Lung Cancer Deaths in Women Decline

June 17, 2011— -- Nationally, deaths from cancer are continuing to decline -- but the big news in this year's report from the American Cancer Society was first decline in lung cancer deaths in women in recorded history, falling nearly 1 percent every year from 2003 through 2007.

But as impressive as that decline was, not all sectors of society are seeing similar benefits.

Those whose education stopped at high school graduation or before faced a cancer death rate 2.6-fold higher than that of the most educated in society, Dr. Ahmedin Jemal of the ACS in Atlanta and colleagues reported online in CA: A Cancer Journal for Clinicians.

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For men, the cancer death rate was 147.85 per 100,000 with no more than a high school education compared with just 55.92 per 100,000 among those who spent at least four years in college, for a relative risk of 2.64 between them.

For women, the rate was 119.38 per 100,000 with 12 or fewer years of education compared with 59.13 per 100,000 with 16 or more years of schooling.

The disparity was most pronounced for lung cancer, which showed almost a five-fold difference in men and nearly a four-fold difference in women between the least and most educated.

Eliminating socioeconomic and racial disparities could have prevented about 37 percent of the premature cancer deaths among 25- to 64-year olds in 2007 alone, saving an estimated 60,370 lives.

Incidence of cancer overall appeared stable in men in the most recent time period from 2005 to 2007, but cancers declined in women at a rate of -0.6 percent annually since 1998.

Incidence declined for all four major cancer sites -- breast, lung and bronchus, prostate and colorectum -- including a significant decline in lung cancer among women in the most recent SEER 13 data at -0.3 percent per year from 2003 through 2007.

"This decline in women is not surprising and we have been awaiting it for quite some time," Dr. Gregory Kalemkerian noted in an email to MedPage Today and ABC News.

The lung cancer incidence had been at a plateau for the past decade or so among women trailing a decline in smoking rates, explained Kalemkerian, who serves as co-director of thoracic oncology at the University of Michigan in Ann Arbor.

Declines in breast cancer likely reflect reduced use of postmenopausal hormone therapy while rapidly falling colorectal cancer incidence in recent years can be chalked up to removal of screen-detected precancerous polyps, Jemal's group suggested.

"Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population with an emphasis on those groups in the lowest socioeconomic bracket," the report said.

Overall the cancer death rate decreased by 1.9 percent per year from 2001 through 2007 in men and by 1.5 percent in women from 2002 through 2007, but education as a marker of socioeconomic status showed a stark divide.

The researchers used incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics to calculate the statistics for 2011.

Based on those figures, they projected a total of 1,596,670 new cancer cases and 571,950 deaths from cancer nationwide in 2011.

Overall cancer death rates have been dropping since the early 1990s and continued to do so in all groups except American Indian and Alaska Native women, who had stable rates.

This trend translated to 898,000 deaths from cancer avoided since 1990 in men and 1991 in women, the reported noted.