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Lung cancer deaths finally fall for women

WASHINGTON – American women have come a long way, and at last that includes the fact that they, like men, finally are dying less often from lung cancer.

More than a decade after the death rate from lung cancer among men started falling, the pace at which women are succumbing to the malignancy peaked in 2002 and dropped almost about 1 percent a year through at least 2007, researchers reported Thursday.

The milestone had been expected for years as the wave of smoking-related illness that arose after women began lighting up in large numbers finally ebbed after they began kicking the habit.

“They took it up a little later so their increase has had a slow rise, and now it’s finally starting to turn around,” said Brenda Edwards of the National Cancer Institute, which documented the decline Thursday in the latest analysis of the nation’s war on cancer, conducted annually with the American Cancer Society, the Centers for Disease Control and Prevention and the North American Association of Cancer Registries.

“Lung cancer deaths in women are now showing a statistically significant decline. It’s the first time,” Edwards said.

In addition to the turnaround in lung cancer deaths among women, the rates at which Americans are being diagnosed and are dying from many leading cancers continued falling, according to a paper published in the Journal of the National Cancer Institute.

“This is good news, and maybe the country can use a little good news about now,” said David Cutler, an economist who studies the impact of tobacco at Harvard University.

Overall, the rates at which cancer is being diagnosed – the incidence – fell for all racial and ethnic groups and both sexes between 2003 and 2007, the period covered by the report. The declines were driven by drops in major tumors such as lung and colorectal cancer in men and lung, breast and colorectal in women.

At the same time, deaths from many cancers also continued to fall, including deaths from 10 of the top 15 cancers among men and for 11 of the top 15 cancers in women, including cancers of the breast, lung, prostate, colorectum, ovaries, kidney, stomach and brain.

“It’s great news,” said Ammedin Jemal, the American Cancer Society’s vice president for surveillance research, noting that while blacks still are dying at a faster rate from cancer than whites, the gap between the races also has narrowed, especially among men.

Experts attributed the decline to a combination of factors, including most prominently the decline in smoking, as well as improved early detection with colonoscopies and mammography and better treatment helping reduce the toll from cancers of colon and breast.

“Basically, we can cure you of cancer if we catch it early and take it out,” Cutler said.

But the experts stressed that despite the gains, the score card against cancer remains decidedly mixed. Many cancers continue to increase, both in their diagnoses and deaths, including melanoma and cancer of the liver, pancreas and uterus.

“It’s not all rosy,” said Donald A. Berry, a professor of biostatistics at the University of Texas M.D. Anderson Cancer Center in Houston. “Too many battles against this disease are lost for us to toast the few wins.”

The reasons for the increases vary. For liver cancer, obesity and hepatitis probably are playing a role. Skin cancer is going up because of sun and other exposures.

Even the decline in lung cancer deaths among women has been modest, several experts noted, with the decline being much smaller than that seen in men. Lung cancer remains the leading cancer killer, and several experts said they worried about the future.

“It seems everywhere I turn, I see young women smoking. Frankly, we have to do a better job at countering the efforts of cigarette marketers for the sake of public health,” said Craig Jordan, scientific director of Georgetown Lombardi Comprehensive Cancer Center.

Many states facing budget crises are cutting successful anti-smoking campaigns.

“As the decline in adult and adolescent smoking rates have stalled with cutbacks to state tobacco control programs, we can expect that the declines in lung cancer death rates that we celebrate today will also stall sometime in the future,” said Joseph DiFranza, a professor of family medicine and community health at the University of Massachusetts Medical School.

Several experts argued the latest report underscores the need for a fundamental shift in the nation’s strategy – away from finding new ways to diagnose and treat cancer and more focused on preventing malignancies in the first place.

“I would say this is clear evidence of indifference of NCI to prevention and overwhelming fixation on diagnosis and treatment,” said Samuel Epstein of the University of Illinois School of Public Health.

But others defended the overall strategy, citing the dearth of knowledge about how to prevent many cancers and the daunting complexity of the disease.

“By and large they’re doing good things,” Berry said. “No one knows how to cure cancer, and that includes me.”

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