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Cancer Prevention Payoff

For the first time, improvement is seen in a key statistic

November 17, 1996

A study released last week by physicians at the University of Alabama shows that improved prevention programs and lifestyle changes have lowered America's age-adjusted cancer death rate for the first time since the start of record keeping.

The actual decrease is small. In1990, cancer caused 24% of the deaths in the United States; now the figure is 23%. The overall cancer death rate is actually increasing because the population is aging and cancer tends to be a disease of old age. But researchers say the decline in age-adjusted mortality rates is accelerating and will continue to do so because, as Dr. Philip Cole of the Alabama team put it, "We are just beginning to see the effects of long-term reductions in smoking and of reduced exposure to other lifestyle carcinogens, such as alcohol and solar radiation."

This advance could be bolstered if promising new animal research proves to be applicable to humans. Last month, researchers at Peregrine Pharmaceuticals in Princeton, N.J., announced that they had developed a drug that cured 70% of cancers in mice and guinea pigs that otherwise would have been fatal. Injected into the bloodstream, the drug tracks down a molecule that tumors secrete to instruct nearby blood vessels to feed them, then the drug kills the tumor by blocking these vessels.

The fight against cancer could be pressed on other fronts as well:

* Programs to prevent and treat cancer must better reach all groups. While the overall cancer mortality rate has declined more quickly for African Americans than for whites since 1991, for instance, overall death rates are still about 40% higher in black men than in white men, according to the National Cancer Institute.

* The managed care industry touts preventive services as one of its main advantages, but a June study of California's largest managed care plans showed major differences in the quality of their preventive care, particularly their offering of regular breast and cervical cancer screenings. Reform in this area could well save lives.

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