Annual Report Shows Progress and Frustration in the War Against Cancer
Overall death rates from cancer continue a gradual decline in American men, women and children, but a surprising rise in particular cancer sites has left many medical experts far from satisfied, questioning the multi-billion dollar war being waged against the disease.
Continuing a trend that began in the early 1990s, cancer death rates dropped by 1.8 percent among men and 1.4 percent among women, according to the Annual Report to the Nation on the Status of Cancer, which was released earlier this week.
The report is co-authored by researchers from the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), the American Cancer Society (ACS) and the North American Association of Central Cancer Registries (NAACCR).
“While this report shows that we are making progress in the fight against cancer on some fronts, we still have much work to do, particularly when it comes to preventing cancer,” said CDC Director Thomas Frieden, M.D.
Deaths from lung, colon, rectum, breast and prostate cancers dropped, but death rates continued to increase for pancreas, liver and uterine cancers, along with melanoma of the skin for men.
The report was based on figures from 2000 to 2009, the last year for which the statistics have been calculated. During that same period, overall cancer incidence rates decreased by only 0.6 percent annually among men and remained stable among women.
The report was released the same week that well-respected scientist James Watson, who won a Nobel Prize for his work with DNA and cancer, presented his own views on the disease in the Open Biology journal. And they were not exactly encouraging.
“The main factor holding us back from overcoming most of metastatic cancer over the next decade may soon no longer be lack of knowledge but our world’s increasing failure to intelligently direct its ‘monetary might’ towards more human-society-benefiting directions,” Watson wrote.
“Even though an increasing variety of intelligently designed, gene-targeted drugs now are in clinical use, they generally only temporarily hold back the fatal ravages of major cancers. … Even though we will soon have comprehensive views of how most cancers arise and function at the genetic and biochemical level, their ‘curing’ seems now to many seasoned scientists an even more daunting objective than when the ‘War on Cancer’ was started by President Nixon in December 1971.”
According to A World Without Cancer, written in 2012 by Margaret Cuomo, M.D., a board certified radiologist and sister of New York Governor Andrew Cuomo, the federal government has spent more than $90 billion on cancer research in the last 40 years with a variety of agencies and with mixed results.
“The system designed to study, diagnose and treat cancer in the United States is fatally flawed,” Cuomo wrote. “More than 40 years after the war on cancer was declared by President Richard Nixon in 1971, we are not much closer to preventing the disease. When have Americans ever waged such a long, drawn-out and costly war, with no end in sight?”
Authors of the annual report emphasized the need for more research to further identify major risk factors for various cancers and better development of appropriate interventions, along with more aggressive cancer prevention strategies.
As an example, the rise in cancers caused by HPV, the sexually transmitted human papillomavirus, has shown that better preventative measures would help considerably.
A protective vaccine for HPV is available, but government figures from 2010 showed that only 32 percent of teenage girls have received the recommended three doses, which is considerably lower than in Canada, Britain and Australia.
The biggest problem area with HPV were oral and anal cancers. The rate of cervical cancer, often caused by HPV, dropped, but it was offset by the rise in the other cancers.
Experts believe that a dramatic decrease in the number of smokers played a big part in the overall decline of cancers deaths in recent years. Yet they also agree that the societal change was offset by an increasingly older population (where cancer is more likely to occur), bad diets and a growing obesity problem.
“The continuing drop in cancer mortality over the past two decades is reason to cheer,” said John Seffrin, chief executive officer of the American Cancer Society. “The challenge we now face is how to continue those gains in the face of new obstacles, like obesity and HPV infections. We must face those hurdles head on … by expanding access to proven strategies to prevent and control cancer.”
Although significant progress has been made with some cancers, there has been little or no progress made with others, reflected by the different figures for men and women.
While incidence rates among men decreased for just five of the 17 most common cancers (prostate, lung, colon and rectum, stomach and larynx), it increased for six of those cancers (kidney, pancreas, liver, thyroid, melanoma of the skin and myeloma) during the same period.
Among women, incidence rates during the same 10-year period decreased for seven of the 18 most common cancers (lung, colon and rectum, ovary, stomach, oral cavity and pharynx, bladder and cervix), but it increased for seven cancers (thyroid, pancreas, kidney, melanoma of the skin, liver, uterus and leukemia). In addition to causing ovarian cancer, exposure to asbestos is the primary cause of mesothelioma cancer.
The incidence rates in both men and women for the other most common cancers, including breast cancer and non-Hodgkin lymphoma, remained stable.