Cancer Death Rates Drop Dr. Martin Abeloff, the director of the Johns Hopkins Kimmel Cancer Center examines a statistical milestone in the fight against cancer. What's working, and why?
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Cancer Death Rates Drop

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Cancer Death Rates Drop

Cancer Death Rates Drop

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NEAL CONAN, host:

There is good news today, about cancer. Fewer people are dying from it, according to newly analyzed data from the National Center of Health Statistics. Some medical experts are hailing the decline, 369 fewer deaths in 2003 then in 2002, as a milestone; but the jury's still out as to whether the decline will continue.

We're going to take your questions about cancer rates for the rest of this hour: 800-989-8255, or email us, talk@npr.org. We turn for information to Dr. Martin Abeloff, Director of the Johns Hopkins Kimmel Cancer Center. He joins us from his office in Baltimore, Maryland.

Good of you to take the time to be with us today.

Dr. MARTIN ABELOFF (Director, Johns Hopkins Kimmel Cancer Center): Good to be with you, Neal.

CONAN: Why did the number of cancer deaths drop in 2003?

Dr. ABELOFF: Well, there are a variety of reasons, extending from the continued decrease in smoking rates to improved screening techniques and improved therapies. This is, this represents initiatives that started many years ago and we're finally beginning to see the fruits of this work.

CONAN: Now, 369 fewer deaths in 2003 as opposed to 2002. Given the number of people who die of cancer every year, it seems like drop in the bucket; you hate to be discouraged...

Dr. ABELOFF: Yes, it is, and in fact, one's got to be very careful in looking these numbers, it's a very small change, as you've said. What is encouraging is that we're actually seeing the death rates from cancer drop in recent years, and with an ever increasingly older population. We will, we were concerned that we would see, even while the death rates decreased, we would see an increase in the total number of cancer deaths. But in fact even a small increase is encouraging. But, as I said, that really doesn't tell the whole story, and is just a indication of what we hope and expect will be better things to come.

CONAN: Nevertheless, you do have that demographic bulge of the baby boom generation moving into, well, a lot of, more opportunity for cancer.

Dr. ABELOFF: That's exactly right. There's no doubt that cancer primarily occurs in the older population. We have, we're going to have dramatic continued growth in the elderly, in this country. And of, we, we're going to be dealing, certainly, with very large numbers of people who have had cancer. We have ten million cancer survivors in this country at the present time, and obviously we would like to, ultimately prevent these diseases, but the ten million cancer survivors does also represent an impressive improvement in the prevention, screening, and treatment of cancer.

CONAN: We're talking with Dr. Martin Abeloff, Director of the Johns Hopkins Kimmel Cancer Center, about the decline in deaths from cancer.

You're listening to TALK OF THE NATION , from NPR News.

And let's get a caller on the line. This is Matt, Matt calling us from Endicott, New York.

MATT (Caller): Hi, thanks for taking my call.

CONAN: Uh huh.

MATT: I was wondering, which cancers have seen the largest decreases and if any have actually increased as well?

Dr. ABELOFF: Well, that, there, the decreases are occurring, for example, in breast cancer, and that is interesting, because it's a result of increased and improved use of mammography and then better therapies at an earlier diagnosis of breast cancer. We're now seeing decreases in lung cancer, and that, that represents the marked improvement in terms of tobacco control in this country.

Something I would point out, smoking and tobacco use is an extraordinarily large part of the cancer problem, and we must remain vigilant about continuing to decrease smoking. We're also seeing, of the somewhat the same order of magnitude, decreases in the death rate from prostate cancer, largely, probably early diagnosis in that case, and from colorectal cancer. In that case, it's a combination of screening and better therapies.

And there's an example where, with appropriate use of screening, we have probably right now the capacity to further decrease the death rate by about 30%, maybe to 40%.

CONAN: What about the other side of the coin though, where cancer is increasing?

Dr. ABELOFF: Sure. For example, we have cancers, we have increasing cancers in certain types of lymphoma. That, at one point we thought might be accounted for by the fact that lymphoma is associated with AIDS, but in fact, that doesn't account for the whole problem. And that's something we have yet to figure out. But, fortunately, there are many effective treatments for lymphoma.

We've also had improved, an increase in the number of brain cancers, and at one point we though, well, perhaps that's due to the increased use of CT scans of the brain and MRI's. But in fact there's something else that's causing that.

And so, at the same time that we see these improvements we obviously do have the other side of the coin. Although I must tell you that, quantitatively, the net gain is looking encouraging.

CONAN: Matt, thanks very much for the call.

MATT: Thank you. I enjoy your show.

CONAN: Oh, thank you very much, Matt.

Broadly speaking, you seem to be talking about earlier detection, better treatment; does lifestyle factor into this?

Dr. ABELOFF: Lifestyle factors in, I think, in a significant way. It really is a challenge to scientifically quantitate that. But certainly, we, there is evidence that certainly exercise and nutrition, and, those are two of the main things. Of course, personal habits such as smoking and excessive use of alcohol also factor in.

And, actually it's my belief that in the long term, it will be a combination as you point out, Neal, of the improved pre-screening and treatment, with lifestyle changes and better health habits that will make the real difference.

CONAN: So do you see this as a significant milestone, that for the first time in 70 years, death rates are going down?

Dr. ABELOFF: I, yes, I...again, I don't look upon it as, in itself, as a dramatic event; I look upon it as part of a trend. And I must say I think at times the, and I understand the public hears of dramatic events and then they hear of friends and neighbors dying of cancer, I think what we're seeing is incremental progress.

I think with the, this age of tremendous discoveries in the understanding of the molecular causes of cancer, we will see continued improvements. But frequently they will be incremental and by themselves will not be highly dramatic.

CONAN: Dr. Abeloff, thanks for being with us today.

Dr. ABELOFF: My pleasure.

CONAN: Martin Abeloff, Director of the Johns Hopkins Kimmel Cancer Center joined us from his office in Baltimore, in Maryland.

Ira Flatow will be here tomorrow with TALK OF THE NATION SCIENCE FRIDAY. We'll see you Monday.

I'm Neal Conan. This is TALK OF THE NATION, from NPR News.

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