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National Cancer Report: Fewer Dying, But News isn’t All Good

Fewer people are dying from the most common cancer types, a new report from the leading U.S. cancer organizations says.

The Annual Report to the Nation on the Status of Cancer shows that steady progress has been made in curbing the nation’s most deadly cancers, including, breast, colon, lung and prostate cancers.

Death rates have steadily fallen for men and women in all major racial and ethnic groups between 2000-2009.

The report, co-authored by researchers from the Centers for Disease Control and Prevention, the North American Association of Central Cancer Registries, the National Cancer Institute, and the American Cancer Society, also found that the overall cancer incidence rate for men decreased and remained stable for women during the same period.

Edward J. Benz, Jr., MD, president of Dana-Farber Cancer Institute in Boston, called the news encouraging, but said that the overall number of cancer incidences and mortality rates are not falling nearly enough.

"Cancer rates are declining, continuing a trend that started some years ago. People are surviving more and we are getting better at preventing some cancers," said Benz in a written statement. "But we're not taking advantage of all the ways to detect cancers at an early stage when they can be the most curable."

Among children, 14 years old or younger, new cancer cases increased 0.6 percent each year from 1992 through 2009, but researchers don’t yet know why. However, the report points out that considerable progress has been seen for many types of childhood cancers, resulting in overall declines in death rates for cancer among children since at least 1975.

Just a few years ago, lung cancer death rates were steadily increasing among women while they were steadily declining in men. Experts saw a correlation between an increase in the number of women smoking, new lung cancer cases and the lung cancer mortality.

But now, for the third straight year, lung cancer death rates are dropping among women as smoking declines, mirroring declines seen in men since the early 1990s.

The report attributes a trending decline in colon cancer deaths to improvements in colon cancer screening and treatments. The number of breast cancer cases remains unchanged between 2000 and 2009, while the number of breast cancer deaths declined.

But the news isn’t positive for all cancer types. Deaths are still rising for liver cancer, pancreatic cancer, and melanoma, the most deadly type of skin cancer.

Also rising is the number of new oral (head and neck) and anal cancers caused by the sexually transmitted human papillomavirus (HPV) in men and women. The report focused on these cancer types.

Based on data from three national cancer registries, HPV-associated head-neck tumors increased from 16 percent in 1989 to nearly 72 percent from 2000 to 2004 — particularly among whites. Anal cancer rates doubled for men and women from 1975 to 2009.

It's widely known that two strains of HPV (16, 18) cause most cervical cancers, but fewer people are aware that the virus is the origin for other cancers too.

While protective vaccines are available, government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Experts believe if at least 80 percent of the target group (boys ages 13-21 and girls ages 13-26) is vaccinated, over time HPV-associated cancers would be substantially reduced — perhaps even eradicated — within the population.

Apart from cultural or religious objections, one of the biggest barriers to getting vaccinated is the $390 price tag for the three-dose series. As of 2010, six states, New Hampshire, New Mexico, Rhode Island, Vermont, Washington, and Wyoming, offer free HPV vaccine to all girls, the report said.

"We are seeing a large number of patients with HPV-associated head and neck cancer and these patients are relatively young, are typically non-smokers and quite often have children," said Robert I. Haddad, MD, chief of Dana-Farber's head and neck oncology program in a university release.

"HPV is a cause of many cancers, so it is really important to support endeavors to vaccinate."

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