Date: Fri 20-Mar-1998

Publication: Bee

Author: CURT

Quick Words:

cancer-health-Marks-James

Full Text:

New Cancer Cases Decline For The First Time

WASHINGTON, D.C. -- Reversing an almost 20-year trend, the rate of new cancer

cases among Americans finally is inching down -- prompting doctors to proclaim

new hope.

Among those doctors announcing the good news March 12 was Dr James S. Marks,

son of Dr and Mrs Eugene Marks of Newtown. Dr James Marks is director of the

National Center for Chronic Disease Prevention and Health Promotion.

In releasing the national report card on cancer at a press conference in the

nation's capital, Dr Marks proclaimed, "Cancer is conquerable and progress is

being made," according to The New York Times .

More than 70,000 fewer people than expected were diagnosed with cancer between

1992 and 1995, as cancer rates dropped 2.7 percent each year, according to

government data released last week.

"We are witnessing an unprecedented downturn," said American Cancer Society

chief executive John Seffrin. "The rate of this downturn can and therefore

must be accelerated."

But everybody did not benefit: Some cancers, such as deadly melanoma, still

are rising, and black men and Asian women in particular missed out on the

progress.

"We have to make sure the best (medical) practices are being applied to

everyone," said National Cancer Institute Director Richard Klausner, warning

that cancer remains "a daunting problem."

What is happening? Scientists could not say exactly -- they still are

analyzing 23 different cancers.

"These data are crucial as we develop cancer policies and programs," explained

Dr Edward Sondik of the Centers for Disease Control and Prevention.

But they said tobacco use, blamed for one-third of all cancer cases, has

dropped. Also, people are getting better testing, meaning not just that cancer

is treated earlier but that, for example, pre-cancerous colon polyps can be

removed before ever turning into tumors.

It is believed that at least one-fourth of all cancers could be prevented by

eating more fruits and vegetables and less fat, but scientists were skeptical

that diet had an impact yet -- obesity actually is rising.

The new study by American Cancer Society and government scientists found

cancer rates increased by 1.2 percent every year from 1973 to 1992, when the

sudden drop began.

Preliminary results from 1996 suggest the downturn is continuing, Sondik said.

The findings come almost two years after doctors spotted the first-ever drop

in cancer deaths. That mortality rate dropped by a total of 2.5 percent

between 1990 and 1995, representing about 30,000 fewer deaths than expected.

The bad news: Black men have the nation's highest cancer incidence rates, and

they still are climbing almost half a percent a year. Women from Asia and the

Pacific Islands saw no change in cancer diagnoses but their deaths increased.

In addition, deadly melanoma from too much time in the sun is rising, as are

non-Hodgkin's lymphoma and bladder cancer. Uterine cancer reversed a pre-1990

downtrend to level off.

Progress against specific cancers varies greatly:

Lung cancer incidence dropped 1.1 percent a year, mostly because of men, who

began quitting smoking earlier than women. Among women, only blacks and

Hispanics saw a lung cancer decrease, and deaths dropped only among Hispanic

women. Male deaths, like cancer cases, dropped among all races. But because an

estimated 3,000 teen-agers start smoking every day, scientists warned lung

cancer could quickly rebound.

New breast cancer cases had increased 1.8 percent a year between 1973 and

1990. They then leveled off except among black women, whose cases still rise

almost 1 percent a year. But these figures are misleading because they count

only invasive breast cancer, not the very early "ductal carcinoma in situ" --

too small to be caught except on X-ray -- diagnosed in thousands of women

annually. DCIS is on the rise, but how dangerous it is and how to treat it are

very controversial. Breast cancer deaths dropped 1.9 percent annually among

white and Hispanic women.

Prostate cancer dropped 1 percent a year since 1990, fueled by white men.

Cases among black men rose a total of 3.9 percent between 1990 and 1995, but

in 1994 began to drop. Whether prostate cancer really is declining, however,

is a big question. The sudden use of "prostate-specific antigen," or PSA,

testing in the early 1990s diagnosed thousands of men with previously

undetected cancer, bumping up numbers that only now may be settling down to

true levels.

Colorectal cancer dropped among all groups, but most among men. White men saw

a 3.3 percent annual drop and Asian/Pacific Islander men 2.5 percent, while

white women did the best among females with a 1.8 percent decline. Scientists

don't know why. Only one-third of people over age 50 -- those most at risk --

get tested for colorectal cancer. Better removal of pre-cancerous colon polyps

may play a role in the decrease.

(AP reports were used in this story.)