For the second consecutive year, the American Cancer Society is reporting that fewer Americans are dying of cancer year by year. And the trend seems to be accelerating.
On the face of it, the numbers look underwhelming. The Cancer Society says cancer deaths went down by about 3,000 between 2003 and 2004, the latest figures available. Considering that cancer kills more than 550,000 Americans each year, that seems like a drop in the bucket.
In fact, the new numbers are evidence of an encouraging trend, says Michael Thun, who tracks the data for the Cancer Society. Although the absolute number of cancer deaths had not gone down for 70 years, the cancer death rate – the number of people out of every 100,000 Americans who die of the disease – has been falling since 1991.
Experts consider the death rate a more reliable barometer than the total number of deaths. It takes into account the total U.S. population and is adjusted to reflect the population's age. Still, Thun acknowledges, the decline in absolute numbers probably means more to most people.
"People understand numbers of deaths [more easily] than the abstraction of a death rate," he says. "So it does have symbolic importance and it makes it very real."
Will the trend last? Maybe not. The Cancer Society itself predicts 6,000 more cancer deaths in 2007 than in 2004. As baby boomers reach their 60s, 70s and 80s, the ages when cancer becomes common, the cancer death rate would have to decrease substantially to keep the absolute number of deaths on a downward arc.
Since cancer is such a stubborn disease — a collection of many diseases, really — that's a tall order. Dr. Tim Byers, deputy director of the University of Colorado Cancer Center, thinks it's possible.
"I don't think there's any reason to believe that death rates from cancer in the United States will ever be as high as they were in 1990," Byers says. He is hopeful that the reasons for the declinig death rate will continue to have an impact.
For starters, fewer people are smoking. Some really big cancer, including breast cancer, are yielding to better treatments. And doctors are becoming better at detecting cancers early and preventing them.
Death rates from colon cancer, for example, have been falling for decades. Nobody knows quite why. But there's no question that more people over age 50 are being screened for cancerous and even precancerous changes in the colon. Experts say that's why colon cancer accounts for three-quarters of the drop in cancer deaths, according to the new statistics.
Dr. Bernard Levine, vice president for cancer prevention and population science at the M.D. Anderson Cancer Center at the University of Texas at Houston, says there's a lot of untapped potential for future gains in just this one cancer. "Perhaps not even one half of the population who should be screened is actually screened," he says. "If [screening] were more widely implemented, I think we could drive down the number of colorectal cancer cases and subsequent deaths possibly by as much as 50 percent."
But for now, the reasons for self-congratulation are limited. Cancer still kills more Americans under 85 than any other disease. Still, after so many years of discouraging cancer news, Byers thinks it's a good time to take stock.
"This is sort of a moment for us to reflect on how far we've come," he says. "And despite the fact that the population continues to increase in size, and despite the fact that the population continues to age, the death rates have come down so low that we're actually seeing absolute numbers of people dying less from cancer."
It may be not be surprising to the experts. But Byers says it's certainly gratifying.
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