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A midpoint assessment of the American Cancer Society's ambitious goal to cut cancer incidence by one-fourth by 2015 finds overall cancer incidence rates were eight percent lower in 2004 than they were in 1992. Despite those gains, the authors of the report say the rate of reduction over the first half of the challenge period was only about half the size necessary to reach the challenge goal, and that new understandings of preventable factors and new efforts are needed, particularly in the areas of tobacco control and obesity, to increase progress. The report is published in the November/December issue of CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society.

In 1998, the volunteer Board of Directors of the American Cancer Society set an ambitious challenge goal for the United States to reduce cancer incidence rates by 25 percent between 1992 and 2015. The new report is an analysis of progress toward that goal through 2004, the midpoint of the challenge period. It shows that incidence rates have been dropping 0.6 percent per year since 1992, the year cancer incidence peaked in the U.S. The greatest declines have occurred among men and among those aged 65 years and older. Although decreasing trends were similar by race, incidence rates continue to be higher among African Americans than among Whites.

The report finds while declining trends have been observed for some cancer sites, others have remained constant or increased over the 12-year period. Drops in incidence were seen for cancers of the prostate, lung (men), colorectum, ovary, oral cavity, stomach, and cervix. A marked decline for invasive breast cancer in women began in 1999, while incidence rates for lung cancer in women have stabilized in recent years. For several sites, no appreciable downturn has been seen: multiple myeloma, non-Hodgkin lymphoma, leukemia, and cancers of the corpus uteri, bladder, pancreas, and brain. Cancer incidence rates have increased for melanoma and cancers of the kidney, liver, thyroid, and esophagus.

The authors say historical declines in the use of tobacco and recent declines in the use of certain hormone therapies have contributed to incidence reductions in several cancer sites and will likely result in steeper declines in the decade to come. However, say the authors, these favorable changes are somewhat offset by the increasing prevalence of obesity, which contributes to higher risk for many types of cancers.

"If we want to increase the progress we're seeing, we will need not only new understandings of the factors that can lower the risk of getting cancer, but also stronger efforts to act on what we already know about cancer prevention," said Tim Byers, MD of the University of Colorado School of Medicine, a member of the Society's Incidence and Mortality Committee and co-author of the report. "In particular, we need to continue to reduce tobacco use and start reversing the epidemic of obesity."

Also in this issue: Clean indoor air laws creating completely smoke-free environments are rapidly spreading throughout the world and are low-cost, safe, and effective, according to a comprehensive review. The report, by Michael Eriksen, ScD, of the Georgia State University Institute of Public Health and Frank Chaloupka, Ph.D., of the University of Illinois Health Policy Center and Department of Economics, reviews clean indoor air laws' effect on public health and the economic impact of their implementation. It concludes that clean indoor air laws protect nonsmokers from involuntary exposure to secondhand smoke, contribute to a reduction in overall cigarette consumption, protect hospitality workers from adverse respiratory conditions, and are well accepted by the general public. Contrary to the fears raised by the tobacco industry and others, comprehensive reviews of research on the economic impact of smoke-free air policies from the Surgeon General, the Task Force on Community Preventive Services, and others consistently conclude that these policies do not have a negative economic impact. The authors say it is likely that clean indoor air laws will continue to spread throughout the United States and around the globe, where smoke-free environments will be the norm and smoking in indoor public areas will be the rare exception. Future progress can be expected in creating smoke-free environments in homes, multifamily dwellings, cars in which children are riding, and outdoor public venues.

Article: "A Midpoint Assessment of the American Cancer Society Challenge Goal to Decrease Cancer Incidence by 25% Between 1992 and 2015," RL Sedjo, T Byers, E Barrera, C Cohen, ETH Fontham, LA Newman, CD Runowicz, AG Thorson, MJ Thun, E Ward, RC Wender, H J Eyre, CA Cancer J Clin 2007;57:326-340.

Article: "The Economic Impact of Clean Indoor Air Laws," M Eriksen, F Chaloupka, CA Cancer J Clin 2007;57:367-378.

The American Cancer Society is dedicated to eliminating cancer as a major health problem by saving lives, diminishing suffering and preventing cancer through research, education, advocacy and service. Founded in 1913 and with national headquarters in Atlanta, the Society has 13 regional Divisions and local offices in 3,400 communities, involving millions of volunteers across the United States. For more information anytime, call toll free 1-800-ACS-2345 or visit http://www.cancer.org/.

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SOURCE: American Cancer Society