Cancer groups stress care for older patients

The need for improved cancer care for an aging population looms ahead, according to latest data analysis published by federal agencies and the cancer society.

By Susan J. Landers, amednews staff. June 10, 2002.

Washington -- Although death rates for all cancers are declining in the United States, the number of cases of cancer should be on the upswing shortly as the baby boomers move through their mid-50s and beyond, according to a new report.

The single most important risk factor for cancer is age, noted the authors of the "Annual Report to the Nation on the Status of Cancer, 1973-1999, Featuring Implications of Age and Aging on the U.S. Cancer Burden." Because the U.S. population is growing and aging, the number of people diagnosed with cancer will increase even if rates of cancer remain constant.

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These factors are expected to lead to a doubling of the incidence of cancer from about 1.3 million cases currently to 2.6 million by 2050.

"The continuing decline in the rate of cancer deaths once again affirms the progress we've made against cancer, but the report also highlights the need for an acceleration of research as the population of the United States ages," said National Cancer Institute Director Andrew C. von Eschenbach, MD.

The predicted increase in the number of people with cancer led researchers to point to a growing need for trained cancer care professionals. Special considerations in treating cancer in older people will require that more attention be paid to existing co-morbidities and the physical limitations of the older population, researchers said.

The report was compiled by researchers at the NCI, the American Cancer Society, the North American Assn. of Central Cancer Registries, the National Institute on Aging and the Centers for Disease Control and Prevention. It was published in the May 15 issue of the journal Cancer.

Lung cancer remains the leading cause of U.S. cancer deaths.

Although lung cancer rates decreased during the 1990s, it is still the leading cause of cancer death in the United States, said Brenda K. Edwards, PhD, of the NCI's Surveillance Research Program and an author of the report. Lung cancer accounts for almost one-third of cancer deaths in men and one-fourth of cancer deaths in women.

Colorectal cancer is the second leading cause of cancer death, followed by breast and prostate cancer. Together the four cancers represent more than half of all cancer cases.

Researchers drew on data that were collected for varying time periods in reaching their findings. They used the period from 1995 to 1999 to represent the most recent cross-section of available data for the current cancer burden. The period from 1973 to 1999 was chosen to represent the best perspective on long-term trends in cancer rates and the years 1990 to 1998 were selected to represent the most recent survival rates.

They found that cancer death rates declined across all age groups by slightly more than 1% per year between 1993 and 1999 and almost 6% for the period 1990 to 1999.

The decrease in death rate during the later period was greatest for those younger than 65.

Mortality rates are based on causes of death reported by physicians on death certificates that are consolidated into a national database by the National Center for Health Statistics.

Lung cancer causes a third of male cancer deaths and a fourth of female cancer deaths.

The first annual cancer report, issued four years ago, had registered the first decline in cancer deaths since the 1930s, when records were kept for the entire country. The current report continues that trend.

The researchers also described cancer incidence and death rates for whites, blacks, Asian and Pacific Islanders, American Indians/Alaska Natives and Hispanics. During 1995 to 1999, black men were found to generally have the highest incidence and death rates from cancer.

Researchers note that they calculated results for this year's report using the more up-to-date 2000 population standard used by other federal agencies. Reports made for the previous four years had used a 1970 population standard.

Cancer rates age-adjusted to the 2000 standard will be higher because there are more older people alive today than there were in 1970. Comparisons between last year's report and this year's will not be valid because of this difference, they note.

ADDITIONAL INFORMATION:

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Q&A concerning "Annual Report to the Nation on the Status of Cancer, 1973-1999, Featuring Implications of Age and Aging on the U.S. Cancer Burden," National Cancer Institute (http://newscenter.cancer.gov/pressreleases/2002reportq&a.html)