Cancer Mortality Rates Continue To Decline in U.S.; Advances in Prevention, Treatment Not Reaching All American Indians, Alaska Natives, Study Indicates
Cancer death rates among U.S. residents declined by an average of 2.1% annually from 2002 to 2004, in large part because of improved prevention, early detection and treatment; however, American Indians and Alaska Natives in some regions are not benefiting from such advances, according to a report published online on Monday, the New York Times reports. Cancer death rates have been declining by an average of 1.1% annually since 1993, according to the Times.
The report, from cancer groups including the American Cancer Society and the National Cancer Institute, says that compared with the rest of the U.S. population, some American Indians and Alaska Natives have higher rates of preventable cancers and late-stage tumors that could have had a better prognosis with earlier detection. Researchers attributed the higher rates to smoking, poverty, lower education levels and a lack of access to health services and health insurance. Many American Indians and Alaska Natives receive health services through the Indian Health Service, but the facilities usually are not able to treat cancer, according to the Times. Such people might encounter "complicated rules and restrictions" trying to find cancer treatment through outside contractors, the Times reports.
According to Elizabeth Ward, director of cancer surveillance for ACS, the report is the first to look at cancer among American Indians and Alaska Natives by region. According to the report, Alaska and the northern and southern plains had the highest rates of lung cancer, while rates were lower on the Pacific Coast, in the East and in the Southwest. Colorectal cancer incidence was three or more times higher in Alaska and the northern plains than in the Southwest. Alaska had the highest rates of breast cancer.
"Access to care truly is the message. When people have equal access to care, they have equal outcomes," Patricia Ganz, director of cancer prevention and control research at the Jonsson Comprehensive Cancer Center at the University of California-Los Angeles, said.
Ward said, "The concern we have is that much of the progress we've attained in reducing death rates comes from tobacco control, screening and access to timely and high-quality treatment, and those positive effects are not being seen in all populations in the U.S."
Neal Meropol, director of the gastrointestinal cancer program at Fox Chase Center, said, "In spite of improvements, it's still a minority of individuals in our country that undergo screening for colon cancer. If everyone were screened appropriately, these incidence numbers would fall even more dramatically annually" (Grady, New York Times, 10/15).
The report is available online.