Cancer Death Rate Drops Fast

GOOD news on the cancer front: Death rates are dropping faster than ever, thanks to new progress against colorectal cancer.

A turning point came in 2002, scientists conclude Monday in the annual "Report to the Nation" on cancer. Between 2002 and 2004, death rates dropped by an average of 2.1 percent a year.

That may not sound like much, but between 1993 and 2001, deaths rates dropped on average 1.1 percent a year.

The big change was a two-pronged gain against colorectal cancer.

While it remains the nation's No. 2 cancer killer, deaths are dropping faster for colorectal cancer than for any other malignancy — by almost 5 percent a year among men and 4.5 percent among women.

One reason is that colorectal cancer is striking fewer people, the report found. New diagnoses are down roughly 2.5 percent a year for both men and women, thanks to screening tests that can spot precancerous polyps in time to remove them and thus prevent cancer from forming.

Still, only about half the people who need screening — everyone over age 50 — gets checked.

"If we're seeing such great impact even at 50 percent screening rates, we think it could be much greater if we could get more of the population tested," said Dr. Elizabeth Ward of the American Cancer Society, who co-wrote the report with government scientists.

The other gain is the result of new treatments, which are credited with doubling survival times for the most advanced patients.

In 1996, there was just one truly effective drug for colon cancer. Today, there are six more, giving patients a variety of chemotherapy cocktails to try to hold their tumors in check, said Dr. Louis Weiner, medical oncology chief at Philadelphia's Fox Chase Cancer Center and a colorectal cancer specialist.

"I can tell you the offices of gastrointestinal oncologists around the country, and indeed around the world, are busier than ever because our patients are doing better," he said.

Among the report's other findings:

_Cancer mortality is improving faster among men, with drops in death rates of 2.6 percent a year compared with 1.8 percent a year for women.

_Lung cancer explains much of the gender difference. Male death rates are dropping about 2 percent a year while female death rates finally are holding steady after years of increases. Smoking rates fell for men before they did for women, so men reaped the benefits sooner.

_Overall, the rate of new cancer diagnoses is inching down about one-half a percent a year.

_New breast cancer diagnoses are dropping about 3.5 percent a year, a previously reported decline due either to women shunning postmenopausal hormone therapy or to fewer getting mammograms.

The report includes a special focus on cancer among American Indians and Alaskan natives. Overall, cancer incidence is lower among those populations than among white Americans, except for cancers of the stomach, liver, kidney, gallbladder and cervix.

The annual report is a collaboration of the American Cancer Society, National Cancer Institute, Centers for Disease Control and Prevention, and North American Association of Central Cancer Registries.●