Research, Early Detection
and Prevention Contribute to Cancer Mortality Decline
Health authorities were heartened a few months ago when two new studies
showed thatcancer death rates had dropped for the first time since statistics
have been recorded.
The decline - about 3 percent for all types of cancer from 1990 to
1995 - reversed a frustrating 6.4 percent rise in cancer mortality observed
over the previous two decades. An analysis of the recent reports prompted
some cancer experts to predict the overall decline should accelerate substantially
in the next 20 years.
Newspaper headlines and prime time television anchors proclaimed the
good news reflected by the reports, which were released shortly before
the 25th anniversary of the National Cancer Act that made cancer research
one of the country's major medical priorities. Dr. Richard Klausner, director
of the National Cancer Institute (NCI), was encouraged by the trend.
"The decline in the cancer death rate is the news we have been
waiting for. Our nation's investment is paying off by saving lives. The
1990s will be remembered as the decade when we measurably turned the tide
against cancer," Dr. Klausner said.
Detailed data compiled by NCI's Surveillance, Epidemiology and End
Results program and a report published by the American Cancer Society demonstrated
these positive patterns between 1990 and 1995:
· Death rate for breast cancer fell 6.3 percent.
· Death rate for prostate cancer dropped 6.2 percent.
· Death rate for men with lung cancer declined 6.7 percent.
· Death rate for colorectal cancer decreased 5.4 percent.
· Death rate for oral cancers fell 9.6 percent.
· Death rate for ovarian cancer went down 4.8 percent.
But there was negative news, too. Death rates for lung cancer in women
and some lymphatic cancers in both men and women continued to increase.
Mortality for assorted other cancers, including chronic leukemia in older
people and multiple myeloma, also rose or reached a plateau over that five-year
period.
Many cancer specialists used the reports to take stock of progress
made since the national cancer program was launched in late 1971. They
all cited the dramatic success in childhood cancers, almost 80 percent
of which can be cured today. Sharp drops in death rates from testicular
cancer, down 66 percent, and Hodgkin's disease, down 58.4 percent, also
were mentioned.
"There is good news in the recent reports, which for the first
time confirm that cancer mortality has peaked and now is decreasing in
the United States. Overall, I believe the new data indicate the early impact
of preventive measures, including the widespread tobacco control efforts
and public education programs promoting healthier lifestyles in general,"
observed Dr. Bernard Levin, M. D. Anderson's vice president for cancer
prevention and holder of the Betty Marcus Chair in Cancer Prevention.
Dr. Levin said the data also "reflect that emphasis on regular
screening and earlier detection, along with improving treatments for many
cancers, is paying off in decreasing death rates."
But he cautioned against complacency.
"We cannot afford to let our guard down and relax. In fact, we
must redouble our efforts to reach all ages and all segments of our society
with current information about how to minimize everyone's risk for cancer
and how individuals can access appropriate screening, diagnostic and treatment
services," Dr. Levin said.
In announcing the new data, Dr. Klausner noted that the "most
important advance in the past 25 years has been in our understanding of
the fundamental biology of cancer." He said NCI has identified multiple
research initiatives to apply this knowledge in hopes of accelerating the
cure rates for all types of cancer.
More than a year ago, M. D. Anderson's faculty and administrative leaders
launched several priority research initiatives to expand the interdisciplinary
collaboration among scientists and clinicians that long has been a hallmark
of the institution's reputation for productive research, quality cancer
care and innovative prevention services.
Articles on the following 10 pages describe the targeted research programs
for brain, breast, ovarian, prostate and skin cancers. Each one aims to
transfer the increasing understanding of cancer biology to better treatment
and prevention strategies for patients with these five major malignant
diseases.
"The faculty, staff and supporters of M. D. Anderson can be proud
of previous achievements that have helped improve the outlook for many
cancers. Now, we have multiple opportunities to exploit new information
at the molecular and genetic level. Sustained scientific commitment and
support are crucial to our success," Dr. Levin said.
Dr. Klausner stressed that "research alone will not reduce the
burden of cancer. We need a health care system that is available to all
and public policies that are consistent with the prevention, detection
and best treatment of cancer."
As he looks to the future, Dr. Levin also warned that people "should
not expect the National Cancer Institute, the American Cancer Society or
any other organization to do everything for us. We at M. D. Anderson have
a responsibility to provide clear and consistent public education messages,
but it's up to individuals to make choices that, hopefully, will lower
their chances for cancer and other major health problems."