ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Thursday, November 14, 1996 TAG: 9611140059
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: WASHINGTON
SOURCE: Associated Press
For the first time in at least 60 years, deaths from cancer are dropping steadily - a five-year trend that has led experts to shed their usual caution and declare true progress in the war on cancer.
``One of the most intractable diseases of the 20th century is now in decline,'' declared Brad Rodu, who with University of Alabama, Birmingham, colleague Dr. Philip Cole uncovered the trend.
The government validated the Alabamans' findings Wednesday, saying overall cancer mortality dropped 3 percent between 1990 and 1995. That's not a big decline, but it was the first sustained drop since national record-keeping began in the 1930s - and possibly the first since 1900.
And it was fueled by declines in fatal lung cancer that doctors have anxiously awaited for decades.
``This looks like a turning point in the 25-year war on cancer,'' said Health and Human Services Secretary Donna Shalala.
Added National Cancer Institute Director Richard Klausner: ``The 1990s will be remembered as the decade when we measurably turned the tide against cancer.''
But the reports aren't all good. The decline in mortality was greater for men, who showed a 4.3 percent drop, than for women, at 1.1 percent. Again, lung cancer was the cause. Lung cancer mortality fell 6.7 percent in men but actually rose 6.4 percent in women, who are less likely to have quit smoking than men, the NCI reported Wednesday.
And the decline in overall cancer mortality was greater among black Americans than whites, 5.6 percent vs. 1.7 percent, a finding experts attributed to recent campaigns to improve cancer care for minorities. Still, rates of cancer deaths among black men remain 40 percent higher than for white men, the NCI said.
The news comes on the eve of the 25th anniversary of the war on cancer. Frustrated patients have spent this year asking if that war was lost, and many doctors anticipate cancer will overtake heart disease to become the top killer by 2000.
There have been signals of progress for some time. As The Associated Press reported in July, NCI figures show deaths from all malignancies except lung cancer actually have dropped since 1971 - and overall mortality inched down between 1990 and 1992.
The difference now is that Cole and Rodu, reporting in the current issue of the journal Cancer, found a five-year trend strong enough to overcome skepticism that the drop was a statistical blip.
``Anytime there is a sustained downturn, that suggests to me it's real,'' said Dr. Robert Warren of Georgetown University's Lombardi Cancer Center. But he urged caution: ``Whether that represents a true turn in the tide or just the fact that we're detecting some of these cancers earlier'' is not proven.
Cole and Rodu reported that the U.S. cancer death rate peaked in 1990, when 135 people out of every 100,000 died of the disease. The death rate declined every year since, to 129.8 deaths per 100,000 people in 1995.
Their death rates are different from those of the government, which says 174 people per 100,000 died of cancer in 1990. That's because the Alabama study adjusted death rates to account for today's older - and thus more cancer-vulnerable - population by using population figures from 1940. The government age-adjusts its figures using data from 1970.
But no matter how the math is done, the mortality rate from cancer did decline about 3 percent, the NCI and the Alabama study agreed.
Lung cancer deaths dropped 3.9 percent and other smoking-related cancers declined by about 2 percent, the Alabama study found.
Rodu said that drop was the long-awaited payoff of the decline in smoking that began in the late 1960s, when 40 percent of Americans smoked. Today, just 25 percent do.
More exciting, the decline appeared to grow slightly larger between 1994 and 1995, said Dr. Harmon Eyre of the American Cancer Society. He used a computer model to predict that if the current momentum continues, cancer death rates could be cut in half within 20 years.
Rodu insists the change isn't all due to more cancer being detected early, when it's easier to cure. The percentage of cancer patients who died within five years of diagnosis dropped from 70 percent in the 1950s to 50 percent by 1990, he said. It's too early to tell if that decline continued in 1995.
LENGTH: Medium: 81 linesby CNB