Deaths from cancer down - again

~ Missouri continues trend of declining cancer death rates, especially for its senior citizens.

ATLANTA -- The tide has turned in the nation's battle against cancer.

Cancer deaths in the United States dropped for the second year in a row, health officials reported Wednesday, confirming that the trend is real and becoming more pronounced, too. In Missouri, while total deaths fluctuate year to year, the number of cancer deaths per 100,000 residents fell or remained steady for each of the last seven years of available data.

The declining death rate from cancer is even more pronounced among people over 45, said Margaret Tyler, a research analyst at the Missouri Department of Health and Senior Services. "We have treatment that is holding down the number of deaths," Tyler said. "We are not so much curing cancer, but making it a chronic disease you manage, allowing people to live longer with cancer and with some quality of life."

Cancer remains the leading cause of death in Missouri for people between the ages of 45 and 74, Tyler said. For people older than 74, cancer ranks just below heart disease as the leading cause of death, she said.

News that total deaths from cancer nationally is falling was cause for celebration among doctors and politicians.

"It's very exciting," said Dr. Felice Schnoll-Sussman, a cancer physician at New York-Presbyterian Hospital/Weill Cornell Medical Center. "When we saw the first decline, the number wasn't that enormous. But once you start to see a trend like this, it obviously makes you feel like 'We must be doing something right!'"

Cancer deaths in the United States in 2004 fell to 553,888 -- a drop-off of 3,014 deaths, or 0.5 percent, from the year before, according to a review of U.S. death certificates conducted by the National Center for Health Statistics and released by the American Cancer Society.

Cancer deaths also fell in 2003, the first drop seen since 1930. But that decline was so small -- just 369 deaths -- that experts were hesitant at the time to say whether it was a triumph of medicine or just a statistical fluke.

Now, it appears "it's not only continuing; the decrease in the second year is much larger," said Ahmedin Jemal, an American Cancer Society researcher.

Cancer deaths in Missouri totaled 12,295 in 2003, up 31 from the year before. Deaths climbed again in 2004, to 12,429, before falling to 12,381 in 2005. But the death rate, the number of deaths per 100,000 people, has been on a downward trend for several years, according to health department statistics.

In Missouri overall, the death rate from cancer fell from 207.8 per 100,000 people in 1999 to 197.8 in 2005. The rate for people aged 45 to 54 saw a similar decline, but the improvement was far more pronounced for people aged 55 to 74. For those aged 55 to 64, the rate fell from 400.4 per 100,000 in 1999 to 356.9 in 2005; for those 65 to 74, the rate declined from 880.8 deaths per 100,000 in 1999 to 798.1 in 2005.

In the four-county region of Cape Girardeau, Bollinger, Perry and Scott counties, the trend is less clear, with rates fluctuating year to year. The death rate in the four counties is, however, generally slightly lower than the state as a whole.

"The numbers are too small to calculate very reliable rates," Tyler said.

For more than a decade, health statisticians charted annual drops of about 1 percent in the cancer death rate -- that is, the number of deaths per 100,000 people. But the actual number of cancer deaths still rose each year because of the growing elderly population and the size of the population overall.

Then, in 2003 and 2004, the cancer death rate declined by about 2 percent each year, more than offsetting the effects of aging and population growth.

Experts are attributing the success to declines in smoking and to earlier detection and more effective treatment of tumors. Those have caused a fall in the death rates for breast, prostate and colorectal cancer -- three of the most common cancers. The lung cancer death rate in men has also been falling, but the female rate has reached a plateau.

The largest drop in deaths among the major cancers was in colorectal cancer. Colorectal cancer deaths dropped by 1,110 in men and by 1,094 in women. Experts said much of the credit goes to screening exams such as colonoscopies that detect polyps and allow doctors to remove them before they turn cancerous.

Increased insurance coverage of colonoscopies has also led to more diagnostic screenings, said Dr. A. Mark Fendrick, the University of Michigan physician who led that study.

The American Cancer Society said it believes cancer deaths will continue to drop.

Staff writer Rudi Keller contributed to this report.