JUDY WOODRUFF: Finally tonight, a Health Unit look at what’s behind a drop in the occurrence of cancer in the United States.
Death rates from many kinds of cancer have been declining here since the ’90s. It is the second-leading killer in the United States, responsible for roughly 560,000 deaths annually. Roughly 1.4 million new cases are diagnosed each year.
But now the latest annual report on cancer statistics finds a drop in newly diagnosed cases, as well, the first time that’s happened since the government began tracking it.
The drop was small — about 0.8 percent annually between 1999 and 2005 — but researchers are trying to understand what accounts for it.
For more, we turn to Dr. Larry Norton. He is a deputy physician in chief at Memorial Sloan-Kettering Cancer Center.
Dr. Norton, what has happened to the occurrence of cancer?
DR. LARRY NORTON, Memorial Sloan Kettering Cancer Center: Well, this is very exciting information, clearly. We’re seeing an across-the-board decrease in incidents, if you look at all sites and deaths, are particularly in the major cancers, in men, lung cancer, colorectal cancer, prostate cancer, in women, colorectal cancer, as well, and breast cancer, where there’s been a big change.
Lung cancer, unfortunately, is stable in women. And that’s because we haven’t been as successful in getting women to stop smoking or not start smoking as we have with men.
JUDY WOODRUFF: And, again, this is not all types of cancer that are decreasing in occurrence, right?
DR. LARRY NORTON: Well, across the board, there’s a decrease. There are the cancers that are not being studied as intensively. We’re not seeing as big a change.
We are seeing an increase in some cancers, and that’s of concern: brain cancer, for example, is a concern; thyroid cancer in women; kidney cancer. And that has to be studied, as well.
I think the important part of the story is that where we’ve been able to concentrate our research efforts, we’ve really been able to make a big difference.
And the diseases where we’ve made a big difference is because we have a multi-pronged attack: public education, prevention, diagnosis, therapy. It all comes together as a package. And when we’re able to do that as a package, that’s when we can really make a difference.
Advancement in many areas
JUDY WOODRUFF: Well, explain -- give us an example of that, for example, with women, breast cancer, with men, prostate cancer.
DR. LARRY NORTON: Well, with women, breast cancer, I think, is the clearest example of better public education. Use of mammography has had a huge impact.
In 2002, there was a very big, well-done National Cancer Institute study that showed that hormone replacement therapy in the post-menopausal years actually increased breast cancer. So there was a big drop, about a 50 percent drop in the use of hormone replacement therapy, and that was immediately translated the very next year and years after, in terms of a drop in the incidence of the disease. So that's had a big impact.
But we've also seen a big impact of better therapy for breast cancer, less mutilating surgery, better radiotherapy, and especially better drug therapy, including anti-hormones, better hormone therapy for people with hormone-sensitive disease.
So it's a package. It's not just one thing that makes a difference; it's the total comprehensive package of advances.
The important thing is that it's all based on scientific evidence, on carefully done studies. So it shows that we can make a difference in cancer. Cancer is not always going to be with us. We're going to be able to prevent it. We're going to be able to treat it better.
We just need a bigger push in doing the research and the application of the research to all Americans to really see an even bigger impact.
Early screening is key
JUDY WOODRUFF: Is it known for certain, Dr. Norton, that this reflects a drop in the actual occurrence of new cancer cases? Or could it be in any way reflecting people getting less -- people being -- not getting the screening that they should get, in other words, that it's not getting picked up?
DR. LARRY NORTON: No, it's actually the opposite. Actually, for example, screening for colorectal cancer picks up polyps that are not cancerous, but they're precancerous.
So by taking the polyps out, we can prevent the incidence of the cancer. And we've seen a drop in colorectal cancer in both men and women because of increased use of screening, in fact.
Where you should see more screening, many studies have shown mammographic screening makes a big difference. Right now, it's only about 60 percent of the people who should be getting mammograms are getting them. And if we can get up to 70 percent, or 80 percent, or 90 percent, we'd see an even bigger drop in cancer death rates.
Also, mammography picks up precancerous changes, something called DCIS. And by proper treatment of that disease, we can prevent the occurrence of cancer.
So we know what to do in many areas. We have to do it better. And, of course, we need more research to be able to make even bigger strides.
More research is needed
JUDY WOODRUFF: Well, that touches on the next thing I wanted to ask you, which is, what does this say about what needs to be done going forward? You need to do more of what?
DR. LARRY NORTON: Well, you need two things. I mean, we have to apply the knowledge we currently have to all Americans. We're doing a better and better job, but there still are major health care disparities, and it tracks along with socioeconomics. So that's one thing we have to do.
But we need much more research. Americans spend six times more on soft drinks than all cancer research combined. The whole National Cancer Institute budget is spent every two weeks in Iraq.
So that we've made real strides, but when you compare it to what we could do if we really had an adequate national prioritization to eradicate cancer, well, that's when we'd really see a huge difference.
And we can do it. The important thing here is that cancer can be defeated. We don't have to have cancer in our lives. We know what has to be done: better science, better application of science. And if we do that, we can really see dramatic changes in cancer in our lifetime.
JUDY WOODRUFF: Well, Dr. Larry Norton at Sloan-Kettering, we thank you very much.
DR. LARRY NORTON: Thank you so much for inviting me.