What’s Behind the Drop in Cancer Rates?

Despite dramatically drop, cancer rates are on the rise for certain groups of people. One of the culprits? Obesity

By Deborah Jeanne Sergeant

MaxianThe rate of cancer mortality has decreased by about 25 percent for many types of cancer over the past two decades, according to the American Cancer Society.

Today, fewer die from lung, breast, prostate and colorectal cancer.

The organization states that the decrease in cancer deaths relates to advances in several areas.

Some of the decrease in cancer incidence has to do with guidelines for cancer screening. If more or fewer receive screening, that affects the statistics.

For many years, smoking rates have decreased, which has reduced rates for many types of cancers. Occupational exposure harmful to lungs, such as applying pesticides on farms, handling asbestos in construction and welding has also decreased, thanks to more safety standards and material regulations.

Improved screening rates and availability for screening represents a big factor for detecting cancer earlier and more curable, such as mammograms, in some cases, pre-cancerous lesions, such as colon cancer and cervical cancer screenings.

From 1989 to 2015, breast cancer deaths decreased 39 percent; from 1989 to 2015 and colorectal cancer went down 52 percent between 1970 and 2015.

HPV vaccine should eventually eliminate cervical cancer for most women, providing they receive vaccination.   

Though care providers have made great progress in preventing and treating cancer, some areas still need improvement.

Ovarian cancer is one of the types that “hasn’t seen statistic change at all,” said Kathleen Maxian, president of Ovarian Cancer Project in Buffalo and survivor of ovarian cancer.

Physicians gave Maxian, now 56, a 20 percent chance of living for five years when she was diagnosed at 47. Most women with ovarian cancer die within five years of diagnosis since most ovarian cancers are detected only in the latter stages, like Maxian’s. Women diagnosed at stage 1 have a 95 percent chance of living five years.

“It’s the deadliest of the gynecologic cancers,” Maxian said. “Fourteen thousand will die from it this year.”

Cancer recurred in her lymph nodes, but it’s been five years since her last treatment.

No routine exam or test such as the PAP smear can screen for ovarian cancer. Called the “silent cancer,” its symptoms could easily signal something else: bloating, pelvic and abdominal pain, urinary frequency, feeling full quickly and fatigue. A blood test for ovarian cancer can offer false positives, so it’s not routinely offered. Only a biopsy can confirm it.

Except for obesity and use of hormone replacement therapy, the risk factors are outside patients’ control, including age, history of endometriosis and family history of cancer of the reproductive organs, colon cancer, or the BRCA-1 or -2 mutation.

Other cancers with obesity as a factor have seen an increase in the past 25 years. An estimated 15 percent of cancers are related to obesity.

The American Cancer Society suggests that obesity-related cancers such as colorectal, pancreas, uterine, kidney, and gallbladder cancers are increasing in people aged 25 to 49, and that the youngest adults, age 25 to 29, are seeing the biggest rise in obesity-related cancers.

It’s uncertain whether it’s obesity itself or causes of obesity — such as poor diet, stress and sedentary lifestyle — contribute to cancer.

Kohman
Kohman

Physician Leslie Kohman, board chairwoman of the American Cancer Society for Upstate New York and professor of surgery and director of outreach at Upstate Cancer Center in Syracuse, said that the cancer death rate is increasing for liver cancer, endometrial cancer, brain cancer and head/neck cancers.

“The death rate in the poorest New York county is far greater than in the wealthiest,” she said. “Everyone should have health insurance but they don’t. Not everyone has equal access to transportation. Poverty is a barrier to medical treatment and screening.”

To address these issues, her organization takes an approach of bringing greater availability to health care, including mobile mammography vans, community outreach, and community education.

“Almost half the cancers can be prevented by what we know now,” Kohman said.

To sum it up, she said that avoiding tobacco, sun exposure, and obesity, and minimizing alcohol and red meat, especially cured and processed meat, can greatly reduce cancer incidences. Mothers should breastfeed as long as possible to protect both mom and baby. Discuss screenings with a healthcare provider.

Each New York county is part of the Cancer Services Partnership, which covers screening for colorectal, cervical, and breast cancer for those who are uninsured.

“Everyone can reduce their own risk of developing cancer,” Kohman said. “The good news is if you develop cancer now, your chance is much better than 25 years ago.”

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