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#130 - Cancer Statistics, 22-May-1989

Is cancer on the rise? What does the National Cancer Institute (NCI)
say?

Overall, cancer incidence among Americans is increasing about 1% per
year, year after year and cancer deaths are increasing, but less
rapidly.

To be precise, since 1950 the average annual increase in cancer
incidence (the number of new cancers occurring each year, per 100,000
population) has been about 0.8% per year, and for mortality (the total
number of cancer deaths each year, per 100,000 people) the increase has
been about about 0.2% per year. Thus the overall general trend is
worsening. Within this trend, a few cancer rates are improving while
many others are worsening.

In a few cases, both the incidence and the death rates are improving.
These are the good news. In this category we find cancers of the
stomach, rectum, and cervix. NCI says stomach cancer is improving for
unknown reasons, perhaps mainly related to improved diet. NCI doesn't
speculate why rectal cancer is decreasing. Early detection and
treatment of pre-cancerous conditions, through use of the pap smear
test, seems to account for reduction in cervical cancers.

Among some cancers, the incidence is worsening but the death rate is
improving. This is true of seven bad news cancers: colon (lower
intestine), larynx ("voice box"), testis, ovaries, urinary bladder,
Hodgkin's disease (a fatal enlargement of the lymph nodes, spleen and
general lymphatic tissue), and childhood cancers. The National Cancer
Institute gives the impression that they are pleased by the general
direction of these cancers because they view this as a medical triumph
over a worsening situation: more people are getting these cancers each
year, yet more are being saved through surgery and to some extent by
radiation therapy and chemotherapy. However, if you look at these
cancers in light of actual human experience --what it's like to live
through these diseases -the picture is bleak and darkening. Anyone who
has survived cancer surgery, radiation therapy or chemotherapy can only
look at the increasing incidence of these cancers as a medical failure.
It's nice to be alive as a result of brutal and extreme treatment by
medical practitioners, but prevention would be ever so much nicer.
Friends and families of the stricken would agree.

Then there are seven cancers for which both incidence and death rates
are increasing: these are the grimmest news. Here we find cancer of the
lung, skin, female breast, prostate gland, kidney, non-Hodgkin's
lymphomas (cancers of the lymph glands), and leukemia (cancer of the
blood-forming cells).

The optimistic view is that cancer increases are really caused by
better detection of the disease. Unfortunately, this is not true. The
NCI's lengthy report (cited below) from which we gathered all our
statistics does not offer this as an explanation for the increases in
cancer incidence. You can be sure if the NCI had a shred of evidence
that better diagnostic techniques were responsible for creating a false
impression that cancer incidence is increasing, the NCI would be the
first to say so. Unfortunately the increase in cancer incidence is
real.

Table 1 summarizes the data on cancer. Overall, we can see that, even
when we exclude lung cancer, there has been a 22.6% increase in the
incidence rate for all other cancers in this country during the past 35
years. A larger percentage of people are surviving these diseases, on
average, but at tremendous expense in money and pain and disfigurement.
Their lives and the lives of those who love them are shattered, in many
cases for a very long time. It is no cause for celebration of self-
congratulation by the medical community.

"Cancer prevention is the direction that national medical programs must
take: this will require a shift in emphasis for the medical and
research communities. Can we count on the doctors to urge the necessary
shift? Unfortunately the plain fact is, there are enormous sums of
money to be made in cancer diagnosis and therapy, but little or none
for those who would prevent cancer. It seems that the impetus to shift
our national medical/research priorities toward prevention will have to
come from outside the medical community itself."

Get: National Cancer Institute, 1987 ANNUAL CANCER STATISTICS REVIEW
INCLUDING CANCER TRENDS: 1950-1985 [National Institutes of Health
Publication No. 88-2789] (Bethesda, MD: National Cancer Institute,
1988). A fat, optimistic volume available free from: Karen Smigel,
Office of Cancer Communications, National Cancer Institute, 9000
Rockville Pike, Building 31, Room 10A19, Bethesda, MD 20892. Phone
(301) 496-6641.

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TABLE 1 -- U.S. Cancer Incidence and Deaths in 1985, and the Percent
Change in Rates of Incidence and Death per 100,000 U.S. Population,
1950-1985

. Incidence Deaths Incidence Death . (in 1985) (in 1985) Increase
Increase . (1950-85) (1950-85) . stomach 24,700 13,949 -72.5% -74.8%
rectum 42,000 7,860 -10.5% -64.7% cervix 15,000 4,508 -77.5% -73.0%
colon 96,000 49,726 +36.4% - 0.1% ovaries 18,500 11,357 + 0.2% - 0.4%
larynx 11,500 3,501 +68.9% -12.2% testis 5,000 425 +85.1% -60.0%
bladder 40,000 9,785 +51.1% -32.7% Hodgkin's 6,900 1,778 +23.9% -61.0%
childhood 6,000 1,840 +31.9% -55.9% leukemia 24,600 17,449 + 0.8% +
2.2% lung 144,000 122,395 +238.6% +246.5% skin 22,000 5,529 +242.3%
+147.9% breast 119,000 40,090 +43.6% +4.4% prostate 86,000 25,940
+68.7% + 5.7% kidney 19,700 8,660 +82.1% +23.1% lymphoma 26,500 15,358
+123.1% +100.3% . All types ex- cluding Lung 766,000 339,125 +22.6% -
15.4% . All types 910,000 461,520 +36.5% + 6.7% . . Source: National
Cancer Institute report (cited above), Table 3, pg. I.22. -----

--Peter Montague

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Descriptor terms: cancer; statistics; tables; nci;