Is cancer on the rise? What does the National Cancer Institute (NCI) say?

Overall, cancer incidence among Americans is increasing about 1% per year, year after year and cancer deaths are increasing, but less rapidly.

To be precise, since 1950 the average annual increase in cancer incidence (the number of new cancers occurring each year, per 100,000 population) has been about 0.8% per year, and for mortality (the total number of cancer deaths each year, per 100,000 people) the increase has been about about 0.2% per year. Thus the overall general trend is worsening. Within this trend, a few cancer rates are improving while many others are worsening.

In a few cases, both the incidence and the death rates are improving. These are the good news. In this category we find cancers of the stomach, rectum, and cervix. NCI says stomach cancer is improving for unknown reasons, perhaps mainly related to improved diet. NCI doesn't speculate why rectal cancer is decreasing. Early detection and treatment of pre-cancerous conditions, through use of the pap smear test, seems to account for reduction in cervical cancers.

Among some cancers, the incidence is worsening but the death rate is improving. This is true of seven bad news cancers: colon (lower intestine), larynx ("voice box"), testis, ovaries, urinary bladder, Hodgkin's disease (a fatal enlargement of the lymph nodes, spleen and general lymphatic tissue), and childhood cancers. The National Cancer Institute gives the impression that they are pleased by the general direction of these cancers because they view this as a medical triumph over a worsening situation: more people are getting these cancers each year, yet more are being saved through surgery and to some extent by radiation therapy and chemotherapy. However, if you look at these cancers in light of actual human experience --what it's like to live through these diseases -the picture is bleak and darkening. Anyone who has survived cancer surgery, radiation therapy or chemotherapy can only look at the increasing incidence of these cancers as a medical failure. It's nice to be alive as a result of brutal and extreme treatment by medical practitioners, but prevention would be ever so much nicer. Friends and families of the stricken would agree.

Then there are seven cancers for which both incidence and death rates are increasing: these are the grimmest news. Here we find cancer of the lung, skin, female breast, prostate gland, kidney, non-Hodgkin's lymphomas (cancers of the lymph glands), and leukemia (cancer of the blood-forming cells).

The optimistic view is that cancer increases are really caused by better detection of the disease. Unfortunately, this is not true. The NCI's lengthy report (cited below) from which we gathered all our statistics does not offer this as an explanation for the increases in cancer incidence. You can be sure if the NCI had a shred of evidence that better diagnostic techniques were responsible for creating a false impression that cancer incidence is increasing, the NCI would be the first to say so. Unfortunately the increase in cancer incidence is real.

Table 1 summarizes the data on cancer. Overall, we can see that, even when we exclude lung cancer, there has been a 22.6% increase in the incidence rate for all other cancers in this country during the past 35 years. A larger percentage of people are surviving these diseases, on average, but at tremendous expense in money and pain and disfigurement. Their lives and the lives of those who love them are shattered, in many cases for a very long time. It is no cause for celebration of self-congratulation by the medical community.

"Cancer prevention is the direction that national medical programs must take: this will require a shift in emphasis for the medical and research communities. Can we count on the doctors to urge the necessary shift? Unfortunately the plain fact is, there are enormous sums of money to be made in cancer diagnosis and therapy, but little or none for those who would prevent cancer. It seems that the impetus to shift our national medical/research priorities toward prevention will have to come from outside the medical community itself."

Get: National Cancer Institute, 1987 ANNUAL CANCER STATISTICS REVIEW INCLUDING CANCER TRENDS: 1950-1985 [National Institutes of Health Publication No. 88-2789] (Bethesda, MD: National Cancer Institute, 1988). A fat, optimistic volume available free from: Karen Smigel, Office of Cancer Communications, National Cancer Institute, 9000 Rockville Pike, Building 31, Room 10A19, Bethesda, MD 20892. Phone (301) 496-6641.

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Descriptor terms: cancers; statistics; tables; nci;