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Cancer rates expected to continue dramatic rise

Category: Cancer Detection and Tumor Markers

The population of the U.S. is aging, and that is expected to bring a dramatic rise in the number of new cancer cases diagnosed over the next 20 years, according to research from The University of Texas M.D. Anderson Cancer Center, hitting minorities and the elderly particularly hard.

"In 2030, 70 percent of all cancers will be diagnosed in the elderly and 28 percent in minorities," said Dr Ben Smith, adjunct assistant professor in M. D. Anderson's Department of Radiation Oncology and the study's senior author, adding that "the number of older adults diagnosed with cancer will be the same as the total number of Americans diagnosed with cancer in 2010."

The study, published in Journal of Clinical Oncology, predicts a 45 percent increase in the number of new cancer cases diagnosed annually in the U.S., from 1.6 million in 2010 to 2.3 million in 2030. Smith adds that many of the types of cancers expected to increase quickly - liver, stomach and pancreas, for example - have very high rates of mortality.

The rate of increase is much higher for minorities and the elderly. Adults aged 65 or older are expected to see a 67 percent increase in the cancer diagnoses, from 1 million in 2010 to 1.6 million in 2030, while in non-white individuals over the same 20-year span, the incidence is expected to double, from 330,000 to 660,000.

An increase in the rate of disease does not have to mean the same increase in the rate of cancer death, Smith insists, but avoiding that result will require specific prevention and/or treatment strategies, including a focus on cancer testing.

The M.D. Anderson team used the United States Census Bureau's latest statistics projecting population growth through 2050 and the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) registry - the premier population-based cancer registry, representing 26 percent of the country's population.

Smith and his team found that the fastest increases will be: stomach (67 percent); liver (59 percent); myeloma (57 percent); pancreas (55 percent); and bladder (54 percent). However, the sites with the highest rate of cancer now are still expected to be the leading cancer sites in the future: breast, prostate, colon and lung. All of these have well established cancer tests with the ability to catch the disease in early stages.

Unfortunately, data from the National Cancer Institute indicates that most Americans do not know when or how often to get cancer tests.
Of particular concern, given the projected spike in cancer rates among minorities, is that according to the Health Information National Trends Survey, knowledge of screening recommendations varied by race and ethnicity.

When asked what the recommended age for getting a colorectal cancer test was, 38 percent of Whites knew the answer, but 79 percent of Hispanic respondents did not know, nor did 75 percent of African Americans and 70 percent of American Indians/Alaskan Natives.

The authors write that "age at diagnosis is a critical factor modifying both cancer biology and response to therapy." Because early detection and proper use of cancer tests are so important to successful treatment of cancer, the researchers say screening for cancer should be strongly encouraged and there will be a need for new and better understanding of early detection tests, such as cancer tumor markers.

"There's no doubt the increasing incidence of cancer is a very important societal issue. There will not be one solution to this problem, but many different issues that need to be addressed to prepare for these changes," said Smith. "I'm afraid if we don't come to grips with this as a society, health care may be the next bubble to burst."