Cancer Deaths in U.S. Drop for 2nd Straight Year

By Abram Katz

Deaths from cancer in the United States have dropped for the second consecutive year, mainly due to less smoking and earlier detection, but now obesity is looming as a large new potential source of patients, cancer experts said Wednesday.

So, although leading Connecticut oncologists consider the decline a clear victory in the war on cancer, they caution that anti-obesity measures may be as necessary as the anti-tobacco campaign to curtail a future spike in incidence and mortality.

The American Cancer Society reported Wednesday that the number of people killed by cancer dropped by 3,014 between 2003 to 2004. In the previous year, cancer deaths declined by 369.

The largest decrease was in colorectal cancer, which claimed 1,110 fewer men and 1,094 women in 2003 compared to 2002, the society found. Deaths from breast and prostrate cancers also dropped.

Still, about 560,000 people are expected to succumb to cancer this year, including about 20,000 in Connecticut.

The 3,014-person decline in mortality is nonetheless significant, cancer experts said.

"It’s an extraordinary number. It’s not a fluke," said Dr. Vincent T. DeVita Jr., former director of the Yale Comprehensive Cancer Center.

"It’s very real. We’ve turned the corner," he said, and mortality will continue to decline as the effects of new medications, adjuvant therapy combining chemotherapy and surgery, and improved screening become evident, DeVita said.

The fact that fewer people died, even as the population grows and ages, is significant, he said.

However, Americans are becoming more obese, and obesity is linked to certain cancers, DeVita said. "We haven’t seen an increase in mortality yet, but it’s a potential dark cloud on the horizon," he said.

Why obesity is not yet reflected in cancer mortality statistics is a puzzle, DeVita said.

Weight-loss surgery may help, though it’s not clear how early obesity contributes its morbid effect, DeVita said. The relationship between obesity, age and cancer is complicated and more research must be done, he said.

Dr. Carolyn Runowicz, director of the Neag Comprehensive Cancer Center at the University of Connecticut School of Medicine, said the continued downward trend in cancer deaths is more telling than the numbers.

"This is a preview of what we’ll be seeing. I would be very upbeat about this. We are winning the war on cancer. We should continue to fund research and keep the pressure on," Runowicz said.

Runowicz said a drop in tobacco use, an increase in colon exams and early detection of breast cancer have all contributed to the decrease in deaths.

The human papilloma virus vaccine promises to curtail future cases of uterine cancer, and new chemotherapy agents, improvements in screening and the recognition of obesity as a risk factor should also help, she said.

Some researchers contend that 15 to 20 percent of cancer deaths in the United States are related to overweight and obesity.

Still, the downward trend in cancer mortality is likely to continue and probably increase, said Dr. Joseph G. Cardinale, medical director of the McGivney Cancer Center at the Hospital of Saint Raphael.

"It’s exciting to see this. A lot of it is due to early diagnosis. The death rate from cancer is going down. Ultimately we’ll see this trend continue," Cardinale said.

Even so, cancer and heart disease will remain the leading causes of death in the United States for the foreseeable future, he said,

Despite the good news, no one should interpret the drop in deaths as a reason to resume smoking, said Dr. Andrea Silber, director of early detection and prevention at the McGivney Center at St. Raphael’s.

"People should take this as a ticket to get their colonoscopy. Two points on a curve doesn’t mean we can kick back. We’re seeing that we’re making a difference. It shows we need a bigger push for early detection," she said.

Quick Links

UConn Cancer Dialogue

A quarterly publication designed for medical professionals who are involved in cancer research or care of patients with cancer. Read the latest edition.