Lung Cancer Rate Drops Significantly in White Men

Two decades after the surgeon general’s warnings prompted men to stop smoking in “substantial numbers,” the national incidence of lung cancer in white men has decreased significantly for the first time in at least a half century, the National Cancer Institute reported Monday.

The institute, in its annual report on five-year cancer incidence and death, said that the lung cancer rate for white men declined 4%, from 82.7 new cases of lung cancer per 100,000 men in 1982 to 79.3 in 1983.

“This proves that people can successfully reduce their cancer risk by quitting smoking or not taking up smoking,” said Dr. Vincent T. DeVita Jr., director of the institute.

However, the lung cancer rates for women and black men were far less encouraging. The institute, noting that lung cancer deaths and new cases of the disease in women showed no signs of leveling off, predicted that there would be no decrease for 15 to 20 years because of women’s smoking patterns.

“This year lung cancer is expected to top breast cancer as the leading cause of cancer deaths among women, and this has already happened in about 15 states,” DeVita said.

“The news about lung cancer isn’t good for black men either,” he added. Their annual lung cancer rate is almost 60% higher than for white men, the institute said, “although it appears to be leveling off.”

Anne Browder, a spokeswoman for the Tobacco Institute, said officials there had no comment on the report.

“We have not had a chance to look at the Cancer Institute’s data base on lung cancer incidence and have no idea of their data source regarding white male smoking rates 20 years ago,” she said. “That being the case, we do not know how they made a smoking connection and cannot possibly provide any comment.”

Unlike the incidence of lung cancer, the death rate for white men did not drop significantly in 1983, the institute reported. In 1983, the mortality rate of 71.2 deaths per 100,000 white men was only slightly lower than the 1982 rate of 71.3 deaths per 100,000. However, the death rate has been stable since 1980, the institute said.

The lung cancer mortality rate for black men decreased slightly from 1982 to 1983, the institute said, from 97.5 deaths per 100,000 black men to 97.3 deaths. The lung cancer death rates for women of both races have continued to increase at 6% per year through 1983, the institute said.

The institute said that lung cancer, the nation’s No. 1 cancer killer, will claim an estimated 125,600 American lives this year--38,600 women and 87,000 men. There will be an estimated 38,400 deaths from breast cancer. In California, one of the 15 states where lung cancer killed more women than breast cancer in 1983, 3,961 women died of lung cancer and 3,920 died of breast cancer.

Decrease in Smokers

“With the dropping in the number of male smokers, it is not surprising there would be a parallel decrease in the incidence of lung cancer,” said Dr. William G. Cahan, a thoracic surgeon at Memorial Sloan-Kettering Cancer Center in New York. “Women have not begun to stop their addiction, so it will take some time for their incidence to head downward. If women were to stop smoking even today--all of them--the momentum of their habit would still continue for 20 to 25 years.”

Cahan said it would take several more years to see a change in lung cancer mortality.

“You’re dealing with a monster,” he said. “It’s very, very hard to control. It spreads all too readily. Nevertheless, we expect to see improvement because of earlier detection and better surgical means of controlling it. This will have an impact on survival. Within five to 10 years, I predict we’ll see a steady fall in the death rates, particularly in males.”

The institute said the annual rates of new lung cancer cases for both sexes and all races increased at an annual rate of as much as 10% from at least the 1930s through the early 1970s.

Death Rate Levels Off

However, the rate for white men grew by only 2.5% a year between 1973 and 1977, the institute said, and its growth slipped to 0.6% a year between 1978 and 1982. The lung cancer death rate for white men, adjusted for the age of the population, has leveled off for the last several years, the institute said.

Among men younger than 55, both the incidence and the death rate for lung cancer have declined almost every year since 1978, it reported. But for older men, both the incidence and the death rate have been rising steadily.

In its annual update on survival statistics for all cancers, the institute said that 49% of those whose cancer was discovered between 1977 and 1982 survived or are expected to survive at least five years from the time of diagnosis. That was up by one percentage point from the 48% rate for patients diagnosed between 1973 and 1976.

The five-year survival rate was 50% for white patients and 37% for black patients.