the US. "The burden of public fear should begin to lift."

It is the first time that cancer, which still kills 1,500 Americans each day, has been in retreat nationwide since records of the disease were first compiled in the Thirties. Overall, the report shows, the incidence of cancer cases fell by 0.7 per cent per year between 1990 and 1995. Deaths from cancer over the period fell by an average of 0.5 per cent.

The picture, nonetheless, is uneven, both as between different kinds of cancer and as between different segments of the population. The statistics are less hopeful for disadvantaged people and for African-Americans, particularly men.

Experts pointed to increased education about the hazards of tobacco in explaining an average annual 1.1 per cent drop in lung-cancer cases. More generally, credit is given to much increased screening, for instance for breast tumours in women, and new forms of treatment. Breast-cancer rates have apparently levelled out after climbing rapidly for two decades.

The sharpest drop was reported in colon and rectum cancer, where cases dropped an average of 2.3 per cent. Mouth and throat cancer was down by 1.8 per cent annually and leukaemias showed a 1.0 per cent drop. By contrast, the incidence of melanomas, or skin cancer, rose during by an average of 2.5 per cent.

The data is bleakest, however, for black men, who have the highest cancer incidence rate of any group in the country and for whom rates are still climbing. This is caused particularly by growing numbers of cases of prostrate cancer. "Some segments [of the population] have not benefited equally," observed John Seffrin, of the American Cancer Society.

According to the society, one in four deaths in the US are caused by cancer. More than half a million Americans are expected to die from some form of cancer this year. One in two American men can expect to develop cancer in their lifetime.