Cancer death rates continue to fall

For the second year in a row, the Centers for Disease Control and Prevention reported that death rates from cancer are falling. In addition, the incidence rate of the top 10 cancers continued to decline.

According to its "Annual Report to the Nation on the Status of Cancer, 1973-1996, with a Special Section on Lung Cancer and Tobacco Smoking," which appeared in the Journal of the National Cancer Institute's April 21 issue, the CDC found that the number of new cancer cases per 100,000 persons for all cancers declined an average 0.9% between 1990 and 1996.

"The greatest decrease occurred after 1992, the year in which the incidence rates peaked," the CDC reported. "This trend reversed a pattern of increasing incidence rates from 1973 to 1990, and continued the downward trend first documented in last year's report."

On average, cancer rates fell 0.6% per year between 1990 and 1996.

The greatest decline in cancer rates was among men, especially those between 25 to 44 years old or 75 years and older. Rates are going down for prostate cancer incidence and mortality, but it was the overall decline in lung cancer incidence and death rates among American men that had the most significant impact. Lung cancer incidence rates dropped among men by roughly 2.6% per year between 1990-1996, and death rates fell by about 1.6% per year.

The CDC attributed these trends to a multi-decade decline in tobacco use and exposure. Tobacco smoke and exposure cause 90% of lung cancers, according to the CDC.

Although lung, prostrate, breast, and colon and rectum cancers were responsible for more than half of all new cancer cases, and were the leading causes of cancer deaths, the CDC reports several encouraging drops in incidence and mortality rates.

Prostate cancer incidence and mortality rates are going down and, although breast cancer incidence rates remained level, deaths from the disease continued to decline at a rate of approximately 2% per year. Colorectal cancer incidence and death rates also fell among both men and women.

"These findings underscore the remarkable progress we've made against cancer, but it also reminds us that our battle is far from over," said Health and Human Services Secretary Donna Shalala. Shalala emphasized the need for continued research and development funding and activity in order to "help bring more effective, new cancer treatments into the mainstream of American medicine."

Role of medicines

In order to do just that, pharmaceutical researchers continue to invest heavily in their search for new ways to fight cancer.

Major pharmaceutical research and development companies have more than 350 potential cancer treatments in the pipeline, including 63 for breast cancer, 58 for skin cancer, 58 for lung cancer and 46 for colon cancer, according to Washington-based Pharmaceutical Research and Manufacturers of America.

"Cancer is no longer a black box," said Robert Kramer, a cancer researcher. "Pharmaceutical industry researchers have opened the box and are zeroing in on what makes cancer tick… and how to stop this disease in its tracks."

Kramer's peer, Derek Raghavan, M.D., of UCLA, added: "If [the war on cancer] were World War II, this would be 1943. We're about three-quarters of the way there."

Among the novel treatments in development are: a vaccine to fight colon cancer, at least 12 medicines that strangle the blood vessels that feed tumors, a protein that inhibits the toxic effects of chemotherapy on non-cancerous cells and a "magic bullet" that could deplete malignant white blood cells that accumulate in leukemia patients' bone marrow and other tissues.

Alan Holmer, president of PhRMA, said: "This large number of potential new medicines should speed up the progress that pharmaceutical research has already made against this deadly enemy." PR