Clean Up Your Act, Live Longer
Cancer deaths in the United States declined through most of the 1990s, and so did the incidence rate of cancer, the number of new cases each year per 100,000 people. Credit improved screening procedures and treatment for the decline in deaths. The drop in the incidence rate is traceable in good part to the decline in smoking among men and, suggests Harmon Eyre, the chief medical officer of the American Cancer Society, to changes in eating habits. Over the last 10 years there has been a “statistically significant increase in the number of individuals who are eating more fruits and vegetables” and less animal fat.
The increase in consumption of low-fat foods is especially notable in light of a new Environmental Protection Agency report that dioxin, a chemical that accumulates in the fat of mammals and fish, poses a cancer risk 10 times higher than the EPA’s previous estimate.
The encouraging message here is that there’s a lot that people can do to protect themselves from cancer. Mortality rates seem to have peaked around 1991. Before then, cancer death rates had been rising 0.2% a year. Between 1991 and 1995 the death rates dropped 0.6% a year, then accelerated to 1.7% a year in 1995 to 1997, the latest year for which statistics are available. Meanwhile, the incidence of new cancer cases declined an average 0.8% a year between 1990 and 1997.
The greatest decline in incidence rates was among men, who overall have higher cancer rates than women. The annual report of the National Cancer Institute, the American Cancer Society, the North American Assn. of Central Cancer Registries and the Centers for Disease Control and Prevention notes that a man has a 42.8% risk of being diagnosed with cancer sometime in his life and a 24% chance of dying from it. A woman has a 37.5% risk of developing cancer and a 20% risk of dying from it.
In men, the lung cancer death rate has been dropping 0.5% a year since 1990. But Eyre said that although the rate of increase among women has declined, “it hasn’t turned down yet.” The incidences of prostate and colorectal cancer have also declined, by more than 2% a year since 1990 for prostate cancer and more than 1.7% a year for colorectal cancer. In both cases patients are taking advantage of better screening procedures, albeit slowly. Breast cancer incidence rates changed little in the 1990s, but the death rates have declined by about 2% a year, accelerating sharply since 1995.
All this is encouraging, but it could be better. Melanoma, the worst skin cancer, is on the increase as people disregard warnings about overexposure to the sun. And the reluctance of Americans to be screened for colorectal cancer means that early intervention is too often being missed. Education and income appear to have a lot to do with both prevention and whether people seek or have access to diagnostic screening. But the good news remains that preventive measures--especially not smoking, regular exercise and caring about diet--are effective. The great need is to spread the word more widely.
