We're losing the war on cancer, according to John C. Bailar III of Harvard University and Elaine M. Smith of the University of Iowa in Iowa City. Bailar and Smith note in the May 8 NEW ENGLAND JOURNAL OF MEDICINE that the number of deaths from cancer increased between 1950 and 1982, even after adjustments were made for the aging population.
But the National Cancer Institute in Bethesda, Md., looking at length of survival after diagnosis as well as death rates, sees an improvement. The mortality rate alone can be slow to reflect progress, says Peter Greenwald of the institute. For example, smoking has been on the decline since the 1960s, but the first decrease in lung cancer mortality didn't come until 1983, he says.
Greenwald questions whether lung cancer deaths should be included in the analysis at all. Both sides agree that, not counting lung cancer deaths, there has been a decline in cancer mortality. Since lung cancer incidence has until recently been on the upswing and has a high mortality rate, it masks progress in other cancers, Greenwald says. But Bailar notes that the improvement essentially disappears if deaths from stomach and cervical cancer, which are both decreasing in incidence, are also left out. "What it boils down to is if you leave out what's going up, the rest is coming down,' he says.
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|Date:||May 17, 1986|
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