Death rate for lung cancer among women declines

WASHINGTON - For the first time, women's death rates from lung cancer are dropping, possibly a turning point in the smoking-fueled epidemic.

It's a small decline, says the nation's annual report on cancer - just under 1 percent a year. And lung cancer remains the nation's, and the world's, leading cancer killer. But the long-anticipated drop - coming more than a decade after a similar decline began in U.S. men - is a hopeful sign.

"It looks like we've turned the corner," said Elizabeth Ward of the American Cancer Society, who co-authored Thursday's report. "We think this downward trend is real, and we think it will continue."

Overall, death rates from cancer have been inching down for years, thanks mostly to gains against some leading types - colorectal, breast, prostate and, in men, lung cancer. Preventing cancer is better than treating it, and the country has documented smaller but real declines in new cases as well.

The report shows death rates falling an average of 1.6 percent a year between 2003 and 2007, the latest data available. Rates of new diagnoses declined nearly 1 percent a year, researchers reported in the Journal of the National Cancer Institute.

But progress is mixed, with diagnoses and deaths still on the rise for other cancer types including melanoma, liver, kidney and pancreatic cancer.

Moreover, cancer is primarily a disease of older adults and the population is graying rapidly, a challenge in maintaining the gains.

Lung cancer is expected to kill more than 159,000 Americans this year, nearly 70,500 of them women. So even a small improvement in survival is welcome, and can add up over time, said Ward.

Smoking became rampant among men long before women, and thus men's lung cancer deaths soared first. But in the early 1990s, death rates began dropping among men as older smokers died and fewer younger men took up the habit. Those rates were dropping 3 percent a year between 2005 and 2007, the new report said.

Researchers had long anticipated the same pattern would appear among women, and had been tracking signs that women's death rates had begun inching down for a few years. But only now with a solid five-year trend are they confident that the decline is real, said National Cancer Institute statistician Brenda Edwards, a report co-author.

But Edwards noted that the cigarette industry targeted advertising toward women in late 1960s and '70s, what she calls "the Virginia Slims effect" that boosted smoking among young women at the time. It's possible that those women will temporarily bump up the death count again as they age, she said.

What about new lung cancer diagnoses? There are indications that that rate is dropping, too, but Edwards notes that the smoking rate varies widely geographically.

Perhaps more troubling is that progress at getting men and women to kick the habit has stalled in the past decade.

The news is "encouraging, but we have to be cautious," said Dr. V. Craig Jordan of Georgetown University's Lombardi Comprehensive Cancer Center.

As Congress considers how much money to budget for medical research this year and next, Jordan worried that cutting investments in cancer research and tobacco control could reverse hard-won gains.

"Like all battles, you just let up a little bit and it's all over," he said.

Among the report's other findings:

• Survival of childhood cancer is continuing a decades-long climb, but new diagnoses are continuing to inch upward, too.

• New cases of breast cancer had abruptly dropped in 2002 and 2003, as many women abandoned postmenopausal hormone therapy. That decline has leveled off.

• Prostate cancer marked a small uptick in diagnoses between 2005 and 2007 but not enough to be statistically significant.

• Cancer death rates remain highest among black patients, but those patients also have experienced the largest drop in deaths over the past decade.

• Among men, incidence of melanoma, liver, kidney and pancreatic cancers continues to rise. Women show increases in melanoma, leukemia, kidney, thyroid and pancreatic cancer.

• Deaths continue to rise for melanoma in men, uterine cancer in women and liver and pancreatic cancer in both.

In addition, the report provides the first in-depth look at brain tumors since the nation formally began counting non-cancerous types in 2004. That's important, since even non-malignant brain tumors can require debilitating treatment and can kill.

Brain tumors are far more rare in children than in adults - but the tumors are more likely to be cancerous in children and non-cancerous in adults. The researchers couldn't explain why.

Nearly two-thirds of childhood brain tumors were malignant, compared to a third among adults.

Survival has improved for adults with any type of brain tumor and for children who experience non-cancerous kinds. But the past decade has brought no improvement in death rates for children with brain cancer.