Cancer: Up or Down?
At the American Cancer Society's annual meeting in Manhattan last week,Statistician E. Cuyler Hammond posed a question: "Are we batting ourheads against a stone wall—an insurmountable barrier?" On the basis ofcrude figures he reported: "We are faced with a frustrating fact. Tenshort years ago, 177,000 Americans died of cancer. This year it isestimated that 243,000 Americans will die of this disease."
Statistician Hammond was quick to point out that a lotof cancer figures can be misleading. Up to 1930, some of the apparentincrease was due to improvements in diagnosis and in the reportingsystem. Since 1930, the overall cancer death rate among males has risenfrom 115 to 146 per 100,000 in a year, but this is due almost entirelyto the explosive increase in lung cancer; in other forms of cancer therate is virtually unchanged. Among women, the cancer death rate hasactually decreased, from 141 in 1930 to 133 in 1950.
Since cancer is mainly a disease of the second half of life , Hammond made no bones about thegrowing problem: "In 1900 there were only 23 million Americans 35 yearsof age and over. Today there are 70 million. [In 1965] there will be 81million, and [in 1975] at least 86 million. Thus no matter howsuccessful the [cancer control] program may be, the magnitude of theproblem will increase. If death rates continue at exactly the presentlevel, the annual cancer death toll will rise to 288,000 within tenyears.
What is worse, if lung-cancer death rates increase at the present tempo,306,000 Americans will die of cancer in 1965. Can we prevent this fromcoming true?"
Statistician Hammond hopefully answered his own question: "One-third ofall those who die of cancer could be saved by methods known to us now."If this is accomplished in the next ten years and lung cancer iscontrolled, only 173,000 will die in 1965. But, said Hammond, there isa big if: these lives can be saved only if physicians apply presentknowledge with maximum effectiveness. And what doctors can do dependsbasically on what cancer victims do—how soon they go for examinationswhen they have suspicious symptoms, how soon they have an operationafter it is recommended, and what kind of operation they agree to.
Other cancer facts and figures discussed at the meeting:
¶Cancer of the cervix is now curable in 75% of cases when treated promptly after the first symptoms appear, but the actualcure rate now is closer to 40% because too many women ignore the earlydanger signals.
¶Cancer of the rectum is 70% curable, 20% cured; ofthe larynx, 80% and 15%; of the mouth, 65% and 30%.¶Breast cancer,the commonest form among Western women,*has been the subject of themost intensive danger signal and self-examination campaigns. It isalso a cause of disagreement among doctors trying to judge the value ofsurgery in some types of cases. In particular, the effectiveness of themost radical operation for advanced breast cancer cannot yet be gaugedbecause it is too new—doctors will not speak of cures until patientshave survived at least five years. But analysis of thousands of casesshows that if breast cancer is operated on before the disease hasspread to the armpit, the chance of cure is twice that in lateroperations. Experts put the figure at 70%; in some medical centers itis higher still. ¶Lung cancer is the runaway villain. New York State has about the world's best-kept records on it,reports that in 20 years the rate has zoomed 505% in men, 55% in women.Among men, this was the only cancer rate to go up, and the increase wasenough to boost the overall male cancer rate by 21%. Among women theoverall rate dropped 16%. Connecticut reports that five-year cures ofall cancers increased by about two-thirds in 15 years. The 1950 rates:20% among men, 32% among women. Today's U.S. cure rates are estimatedat 25% to 30%.
*Though less so, apparently, among those who nurse theirbabies.
Next:The Second Revolution
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