Decline in U.S. Cancer Rates Raises Future Policy Concerns

By Melanie R. Margolis

On March 12, 1998, the American Cancer Society, the National Cancer Institute, and the Centers for Disease Control and Prevention released a report card on cancer. The report card showed that the incidence rate for all cancers combined declined 0.7% annually from 1990 to 1995, an improvement over the period from 1973 to 1990 when the rate increased 1.2% annually. The report card also showed that the incidence rate declined for both men and women in most age groups and most racial and ethnic groups, but the rate for black males increased. Overall cancer death rates declined by approximately 0.5% annually during 1990-1995. The decline was greater for men than for women and included all racial and ethnic groups except Asian and Pacific Islander women.

Experts have pointed out flaws in the report card, according to the Houston Chronicle, chronicle/page1/98/03/13/cancer.2-0.html. Primarily, they noted that because the rates are based on data from 5 state cancer registries (Connecticut, Hawaii, Iowa, New Mexico, and Utah) and four metropolitan registries (Atlanta, Detroit, San Francisco-Oakland, and Seattle-Puget Sound), large segments of the population are not included, which could negatively impact cancer policy-making. Based on positive trends revealed in the report card for most Americans, policy-makers could be convinced that no problem exists for certain segments of the population when, in fact, that may not be true.

For now, at least, policy-makers seem to be aware of the disparities and are committed to the fight against cancer.

On February 21, 1998, President Clinton announced an initiative to eliminate the disparity in health status that affects racial and ethnic minorities in the United States, citing findings that:

The Department of Health and Human Services will initiate a major outreach campaign to send critical treatment and prevention messages to Americans with a special focus on reaching racial and ethnic minorities. The goal of the President's plan is to eliminate health disparities by 2010 in 6 areas, including cancer screening and management.

On January 29, 1998, Vice President Gore announced an historic cancer initiative, calling for a $4.7 billion increase in spending for cancer research at the National Institutes for Health and coverage of cancer clinical trials for Medicare beneficiaries. The Administration proposes to build on bipartisan legislation pending in Congress, specifically, Senator John Rockefeller's (S. 381) and Representative Nancy Johnson's (H.R. 1628) proposed legislation that would provide clinical trial coverage for Medicare beneficiaries.