As Fewer Smoke, Lives Are Saved
This year, says the American Cancer Society, about 142,000 Americans will die of lung cancer while another 155,000 new cases of the disease will be diagnosed. The society says that smoking is the cause of 85% of all lung cancer cases among men and 75% of the cases among women. Lung cancer is the most common of fatal cancers in the United States. It is also the most preventable. A quarter-century ago the U.S. surgeon general’s report on smoking and cancer inaugurated a new emphasis on prevention. There are encouraging indications that this emphasis is paying off.
In a study published this week in the Journal of the National Cancer Institute, federal researchers report that lung-cancer death rates in people under 45 have dropped significantly for the first time in several decades. For white men under 45, the death rate fell from 13.4 per 100,000 in the mid-1970s to 9.6 per 100,000 in the mid-1980s, a decline of 28.7%. For black males in the same age group, a higher proportion of whom tend to smoke, the decline was 14.2%. The fall in mortality rates for black women was 8.9%, and 5.3% for white women.
The figures are the most dramatic indication yet that lower smoking rates lead to lower lung-cancer death rates. In 1965, nearly 50% of all white men smoked. By 1987 the rate had fallen to under 30%. Statisticians predict that the percentage of the population that smokes will continue to decline, and that reduced mortality rates from lung cancer will become increasingly evident in older age groups. The basis for predicting a continuing favorable trend is called the cohort phenomenon. A group of people who are born during the same period--a cohort--tends to share similar behavioral risk factors and environmental exposures. Thus today’s 45-year-olds, with lower lung cancer rates than 45-year-olds a decade earlier, can be expected to continue showing lower rates as they grow older.
It’s important to note that the decline in the lung cancer death rate is due to a decline in the occurrence of the disease, rather than to more effective treatment. Lung cancer survival rates have in fact shown little improvement in recent years, with only about 13% of those with the disease still alive five years after diagnosis. It’s important to remember as well that overall lung cancer mortality rates are still increasing for the nation as a whole. The improvement in mortality rates for younger men and women reflects the decisions by those in a particular age group not to start smoking or to shed themselves of the addiction.
One final statistic. The American tobacco industry, says the National Cancer Institute, continues to spend more than $2 billion a year to promote smoking. The greater part of its promotion campaign is aimed at younger people. This is the same group, evidence shows, that can most effectively be targeted by prevention programs. The good news is that these programs are working, that the tide of battle has turned. As a result, 10, 20, 30 years from now, hundreds of thousands of Americans who would otherwise have died prematurely will still be alive, because they chose not to smoke.
