Rate
of Cancer Highest in North America
North America leads
the world in the rate of cancers diagnosed in adults, followed
closely by Western Europe and Australia and New Zealand, according
to a recent estimate of worldwide cancer rates.
The study found that
1.5% of the North American population aged 15 years and older
-- more than 3 million people -- had been diagnosed with at least
one of 25 different cancers within the past 5 years. The results
only include individuals diagnosed in the past 5 years because
people who live longer are considered to be cured.
About 1.2% of the population
of Western Europe, or nearly 4 million people, had been diagnosed
with cancer between 1986 and 1990, while just over 1% of the population
of Australia and New Zealand -- about 200,000 people -- had been
diagnosed over the same period.
Japan was next in line
with 1% of the population diagnosed with cancer within the past
5 years, followed by Eastern Europe with 0.7% of adults living
with cancer, and Latin America and the Caribbean countries with
0.4% of the population diagnosed with cancer, according to the
report.
The researchers suggest
that higher cancer rates in nations with higher income reflect
longer life expectancies in older adults, who are more susceptible
to cancer.
Most of the difference
is explained by different demographic patterns with high-income
countries having long life expectancy in age groups when the risk
of the disease is highest.
In other findings,
cancer rates were similar for men and women living in developed
countries. In developing nations, however, more women lived with
cancer for at least 5 years, suggesting that men are more frequently
stricken with cancers that do not respond well to treatment, such
as liver, esophagus and stomach cancers.
Breast cancer was the
most common type of cancer diagnosed in women regardless of country.
In men and women living in developed nations, colorectal cancer
was the second leading cause of cancer, followed by cancer of
the lung, bladder and stomach in men.
The study did not include
the most common types of skin cancer, which are extremely prevalent
and rarely life threatening, but did include melanoma, a relatively
rare and dangerous type of skin cancer.
International Journal
of Cancer January 2002;97:72-81
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COMMENT by
DR. SAMUEL S. EPSTEIN:
A report from the World
Health Organization's International Agency for Research on Cancer
(IARC), published in the current issue of the International Journal
of Cancer, confirms that the crude prevalence of overall and organ-specific
cancers in men and women is higher in developed than in developing
nations. Among developed nations, the highest prevalence is in
the U.S., followed by Western Europe, Australia and New Zealand.
It should be stressed
that incidence is the major determinant of crude cancer prevalence,
so that regional and national variations reflect variations in
risk, and thus avoidable causes of cancer. That the U.S. invidiously
leads the world in this respect is troubling, and is in inverse
relationship to the massive public and private funding of the
U.S. cancer establishment, the National Cancer Institute, and
American Cancer Society, compared to relatively low funding in
other developed nations and regions.
Illustratively, funding
for the U.S. National Cancer Institute has increased exponentially
from $170 million in 1971 to current levels of $4.2 billion. Thus,
the IARC report is an indictment of the indifference of the U.S.
cancer establishment to cancer prevention, in sharp contrast to
fixation on damage control -- screening, diagnosis and treatment
-- besides molecular biology, and their disproportionately high
funding.
Samuel S. Epstein,
M.D.
emeritus Professor Environmental and Occupational Medicine
University of Illinois School of Public Health
and Chairman, Cancer Prevention Coalition
www.preventcancer.com
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