Cancer Fatality Rate Falling in Under-55 Group

WASHINGTON — Despite a slow increase in the incidence of cancer among Americans under age 55, the rate at which members of this age group are dying of the disease is continuing to slow, the National Cancer Institute reported Sunday.

Dr. Vincent T. DeVita, director of the institute, called the trend “one of the most encouraging cancer statistics we see this year,” and attributed the declining death rate to advances in treatment.

The institute, in its annual report on cancer incidence and survival, also reported an unexpected slowdown in the incidence of new cases of lung cancer in white women.

“We still don’t see a turnaround, but we are seeing a significant slowing in a rate that had been skyrocketing,” said Dr. Edward Sondik, chief of the institute’s surveillance and operations research branch.

Fatalities Down 7%

The institute said the cancer death rate among people under 55 has fallen 7%, from 38.2 per 100,000 individuals in 1975 to 35.7 in 1984, while the rate of cancer occurrence in the same age group rose an average of 0.2% yearly, to 99.8 per 100,000 population in 1984.

The institute also said that the five-year survival rate among cancer patients younger than 55 who were diagnosed between 1974 and 1983 was 59%, compared to 49% among all age groups during the same years. The five-year survival rate is the percentage of patients who live five years following diagnosis of cancer, adjusted for normal life expectancy.

Data on cancer incidence and deaths is available through 1984, and survival statistics are available through 1983.

The under-55 age group ac counts for 24% of all new diagnoses of cancer, the report said.

“We’re being particularly successful in treating these patients,” DeVita said.

Last year, the institute reported a significant decrease in the incidence of lung cancer in white men in the United States, but it said then that the number of new cases in women showed no sign of leveling off. The agency predicted no decrease for 15 to 20 years, because of women’s smoking habits.

This year, however, the institute said that the incidence of lung cancer in white women remained about the same between 1983 and 1984--after increasing by an annual average of 5% in previous years. In 1983, it said, there were 33.8 cases per 100,000 women, and in 1984 the figure was 33.7.

Further, the overall death rate from lung cancer among women rose only 2.9% between 1983 and 1984, from a rate of 24.3 per 100,000 to 25, the institute said. That rate had been rising by an average of 5.5% yearly since 1975.

‘More Hope’ Indicated

“When I look at 10 years’ worth of data, the overall trend is still a very fast increase, but, over the last few years, we’re able to see a slowdown that I wouldn’t have anticipated,” Sondik said. “It isn’t a turnaround or a start down--but it gives more hope for female lung cancer than I would have given before.”

This year’s statistics also indicate a continuing decrease in the incidence of lung cancer in white men. “Again, we’re seeing evidence that individuals can take positive steps to reduce their risk for certain cancers by not smoking,” DeVita said.

In 1965, 34.1% of women over 20 smoked, compared to 27.9% in 1985, Sondik said. The comparable figures for men were 52.4% in 1965 and 33.2% in 1985.

“There has been a major decline in males, but the decline in females has been relatively modest,” Sondik said. “It may be that the slowdown in the increase in women may be due to the quitting that took place 15 or 20 years ago.”

New statistics on breast cancer show that between 1983 and 1984, the death rate among white women under 50 rose from 5.9 to 6.3 per 100,000 women, compared to a 1% average yearly decrease over the past decade. The institute said it is uncertain of the reason for the increase, and that it may simply reflect a random fluctuation in the data.

Breast Disease Data

The breast cancer death rate among black women under 50 was 9.3 per 100,000, the report said.

Lung cancer was expected to surpass breast cancer as the leading cause of cancer deaths among U.S. women during the mid-1980s, the institute said, but, “because of this increase in the breast cancer death rate, it is not certain when or if this will happen.”

Among the overall U.S. population, the incidence of cancer of any type has been rising by an average of 0.7% yearly. It was 351.8 per 100,000 people in 1984, the report said. The cancer death rate has also been rising, by an average of 0.5% yearly, and it was 170.7 per 100,000 in 1984, according to the institute.

Among white patients diagnosed between 1977 and 1983, the five-year survival rate was 49.8%, but the figure for blacks was only 37.6%.

The institute also reported a decrease in colon cancer deaths among people of all ages, although the number of cases has been rising. It attributed the lower death rate to advances in treatment and earlier detection.

The five-year survival rate among colon cancer patients improved, from 49.5% of those diagnosed between 1974 and 1976 to 52.6% of patients diagnosed between 1977 and 1983, the institute said.

The colon cancer death rate has been dropping by about 0.6% each year. It was 21 per 100,000 people in 1984. The incidence of colon cancer, however, has been rising by about 0.5% annually, and was 50.3 per 100,000 in 1984, the institute said.