Cancer death rates have declined steadily in the United States over the last 15 years and are expected to do so again this year. Estimated new cases, however, are expected to tick up slightly from 2008 -- because of the increased use of screening, experts say, not necessarily a surge in risk.
Beyond those broad outlines, cancer's portrait is considerably more nuanced, depending on age, race, gender, lifestyle and a host of other factors that vary from person to person.
In its new Cancer Facts & Figures 2009, the American Cancer Society says that an estimated 650,000 deaths have been avoided over the last 15 years because of a decline in overall cancer rates. The 2009 report says that cancer death rates in 2005 compared with those in 1990 in men and in 1991 in women decreased by 19.2% and 11.4%, respectively.
Though men are more likely to be diagnosed with prostate cancer than any other type of cancer and women more likely to be diagnosed with breast cancer, neither is the leading cause of cancer death. For both men and women, the leading cancer killer is lung and bronchial cancer. There is no routine screening considered effective for detecting lung cancer.
The predominant reasons for the decline in deaths to date are increased screening (leading to earlier diagnoses of some cancers and thus a higher cure rate), improved treatments and a reduced incidence of smoking-related cancers in men, says Elizabeth Ward, vice president of surveillance and health policy for the American Cancer Society.
The survival rates have also increased. There are approximately 11 million cancer survivors in the country -- more than three times greater than in 1970, according to the National Cancer Institute. This is mainly due to improved treatments that have increased the overall five-year survival rate from 50% in the mid-1970s to 66% today, the report notes. The survival rate for children's cancers has jumped from less than 50% to 80% over the same time period.
"We can continue to reduce deaths," Ward says. "We can continue to make great progress by encouraging public policy and screening. It is also important to do research because there are still some areas where we have limited tools."
Ward says the growing number of survivors merits more focus on helping them live healthy lifestyles, manage long-term side effects of medications and avoid cancer recurrence.
Cancer Statistics 2009, released in May, is the most recent update on the state of cancer in the United States.
The report estimated that this year:
* 1,479,350 people will be diagnosed with cancer -- 766,130 men and 713,220 women, up from 745,180 and 692,000, respectively, in 2008.
* 562,340 will die of the disease -- 292,540 men, and 269,800 women, down from 294,120 and 271,530 in 2008.
* The disease, almost half of which will be lung, colon, prostate and breast cancers, will kill almost 1,500 a day.
* The most common cancer diagnoses in men will be prostate, lung and colon, with prostate accounting for one-fourth of new cases.
* The most common cancer diagnoses in women will be breast, lung and colon, with breast accounting for about 27% of new cases.
* About one-third of the expected cancer deaths will be linked to behavior-related factors such as obesity, physical inactivity and poor nutrition. There will also be more than 1 million skin cancers diagnosed, many of which are caused by indoor tanning and overexposure to the sun.
But overall, Americans are increasingly aware of the influence of lifestyle modifications such as reduced alcohol intake, healthful eating and increased exercise, says Sandhya Pruthi, the director of the Mayo Clinic's Breast Diagnostic Clinic in Rochester, Minn.
So while cancer is still the nation's second-leading killer, behind heart disease, it's not the uniform threat many Americans once thought.