Deaths and diagnoses for prostate and several other cancers fell between 2001 to 2005, the latest years for which data have been analyzed, according to reports this week by the National Cancer Institute and American Cancer Society.

Although overall cancer death rates dropped for the past 10 years, NCI says, this is the first time cancer incidence (the rate at which new cancers are diagnosed) has dropped along with overall death rates from cancers in men and women in most racial and ethnic groups.

The drop in deaths was mostly due to a reduction in deaths from prostate, lung and colorectal cancer in men and breast and colorectal cancer in women. Lung cancer in women continues to rise in the South and the Midwest but nationwide deaths are leveling off. Certain other cancer rates are rising:

Among men, incidence rates dropped for cancers of the lung, colon/rectum, oral cavity, and stomach. Prostate cancer incidence rates decreased by 4.4 percent per year from 2001 through 2005 after increasing by 2.1 percent per year from 1995 to 2001. In contrast, incidence rates increased for cancers of the liver, kidney, and esophagus, as well as for melanoma (2003-2005), non-Hodgkin lymphoma, and myeloma. Incidence rates were stable for cancers of the bladder, pancreas, and brain/nervous system, and for leukemia.

The 4.4 percent annual rate of decline in diagnosed prostate cancer might indicate that fewer men are developing the disease thanks to lifestyle changes such as reduction in smoking and dietary improvements and increase awareness of the need for exercise.

A wild card factor might be wider use of statins and other medications prescribed for coronary diseases.

In addition the introduction of PSA screening in the 1990s (which sent the incidence rate sky high) may have caught some cancers which otherwise would not have been detectable till 2001-2005 or beyond.

As displayed by Otis W. Brawley, M.D., chief medical officer of the American Cancer Society (ACS), a note of caution is appropriate:

we have to be somewhat cautious about how we interpret it, because changes in incidence can be caused not only by reductions in risk factors for cancer, but also by changes in screening practices. Regardless, the continuing drop in mortality is evidence once again of real progress made against cancer, reflecting real gains in prevention, early detection, and treatment.

The US saw a sharp decline in smoking down to 2006 (since leveled off) but early detection of lung cancer is not yet reliably available and the disease is hard to cure. The screening factor may help explain why prostate cancer, which like lung cancer has a long lead time, has done better in both deaths and incidence rates.

In fact, from 1994 to 2005 prostate cancer deaths have declined by 4.1 percent per year.

As the UK Independent reported earlier this year, Prostate cancer deaths fall four times faster in US.

Race and socioeconomic status affect access to cancer diagnosis, cancer treatments and cancer survival in the USA. African-American men have twice the incidence of prostate cancer as white men, but both groups have experienced a 4 percent annual rate of decline in prostate cancer deaths from 1996 to 2005.

According to NCI American Indian and Alaskan Native men are doing poorly. “From 1996 through 2005, death rates for all cancers combined decreased for all racial and ethnic populations and in both men and women, except the rates for AI/AN men and women, which were stable. Similarly, death rates for cancers of the lung, prostate, and colorectum in men decreased for all racial and ethnic populations, except prostate and colorectal cancer in AI/AN men.”

Even so, some improvement occurred between 2001 and 2005 in Contract Health Service Delivery Areas (CHSDA counties). American Indian and Alaskan Native men in those areas show a lower absolute death rate (21 per 100,000 compared to 59 for African-Americans and 26 for White) and now are achieving a 1.9 per cent annual decline in deaths.

Pacific Islanders, American Indians, Alaska Natives and Hispanic men all have lower rates of prostate cancer deaths than do White and Black men.

Source:
Annual Report to the Nation on the Status of Cancer, 1975–2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control