According to www.cancercontrol.com, cancers of the breast, prostate, lung, and colon/rectum accounted for more than half of all cancer deaths in the United States in 2003, and lung cancer accounted for more than a quarter of all deaths. In spite of the aging of the population, however, overall mortality rates from cancer have stabilized. This is true in all groups of the U.S. population except black males. The incidence of most cancers is also in decline; only a few have increased.

Why the Change?
In a word, screening. Because some cancers, including those of the breast, colon, cervix and prostate are being detected earlier, they have a higher rate of being cured. Here’s a quick look at how screening has affected some of the most common forms of cancer:

• Breast cancer: annual screening mammograms have made a difference; the mortality rate has declined in white women, but not in black women.
• Colon cancer: screening colonoscopies have had a positive impact on survival through earlier diagnosis and treatment.
• Cervical cancer: the Pap smear has detected and been responsible for increasing the earlier diagnosis and ultimate curability of cervical cancer.
• Prostate cancer: incidence and overall death rates have been declining, likely due to screening with prostatic specific antigen (PSA).

Unfortunately, there is no good screening test for lung cancer. For these patients, the treatments are curative only in the earliest cases. Screening high-risk people—such as heavy smokers—is beneficial in the early detection of lung cancer. However, the screening test is expensive and is not presently the formal recommendation of the national societies. Despite this, the incidence and mortality from lung cancer has improved overall.

Cancers in Decline
The following cancers are in decline, thanks to advances in treatments and greater awareness.

• Head and neck
• Uterus
• Ovary
• Thyroid
• Testis
• Vagina

Cancers to Watch Out For

• Esophagus: death rates may be increasing for adenocarcinoma.
• Stomach: death rates may be increasing.
• Lymphoma: decreasing death rates in whites, but increasing in blacks. Likely related to treatment.
• Lung cancer: decreasing death rates in whites but not in blacks. Due primarily to a decline in smoking. Some extent due to treatment-related issues.

Staying on Top of Your Cancer Risk
Although genetic factors play a role in cancer, there are steps that you can take to reduce your risk. If you are at a higher risk because you have a family history of certain cancers, you may benefit from genetic testing. Adopt a healthy lifestyle by eating a diet rich in vegetables, fruit, beans and legumes, and incorporating some form of daily physical activity into your life. And get screened -- early cancer detection increases the cure rate for many cancers.