Liver cancer
seems to be on the rise, a blip of bad news in the
nation's otherwise optimistic annual report on
cancer that shows survival continuing to improve.
Overall, Americans' death rates from cancer have
dropped 1.1% a year since 1993, a trend that continued in
2002--the most recent year for which figures
are available--researchers reported Tuesday
in the Journal of the National Cancer Institute.
Rates of new
cases are holding steady for men. But a small but stubborn
increase in female diagnoses continues--0.3% a year
since 1987--fueled mostly by steadily rising
rates of breast and thyroid cancer, melanoma, and
lymphoma.
Surprisingly,
another fairly rare malignancy is becoming more common:
liver cancer. The report found annual increases of 3% among
white men, 4.5% among African-American men, 3.7% among
white women, and 5% among Latina women. It's
not clear what's spurring the rise; one factor may be
hepatitis infections.
"It's a concern worldwide," said Brenda
Edwards of the NCI, who cowrote the report with
scientists from the Centers for Disease Control and
Prevention, the American Cancer Society, and the North
American Association of Central Cancer Registries.
Another concern
is ensuring that patients receive care based on the
latest expert guidelines. The report shows growing numbers
of patients do, which is considered a significant
reason why deaths are dropping. But there are gaps,
including:
More breast
cancer patients are getting just the tumor removed instead
of the entire breast, but a significant number skip
the follow-up radiation recommended to kill any
leftover cancer cells.
Patients 65 or
older are less likely to receive recommended chemotherapy
after surgery for advanced colorectal cancer.
Only 34% of
female Medicare beneficiaries had their ovarian cancer
removed by a gynecologist-oncologist, a specialist
considered to have better outcomes than more general
surgeons.
While there is a
dispute over what is the most appropriate prostate
cancer treatment, in general African-American men receive
less aggressive care than white men. (AP)