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U.S. Ca death rates dropped from 1990 to 2005.

From 1990-1991 to 2005, cancer death rates per 100,000 U.S. population declined by 18.4% among men and 10.5% among women, even though the actual number of deaths increased slightly from 2004 to 2005, according to an annual report issued by the American Cancer Society.

That decline in the death rates means that 544,500 cancer deaths were avoided during the 15-year time period, reported Ahmedin Jemal, Ph.D., a strategic director in the department of epidemiology and surveillance research of the ACS, and colleagues (CA Cancer J. Clin. 2008;58:71-96).

Although the number of cancer deaths fell from 2002 to 2003, and again in 2004, the number of deaths increased from 553,888 in 2004 to 559,312 in 2005, the last year for which actual figures were available.

Cancer deaths represented 23% of all deaths in the United States in 2005, and of the total number of cancer deaths that year, 475,848 deaths occurred in persons younger than age 85 years, compared with 408,550 deaths from heart disease.

The increase in 2005 was largely the result of a less significant improvement in survival relative to the previous years, together with an increase in the overall and older populations, Dr. Jemal and colleagues said.

The increase in the number of cancer deaths in 2005 after 2 years of historic declines "should not obscure the fact that cancer death rates continue to drop, reflecting the enormous progress that has been made against cancer during the past 15 years," John R. Seffrin, Ph.D., CEO of the ACS, said in a prepared statement about the report.

The report is based on data collected by the Centers for Disease Control and Prevention, the National Cancer Institute, the North American Association of Central Cancer Registries, and state and local health agencies.

Death rates from all cancers peaked in 1990 for men and in 1991 for women. The incidence rate for men peaked in 1991 and for women in 1997.

Among men, reductions in mortality from lung, prostate, and colorectal cancers accounted for 80% of the decrease in deaths. For women, reductions in mortality from breast and colorectal cancers accounted for 60%.

The lifetime probability of being diagnosed with invasive cancer is 45% in men and 38% in women, the authors said. However, women have a slightly higher probability of being diagnosed before they reach age 60 years because of the relatively early age of breast cancer onset.

The report estimates that the number of cancer cases expected for 2008 is 1.4 million, and the number of expected deaths is 565,650. Among men, 25% of all cancers will be prostate cancer, and among women, 26% of all cancers will be breast cancer.

Other trends and facts noted in the report include the following:

* Improvements in 5-year survival. The 5-year survival rate for most cancers has improved since 1975. In colon cancer, for example, 5-year survival increased from 51% in those diagnosed in 1975-1977 to 65% for those diagnosed in 1996-2003. The 5 year survival rate for breast cancer increased from 75% to 89%, and for prostate cancer it increased from 69% to 99%.

Those cancers for which it has not improved substantially include uterine corpus, cervix, larynx, lung, and pancreas.

* Minorities. Considering all cancers, African American men have a 19% higher incidence rate than do white men, and a 37% higher death rate. African American women have a 6% lower incidence rate than do white women, but a 17% higher death rate.

* Children. Cancer is the second most common cause of death in children aged 1-14 years, ranking only behind accidents and representing 12% of all deaths in children.

The 5-year cancer survival rate in children has improved dramatically over recent years. The 5-year survival rate among children for all cancer sites improved from 58% in 1975-1977, to 80% for those diagnosed in 1996-2003.

Leukemia is the most common cancer in children, and 5-year survival for acute lymphocytic leukemia increased from 58% for those diagnosed in 1975-1977 to 87% for those diagnosed in 1996-2003. Survival increased from 19% to 54% for acute myeloid leukemia at 5 years.

* Lung cancer in women. While lung cancer incidence in men has been in decline, the incidence in women has been plateauing in recent years. In addition, mortality increased about 0.2% per year from 1995 to 2004.

* Lung cancer will account for 26% of all cancer deaths in women in 2008.

* Breast cancer. Breast cancer incidence decreased by 3.5% per year from 2001 to 2004, after having been on the increase since 1980. One reason for the reversal of this trend may be the decreasing use of hormone therapy following the publication of data from the Women's Health Initiative study in 2002, Dr. Jemal and colleagues said.

BY TIMOTHY F. KIRN

Sacramento Bureau
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Title Annotation:Clinical Rounds
Author:Kirn, Timothy F.
Publication:OB GYN News
Date:Mar 15, 2008
Words:805
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