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Cancer study finds declines, complexities and good news on data

WASHINGTON - The nation's vanguard organizations against cancer released a study Oct. 15 that found the cancer death rate has declined by almost twice the previous rate in the general U.S. population, while cancer incidence among all races and both sexes declined slightly.

Cancer incidence rates refer to newly diagnosed cancer. A special section of the report examined the most full and accurate cancer data ever compiled for American Indians and Alaska Natives, and the key finding here was that cancer incidence varies regionally and by cancer type. Although Native cancer incidence rates were higher for cancers of the stomach, liver, kidney, gallbladder and cervix, the incidence rate for all cancers is lower than for non-Hispanic whites from 1999 to 2004.

For the nation as a whole, said John R. Seffrin, Ph.D., CEO of the American Cancer Society, ''The evidence is unmistakable: we are truly turning the tide in the cancer battle. The gains could be even greater if everyone in the U.S. had access to essential health care, including primary care and prevention services.''

The report's findings are also good for Indian country, said Judith Salmon Kaur, a professor of oncology and director of Native American programs at the Mayo Clinic in Minnesota. Nationally and for Native people, she said, ''I think the nugget is that screening really can make a difference. ... I'd rather prevent cancer than have people coming to me for radiation, chemotherapy, operations. ... We're not there yet, but we can be doing a lot more to prevent cancer.''

The variety in regional rates - with lung and kidney cancer showing a higher incidence in the northern and southern Plains, Alaska and urban areas than in the Southwest, where cigarette smoking is more constrained - in effect targets the higher-incidence regions for anti-smoking intervention, she said. The same holds true for many of the cancers that vary in regional incidence.

Kaur added that the study has delivered Indian country from flawed data. ''The rates looked better than they were. ... Most cancer is treated off the reservation.'' She explained that previously, unless American Indians and Alaska Natives self-identified during off-reservation treatment, they were not counted for purposes of establishing incidence rates. But the ''Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives,'' reflects solid data gathered through the combined efforts of the Centers for Disease Control and Prevention, the American Cancer Society, National Cancer Institute, North American Association of Central Cancer Registries and the IHS. The National Institutes of Health, a division of the Department of Health and Human Services, issued the report.

Kaur said that in light of the improved data, funding requests can be made with more authority, and funding decisions with more confidence.

Free information on cancer can be obtained by calling (800) 4CANCER, according to James Alexander of the National Cancer Institute's Office of Communications and Education. The report appears online at www.interscience.wiley.com/cancer/report2007. A Native-specific question-and-answer document is also available at http://cancer.gov/newscenter/pressreleases/ReportNation2007QandA.