Death rates from most cancers fall

By Keith Rogers
Review-Journal

      Reports on cancer cases nationwide show that sunny Nevada is projected to have the third highest rate of deaths in 1998 from melanoma, a form of skin cancer.
      But early detection and awareness of the disease and its causes have generally kept death rates down, according to statistics kept by American Cancer Society Inc. and the National Cancer Institute.
      Vermont will top the melanoma death rate for 1998, listing an estimated 3 deaths per 100,000 people. Delaware follows, also with 3 deaths per 100,000, and Nevada and Utah are each projected to have 2.8 deaths per 100,000.
      Using a population base of 1.6 million Nevadans -- the figure used by the state's Cancer Registry -- 300 new melanoma cases will be reported this year and 45 people will die from the disease.
      The projected death rate will not exceed historically high rates in the past, said Sherry Bolden, an American Cancer Society program specialist who helped compile the 1998 state-by-state breakdown.
      In 1973, the nationwide rate for melanoma was 5.7 cases per 100,000 people. By 1994, it had increased to 12.5 per 100,000, an increase of about 4 percent per year, according to the American Cancer Society report.
      Sarah Landis, an epidemiologist and author of the society's Cancer Facts and Figures report, said heightened awareness about exposure to the sun's harmful ultraviolet rays has helped keep melanoma deaths in check.
      "Sun safety didn't really take on until the mid-1980s," Landis said last week. She noted that researchers are studying different age groups and the steps people take to protect themselves from the sun to determine links to melanoma rates.
      Melanoma rates are about 20 times higher among whites than blacks, according to the organization's report.
      Without more in-depth analysis of the age groups, genetic backgrounds and habits of Nevadans who contract melanoma, epidemiologists won't know exactly what makes the state third on the national list of projected deaths for this year. But possibilities, according to Landis, include the state's sunny conditions and the physical traits that might put certain residents at higher risk.
      For all skin cancers nationwide, the society projects 9,200 deaths this year, with most of those -- 7,300 -- resulting from melanoma.
      "Mortality rates for melanoma have been relatively constant at about 2 per 100,000 since the late 1970s," the report said.
      It recommends that fair-skinned people, who are most at risk to exposure to ultraviolet rays, use sunscreen, wear long-sleeved shirts, and avoid exposure to the sun between 10 a.m. and 4 p.m. when ultraviolet rays are strongest.
      Observations in the past decade show a thinning of the ozone layer, which shields living things from exposure to the sun's ultraviolet radiation. Many scientists believe chemicals released into the air, particularly those from aerosols and coolants that contain chlorofluorocarbons, are depleting this protective layer.
      Landis said other nationwide trends show lung cancer is increasing among women. There has been a downturn in male lung cancer deaths -- likely an indication that men are beginning to quit smoking earlier in their lives.
      The number of new prostate cancer cases in the nation appears to have dwindled from last year.
      "In 1997, we made an estimate of 334,500," Landis said. "By midyear, we realized the estimate was very high because incidence had begun to decrease. It came down to 209,000. This year, the estimate is for 184,500."
      The decrease in new prostate cancer cases, she said, is attributable to a more specific screening techniques.
      For Nevada, the organization estimates there will be 1,100 new prostate cancer cases this year and about 200 deaths from the disease.
      For all types of cancer, it projects 7,600 new cases in Nevada this year and 3,500 deaths. About 1,000 new breast cancer cases are expected, bringing 300 deaths.