Progress Report 3

The view of Bailar and colleagues was not as negative as that held by a small segment of the public, especially those who are more favorably disposed to the use of "natural" remedies. Their view is that there is a conspiracy among researchers and the pharmaceutical industry to suppress a cure for cancer because it is a lucrative business. Cancer treatments are expensive for patients but rewarding for those who devote their careers or their investments to cancer treatment. In their view, there is no incentive to find a real cure. This is not a scientific perspective, but the perception should not be ignored.

Finally, Some Good News

In 1998 there was finally some good news about the rate of mortality from cancer, the kind of news that suggested that the War on Cancer is being won. The American Cancer Society, along with NCI, the Centers for Disease Control and Prevention, and the National Center for Health Statistics (NCHS), released a report card to the nation (Wingo et al., 1998) indicating that for the period from 1990 to 1995 death rates from cancer for all sites of cancer combined decreased 0.5 percent per year, after increasing 0.4 percent per year between 1973 and 1990. This was a significant change in direction. The declines per year for all sites of cancer combined were significant among African Americans (-0.8 percent), whites (-0.4 percent), and Hispanics (-0.6 percent). For Asians and Pacific Islanders the death rates from cancer for all sites combined were not changed because the rate increased for females and decreased for males. Cancer remains the leading cause of death among women of Asian and Pacific Islander decent; this is not the case among any other ethnic or gender group. Among males, the rate of mortality from prostate cancer increased 1.6 percent per year during the same period. Among white and African-American females, rates of lung cancer increased 1.7 and 1.0 percent per year, respectively (Wingo et al., 1998).

These data would be even more impressive if the reasons for the declines were understood. In the case of lung cancer the decrease is clearly related to the smoking rate reductions that have taken place over the past 30 years, suggesting the effectiveness of previous cancer control programs. The reasons for the decrease in the rate of mortality from prostate cancer remain unclear. The decline in the rate of mortality from breast cancer among white females is most likely due to the increased use of mammography, but there was no decrease in the rate of mortality from breast cancer among black females, despite the increased use of mammography by that



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