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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
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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