U.S. progress in cancer fight likely stalling

WASHINGTON — Cancer deaths may be leveling off after several years of decline, and many states are lagging in proven methods to fight the most common tumors, says the nation's annual report on cancer.

Sixteen states spend less than $1 per person on tobacco control — far less than the $5 to $10 per person recommended — even though smoking is the leading cause of lung cancer, the nation's top cancer killer. Screening for breast and colorectal cancer varies widely, too.

And there's a widening racial gap as white Americans increasingly survive certain tumors better than blacks, says the report published Tuesday in the Journal of the National Cancer Institute.

"The progress against cancer continues to be mixed," said co-author Dr. Michael Thun of the American Cancer Society.

Instead of awaiting the next anti-cancer discovery, the report shows states how to better target programs already proven to save lives but that are not being offered equally across the country, he said.

"There are substantial opportunities in applying what we already know," Thun said. Yet "because of the state budget crises, programs like tobacco-control programs are being cut at a critical time, when there's terrific opportunity for progress."

The report's overarching finding is somewhat sobering: Death rates for all cancers had been inching down by about 1.4 percent a year through the mid-1990s, but by 2000 that decline seems to have leveled off.

At least part of that is due to a statistical quirk — a change in how cancer deaths are recorded that mean fewer were being missed in national counts starting in 1999.

Still, "we're seeing perhaps a slowing of the decline," said Brenda Edwards of the National Cancer Institute, which co-authored the report with the cancer society and Centers for Disease Control and Prevention. "It gives us pause."

An estimated 556,500 Americans will die of cancer this year, and 1.3 million will be diagnosed with it.

Death rates for the four most common cancers — lung, breast, prostate and colorectal — still are declining for all but one group, women with lung cancer. Lung cancer deaths are increasing by just under 1 percent a year among both white and black women.

Most striking are the racial disparities. By 2000, death rates for whites were substantially lower than those for blacks, particularly among breast and colorectal cancer patients, where the gap appeared to have been widening.