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Kicking Off a Trend: Cancer-Related Deaths Decline
“This shows everything we’re doing—prevention, detection, improved drugs, better diets, and more exercise—is working. There’s a real curve at work—the trend is unmistakable,” said Maurie Markman, M.D., vice president for clinical research at M. D. Anderson Cancer Center. Areas of improvement Experts believe the improvements in survival—colorectal, breast, and prostate cancers caused fewer deaths in general, and deaths from lung cancer declined among men—were an effect of smoking cessation and the improved detection and treatment of these cancers. According to Gabriel N. Hortobagyi, M.D., a professor and chair of the Department of Breast Medical Oncology, these declines are especially encouraging because they occurred during a period of population growth. The greatest decline was in deaths from colorectal cancer: 1110 fewer men and 1094 fewer women died from it, partly because more people have undergone screenings, including colonoscopy and sigmoidoscopy. Some doctors have called this “the Katie Couric effect,” because colonoscopy rates increased more than 20% in the months after Ms. Couric underwent a colonoscopy on national television in 2000. Still, more people should be screened for colorectal cancer. Bernard Levin, M.D., vice president for cancer prevention and population science, said, “Perhaps not even half of the population who should be screened is actually getting screened. If screening were more widely implemented, I think we could drive down the number of colorectal cancer cases and subsequent deaths possibly by as much as 50%.” After colorectal cancer, the next largest drop was in deaths due to breast cancer—666 fewer women died from it. “This reduction is likely due to increased mammographic screening having led to earlier diagnosis and more effective treatments,” said Dr. Hortobagyi. As for men, the 2004 data held good news—prostate cancer caused 552 fewer deaths—but many believe that the aging of the U.S. population in the coming decades will lead to an increase in the number of prostate cancer deaths. Researchers at M. D. Anderson are searching for new markers that correlate to tumors rather than prostate tissue. They hope to develop more accurate prostate cancer screening tools, ones that will help keep the number of deaths from rising. Other M. D. Anderson investigators are conducting a study on the role of selenium and vitamin E in prostate cancer prevention. Areas of ongoing concern Even though 333 fewer men died from lung cancer, this improvement was offset by the deaths of 347 more women from the disease, although researchers expect that the decline in deaths that benefited men will reach women in the next few years. Many efforts to reduce the number of deaths from lung cancer in the future are based on the fact that smoking accounts for 30% of all cancer deaths and 87% of deaths from lung cancer. As part of its efforts, M. D. Anderson started a Tobacco Treatment Program, which offers free counseling and pharmacological treatment to patients who smoke or are recent quitters. Other areas in which death rates rose somewhat include esophageal cancer in men and liver cancer in both men and women. Racial and social disparities Although death rates declined overall, physicians and researchers noted significant racial disparities in the rates of decline. For almost every kind of cancer, African-Americans had a much higher death rate than whites: African-American men and women had death rates 38% and 17% higher than those of white men and women, respectively. And while Hispanics had lower incidence rates than whites for the most common cancer sites, they had higher rates of the cancers associated with infection, including liver, uterine cervix, and stomach cancers. M. D. Anderson researchers are conducting numerous studies to address these differences, as well as disparities evident across categories other than race.For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789. Other articles in OncoLog, February 2007 issue:
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It’s the news physicians and researchers have been steadily working toward for years—new data show a significant drop in deaths from cancer. According to the American Cancer Society, 3014 fewer people died from cancer in 2004 than 2003, following a decline of 369 deaths in 2003 from 2002. 
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