Fall in cancer deaths overshadowed by rise in number of cases

Deaths from cancer fell last year, prompting one charity to claim a `success story'. But cases of cancer are rising sharply and the improvement in the death rate is unlikely to be sustained, writes Jeremy Laurance, Health Editor.

Better treatments, detection and screening for cancer have contributed to a fall of more than 5,000 deaths a year since the early1990s, the Cancer Research Campaign claims today.

Figures for 1996 show 153,000 people died from the disease compared with around 158,000 in the early 1990s. A fall in deaths from lung cancer in men and from breast cancer in women account for two thirds of the reduction.

Experts from the charity expressed satisfaction at the fall but warned that it might not be maintained. Dr John Toy, director of clinical programmes, said: "Although it is too soon to say we have turned the corner these figures are very encouraging and show a new low for cancer mortality in Britain over the last 10 years. We believe a greater understanding of cancer is the reason for this success story."

However, figures published by the Office for National Statistics show that between 1979 and 1991 the number of cancer cases in England and Wales rose by 21 per cent among men and nearly 30 per cent among women. Although ageing accounted for a third of the rise in women and half of the rise in men, the rest is due to other causes.

One of the fastest-rising cancers is malignant melanoma, the most serious form of skin cancer, which is often caused by excessive exposure to the sun. Prostate cancer cases have also risen rapidly and deaths from the disease are set to overtake those from bowel cancer making it Britain's second main cause of death from cancer.

On the plus side, there have been dramatic improvements in survival from childhood cancers and death rates from stomach and cervical cancer have fallen. But the Cancer Research Campaign's claim that the improvement is due to better treatment and screening is only partly true. Modern lifestyles account for most of the changes in cancer death rates - both good and bad.

The sharp fall in lung cancer deaths among men reflects the fall in smoking that began over 20 years ago. The dramatic fall in stomach cancer that began 50 years ago has accompanied the rising consumption of fresh food. Although the fall in cervical cancer deaths has accelerated in the last decade, it was already on a downward track before the national screening programme was introduced.

Where research has scored successes is in the treatment of childhood cancers, although these are rare, and in the use of tamoxifen in post- menopausal women with breast cancer, which is the most likely explanation of the fall in deaths from that disease.

A study by Cambridge University scientists published last summer suggested that on present trends the number of people affected by cancer will rise by 70 per cent in the next 20 years to 1.3 million. The disease will strike every other Briton at some point in their lives in the next generation compared with one in three people today - unless improved treatments and preventive measures can reverse the trend.