Breast cancer cases rise, cancer deaths decline

Doctors say early screening for cancers has helped to reduce death rates

From Rea Blakey
CNN

(CNN) -- Cancer deaths -- particularly those for breast, prostate, lung and colon cancers -- declined during the 1990s, the National Cancer Institute reports. Doctors said early detection might be saving more lives.

From 1995 to 1998, deaths from breast cancer fell 3.4 percent; prostate cancer, 4.5 percent; colorectal cancer, 1.3 percent; and lung cancer, 0.8 percent.

However, the number of new breast cancer cases rose 1.2 percent per year, from 1992 to 1998. Mammography and early detection have helped to raise incidence rates, said Brenda Edwards of the National Cancer Institute, the final author of the report.

"We think that there may be some changes in both the clinical management, surgical management, looking for nodes and the way they're being diagnosed pathologically that may be helping us find more," Edwards said.

The figures come from an annual report that is a collaborative effort by the National Cancer Institute, the American Cancer Society, the North American Association of Central Cancer Registries and the Centers for Disease Control and Prevention.

Early screening for prostate specific antigen, or PSA, has helped to reduce the death rate for prostate cancer. The overall death rate declined, but the study noted that the death rate and incidence vary widely by race, ethnicity and geographic region.

From 1992 to 1998, overall lung cancer incidence decreased almost 2 percent, primarily because of a 2.7 per year decline among men. While the mortality rate for lung cancer fell about 1.9 percent per year for men, it rose by 0.8 percent per year in women.

The National Cancer Institute report confirms that lung cancer is the biggest cancer killer of women

The report in the Journal of the National Cancer Institute confirms that lung cancer is the biggest cancer killer of women. While many specialists want more tobacco settlement funds used for cancer research and treatment, some still predict a future lung cancer epidemic.

"The most common smokers are in the 12- to 17-year-old group, which is truly frightening," said Dr. Naiyer Rizvi, a lung cancer specialist at Georgetown University Hospital.

"Although the incidence rates for lung cancer are starting to plateau, and we're starting to see the adult population slowing down in their smoking, there's this wave of teen-age smoking that really is worrisome for another epidemic of lung cancer."

Lung cancer is the leading cause of cancer death among both men and women, taking 150,000 lives each year. Cancer experts say 90 percent of lung cancers are attributable to cigarette smoking. The increase in female lung cancer mortality, they add, is evidence of a tobacco use trend that trails 25 years behind that of men.

Continuing the overall progress in the war against cancer will require further advances in prevention and early detection, according to the American Cancer Society. Only heart disease kills more Americans than cancer.

Other findings in the report include a 1.3-percent decline in the colorectal cancer rate for white men, from 1992 to 1998 -- it remained the same for women and black men. Death rates remained stable for black women during that time period, but increased for men and white women.

The report also identified 10 cancers in which one or more population subgroups experienced an increase in incidence or mortality -- liver and intrahepatic bile duct cancer; esophageal cancer; non-Hodgkin's lymphoma; melanoma; acute myeloid leukemia; omentum and mesentery cancer; and soft connective tissue cancers, including heart, thyroid, small intestine, vulva and peritoneum.