Helping Families Face the Challenges of Cancer

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Cancer Facts
(reproduced from American Cancer Society)

How Many People Are Expected to Die of Cancer?

What Is the National Cancer Death Rate?

How Many People Alive Today Have Ever Had Cancer?








What Is Cancer?
Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death.

What Causes Cancer?
Cancer is caused by both external (chemicals, radiation, and viruses) and internal (hormones, immune conditions, and inherited mutations) factors. Causal factors may act together or in sequence to initiate or promote carcinogenesis. Ten or more years often pass between exposures or mutations and detectable cancer.

Can Cancer Be Prevented?
All cancers caused by cigarette smoking and heavy use of alcohol could be prevented completely. The ACS estimates that in 1998 about 175,000 cancer deaths are expected to be caused by tobacco use and an additional 19,000 cancer deaths are related to excessive alcohol use, frequently in combination with tobacco use. Many cancers that are related to dietary factors could also be prevented. Scientific evidence suggests that up to one-third of the 564,800 cancer deaths that are expected to occur in the US this year are related to nutrition. In addition, many of the one million skin cancers that are expected to be diagnosed in 1998 could have been prevented by protection from the sun's rays.

Screening examinations, conducted regularly by a health care professional can result in the detection of cancers of the breast, colon, rectum, cervix, prostate, testis, tongue, mouth, and skin at earlier stages, when treatment is more likely to be successful. Self examinations for cancers of the breast and skin may also result in detection of tumors at earlier stages. The nine screening-accessible cancers listed above account for approximately half of all new cancer cases. The 5-year relative survival rate for these cancers is about 80%. If all Americans participated in regular cancer screenings, this rate could increase to more than 95%.

How Is a Person's Cancer Treated?
By surgery, radiation, chemotherapy, hormones, and immunotherapy.

Who Is at Risk of Developing Cancer?
Anyone. Since the occurrence of cancer increases as individuals age, most cases affect adults middle-aged or older. Cancer researchers use the word risk in different ways. Lifetime risk refers to the probability that an individual, over the course of a lifetime, will develop cancer or die from it. In the US, men have a 1 in 2 lifetime risk of developing cancer, and for women the risk is 1 in 3.

Relative risk is a measure of the strength of the relationship between risk factors and the particular cancer. It compares the risk of developing cancer in persons with a certain exposure or trait to the risk in persons who do not have this exposure or trait. For example, smokers have a 10-fold relative risk of developing lung cancer compared with nonsmokers. This means that smokers are about 10 times more likely to develop lung cancer (or have a 900% increased risk) than nonsmokers. Most relative risks are not this large. For example, women who have a first-degree (mother, sister, or daughter) family history of breast cancer have about a twofold increased risk of developing breast cancer compared with women who do not have a family history. This means that women with a first-degree family history are about two times or 100% more likely to develop breast cancer than women who do not have a family history of the disease.

How Many People Alive Today Have Ever Had Cancer?
The National Cancer Institute estimates that approximately 8 million Americans alive today have a history of cancer. Some of these individuals can be considered cured, while others still have evidence of cancer.

How Many New Cases Are Expected to Occur This Year?
About 1,228,600 new cancer cases are expected to be diagnosed. Since 1990, approximately 11 million new cancer cases have been diagnosed. These estimates do not include carcinoma in situ (non invasive cancer) except for urinary bladder, or basal and squamous cell skin cancers. Over 1 million cases of basal and squamous cell skin cancer are expected to be diagnosed this year.

How Many People Are Expected to Die of Cancer?
This year about 564,800 Americans are expected to die of cancerómore than 1,500 people a day. Cancer is the second leading cause of death in the US, exceeded only by heart disease. One of every four deaths in the US is from cancer. Since 1990, there have been approximately 5 million cancer deaths.

What Is the National Cancer Death Rate?
Between 1991 and 1995, the national cancer death rate fell 2.6%. Most of the decline can be attributed to decreases in mortality from cancers of the lung, colon-rectum, and prostate in men, and breast, colon-rectum, and gynecologic sites in women. The declines in mortality were greater in men than in women, largely because of changes in lung cancer rates; greater in young patients than in older patients; and greater in African Americans than in whites although mortality rates remain higher in African Americans.

How Many People Are Surviving Cancer?
In the early 1900s, few cancer patients had any hope of long-term survival. In the 1930s, about one in four was alive five years after treatment. About 491,400 Americans, or 4 of 10 patients who get cancer this year, are expected to be alive five years after diagnosis.

This 4 in 10, or about 40% is called the "observed" survival rate. When adjusted for normal life expectancy (factors such as dying of heart disease, accidents, and diseases of old age), a "relative" 5-year survival rate of 58% is seen for all cancers. Five-year relative survival rates, commonly used to monitor progress in early detection and treatment of cancer, include persons who are living five years after diagnosis, whether in remission, disease-free, or under treatment. While these rates provide some indication about the average survival experience of cancer patients in a given population, they are less informative when used to predict individual prognosis.

What Is the Difference Between In Situ and Invasive Cancer?
Carcinoma in situ (non invasive cancer) is the earliest stage of cancer. At this stage, the cancer cells are only in the layer of cells they developed in, and have not yet spread to other parts of that organ or elsewhere in the body. Most in situ cancers are curable if they are treated before they progress to invasive cancer. For this publication, unless otherwise specified, statistics are for invasive cancers only. Because most in situ cancers cause no symptoms and do not always progress to invasive cancers, they cannot be counted as accurately as invasive cancers.

What Are the Costs of Cancer?
The financial costs of cancer are great both to the individual and to society as a whole. The National Cancer Institute estimates overall annual costs for cancer at $107 billion; $37 billion for direct medical costs, $11 billion for morbidity costs (cost of lost productivity), and $59 billion for mortality costs. Treatment of breast, lung and prostate cancers account for over half of the direct medical costs.

The debate on health care system reform highlights the cost of treating cancer in a new way. According to 1994 data, about 18% of Americans under age 65 have no health insurance, and about 14% of older persons have only Medicare coverage. The proportion of the population that is uninsured, moreover, does not take into account the millions of Americans now living with disease or disability who daily encounter problems with our health care system, including the 8 million Americans who have had cancer.

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