What’s Behind the Drop in Cancer Rates?

Despite dramatically drop, cancer rates are on the rise for certain groups of people. One of the culprits? Obesity

By Deborah Jeanne Sergeant

Kohman
Kohman

The rate of cancer mortality has decreased by about 25 percent for many types of cancer over the past two decades, according to the American Cancer Society.

Today, fewer die from lung, breast, prostate and colorectal cancer.

Unfortunately, not all types of cancer have experienced a decrease in that timeframe.

Physician Leslie Kohman, board chairwoman of the American Cancer Society for Upstate New York and professor of surgery and director of outreach at Upstate Cancer Center, said that the cancer death rate is increasing for liver cancer, endometrial cancer, brain cancer and head/neck cancers.

She said said that socio-economic status plays a role in the disparity of cancer survival rates.

“The death rate in the poorest New York county is far greater than in the wealthiest,” she said. “Everyone should have health insurance but they don’t. Not everyone has equal access to transportation. Poverty is a barrier to medical treatment and screening.”

To address these issues, her organization takes an approach of bringing greater availability to health care, including mobile mammography vans, community outreach, and community education.

“Almost half the cancers can be prevented by what we know now,” Kohman said.

One of the biggest pushes from health care providers for the past 20 years has been tobacco cessation, according to physician Jonathan Friedberg, director of Wilmot Cancer Institute and a lymphoma specialist.

Friedberg said that tobacco use contributes to “many, many cancers,” including bladder cancer and head and neck cancers.

For many years, smoking rates have decreased, which has reduced rates for many types of cancers. Occupational exposure harmful to lungs, such as applying pesticides on farms, handling asbestos in construction and welding, has also decreased, thanks to more safety standards and material regulations.

Friedberg points to improved screening as a big factor for detecting cancer earlier and more curable, such as mammograms, in some cases, pre-cancerous lesions, such as colon cancer and cervical cancer screenings.

From 1989 to 2015, breast cancer deaths decreased 39 percent from 1989 to 2015 and colorectal cancer went down 52 percent between 1970 and 2015.

Friedberg predicts that HPV vaccine should eventually eliminate cervical cancer “for a whole generation” once providers reach complete compliance among patients.

Improved screening rates and availability for screening represents a big factor for detecting cancer earlier and more curable, such as mammograms, in some cases, pre-cancerous lesions, such as colon cancer and cervical cancer screenings.

The American Cancer Society suggests that obesity-related cancers such as colorectal, pancreas, uterine, kidney, and gallbladder cancers are increasing in people aged 25 to 49 and that the youngest adults, age 25 to 29, are seeing the biggest rise in obesity-related cancers.

It’s uncertain whether it’s obesity itself or causes of obesity — such as poor diet, stress and sedentary lifestyle contribute to cancer.

Friedberg said that an estimated 15 percent of cancers are related to obesity.

“Obesity is a risk for developing cancer, and once you have cancer, treatment is more complicated for those who are obese,” he said.

Rachel David, a hematologist and oncologist with Rochester Regional Health, echoed that thought.

“These obesity-related cancers are actually increasing in some age groups,” she said.

To sum it up, Kohman said that avoiding tobacco, sun exposure and obesity, and minimizing alcohol and red meat, especially cured and processed meat, can greatly reduce cancer incidences. Mothers should breastfeed as long as possible to protect both mom and baby. Discuss screenings with a healthcare provider.

Each New York county is part of the Cancer Services Partnership, which covers screening for colorectal, cervical, and breast cancer for those who are uninsured.

“Everyone can reduce their own risk of developing cancer,” Kohman said. “The good news is if you develop cancer now, your chance is much better than 25 years ago.”

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