Cancer awareness in Warsaw Good news: cancer mortality rates are on the decline, and are estimated to continue declining in the coming year, according to a report published last week in Annals of Oncology. The study used information from the World Health Organization to analyze data from past years and predict cancer deaths in 2012 among men and women in the European Union (EU). The data revealed that overall cancer death rates have fallen ten percent in men and seven percent in women since 2007.

The report predicted that the total number of cancer deaths in the EU in 2012 will be 1,283,101 (717,398 men, 565,703 women), as compared to deaths in 2007 totaling 1,261,134 (706,619 men, 554,515 women). While at first look these numbers appear to be going up, when considered in view of the aging EU population and adjusted accordingly, they actually represent a decrease in cancer mortality rates. The report predicted declines for stomach, leukemias, lung, prostate and colorectal cancers in men, and declines in stomach, leukemias, uterus, colorectum and breast cancers in women. Almost stable rates are predicted for pancreatic cancer, and increases in female lung cancer deaths are projected.

Encouragingly, younger women show the greatest decrease in breast cancer mortality rates in the EU. The breast is still the leading cancer mortality site in women in the EU, but important advancements in breast cancer treatment and management have played a major role in mortality declines. The role of breast cancer screening in this decline is hard to quantify, and analysts explain that better treatment, rather than screening, seems to be the principal driving force behind the lower death rates. Mammographic screening is usually restricted to women between the ages of fifty and seventy in most EU countries, so decreased mortality in younger women is likely due to improved treatment, rather than earlier detection. On a related note, obesity has been identified as a major risk factor for breast cancer, but only after menopause. An increase in overweight and obese Europeans over the last few decades has likely influenced breast cancer incidence trends in women over fifty, and even more so in those over seventy years old. Furthermore, many important breast cancer risk factors, such as menstrual and reproductive factors, physical activity and obesity have not changed favorably, and breast cancer incidence has probably not decreased. In the UK, where breast cancer deaths are higher as compared with other EU countries, great emphasis and financial resources have been placed on increasing the number of oncologists, reducing the length of time patients wait to be seen, and improving the availability of treatments.

Women receiving chemotherapy The reported data and predictions for cancer mortality rates in the EU are relatively on par with the US, which reported a 1.6 percent per year decline in cancer mortality (1.8 in men, 1.1 in women) between 2003 and 2007. The rates estimated for 2012 are also in keeping with those for 2011, lending credibility to the study. The fall in mortality from major cancers in the EU, the study explains, essentially reflects the decline in tobacco smoking in men and continuing progress in cancer prevention, early detection and treatment in both sexes. The report emphasized that estimating current cancer mortality figures is important for defining priorities for prevention, management and treatment.

The European Code Against Cancer had originally set a goal to decrease cancer mortality in the EU by fifteen percent in the fifteen year period between 1985 and 2000, but was shy of its mark, realizing a ten percent decrease in men and eight percent in women during that time. Over the past twelve years, however, the goal has been met with an eighteen percent decline in men and thirteen percent in women.

In view of this report’s data and analysis, it is clear that a greater emphasis must be placed on earlier cancer screening to increase the efficacy of cancer prevention and treatment. The US is on the right track with suggested yearly or biyearly mammograms starting at age forty, ten to twenty years before that suggested in the EU, but more can be done. Early genetic testing for cancer predisposition may be of great value in preempting tumor development and strategizing treatment plans. This testing is already available for several cancers, but may be limited in accessibility by insurance and cost restrictions. Cancer vaccines may also provide a viable option for continuing to decrease cancer mortality rates. A simpler, more obvious solution for decreasing some forms of cancer, as pointed out by the scientists behind the mortality report and has been known for years, is not smoking, eating healthily and staying active.