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Release: Immediate

Iowa Cancer Registry estimates slight declines in cancer incidence, deaths in 1999

IOWA CITY, Iowa -- While overall cancer deaths and new cases are estimated to decline slightly this year in Iowa, lung cancer will remain the leading cause of death for men and women. Breast cancer will be the most common newly diagnosed cancer in women, and prostate cancer will be the most common newly diagnosed cancer in men.

These are some of the assessments presented in Cancer in Iowa: 1999--the annual report issued by the State Health Registry of Iowa, based at the University of Iowa College of Medicine.

Cancer will claim the lives of an estimated 6,250 Iowans this year. Another 13,800 people in the state will be newly diagnosed with some type of the disease. These projections represent 100 fewer deaths and 200 fewer new diagnoses compared to projections for 1998.

"Nationwide, we're seeing an overall decline in cancer mortality for the first time since records were kept, and Iowa often mirrors what's going on nationally," said Charles F. Lynch, M.D., Ph.D., UI professor of preventive medicine and environmental health and medical director of the Iowa Cancer Registry. "The numbers show we're starting to make progress."

Iowa's overall decline in cancer cases and deaths reflects well with objectives the state set in 1991 as part of Healthy Iowans 2000. The project is the state's contribution to Healthy People 2000, the federal government's national public health plan coordinated by the U.S. Department of Health and Human Services. The project calls for each state to contribute initiatives for improving the health of all Americans in two dozen areas such as physical activity, tobacco use, cancer and immunizations.

Lynch said it appears Iowa will meet its year 2000 mortality objectives for these cancers: female breast, invasive cervix, oral cavity and pharynx, male lung cancer and female skin melanoma. It is less certain that the state will reach its goal for decreased colorectal cancer deaths. In addition, Iowa will likely not meet its goal of fewer lung cancer deaths in women and melanoma deaths in men.

The report also describes progress toward the Healthy Iowans 2000 goals for the early detection of female breast, colorectal, skin melanoma and cervical cancers. Lynch said that of these four cancers, early detection for breast cancer may be the only cancer for which the state may not reach its year 2000 objective. "Our ability to set early detection goals for specific cancers is made possible by having a statewide cancer surveillance program," Lynch said. "This gives us access to important information that many states do not have."

According to the registry's report, breast, lung and colorectal cancers will make up more than half of all new cancer cases in women this year. For men, more than 60 percent of new cancers in 1999 will involve the prostate, lung or colon and rectum. The report estimates the number of cancer deaths and new cases by county for this year. It also includes a section comparing the estimated annual percent change in U.S. and Iowa rates of cancer cases and deaths from 1990 to 1995.

Those data reveal that the reporting of new cases of prostate cancer increased from 1990 to 1992, likely due to the greater use of prostate-specific antigen screenings (PSA) that improved early detection. "New cases of prostate cancer have since declined, likely because of a decline in existing but previously undetected prostate cancer and because of more judicious use of PSA testing," Lynch said.

The report concludes that the greatest decline in Iowa mortality from 1990 to 1995 was seen in female breast cancer.

Despite advances in cancer detection and treatment, cancer remains second to heart disease as a cause of death in Iowa. Cancer occurs in people of all ages, although more than 80 percent of all new cancers occur in those 55 and older.

"Cancer incidence in Iowa is down slightly, but shortly this decrease may become more significant," Lynch said. "We're excited about this progress and would like to see it continue."

George Weiner, M.D., director of the UI Cancer Center and UI associate professor of internal medicine, said, "It's encouraging to see advances in the war against cancer and to know that the work being done at the UI Cancer Center and other cancer research institutions across the nation is helping lead to better cancer detection and treatment for Iowans."

He added, "However, the fact that the most common cancer killer in the state--lung cancer--is preventable shows we must continue to promote cancer prevention and anti-smoking activities at all levels in Iowa."

Since 1973 the State Health Registry of Iowa has been recording data on Iowans newly diagnosed with cancer as part of the National Cancer Institute's Surveillance, Epidemiology and End Results Program. Iowa is one of 10 registries nationwide providing data to the National Cancer Institute. The cancer mortality data presented in the report were obtained from death certificate information provided by the Iowa Department of Public Health.

The State Health Registry is one of several teams that contributed to Healthy Iowans 2000 and that are now contributing to the next related project, Healthy Iowans 2010. With support from the National Library of Medicine, researchers and administrators from the UI Hardin Library for the Health Sciences and the College of Medicine are working with the Iowa Department of Public Health to support the Healthy Iowans 2010 effort for health promotion and disease prevention.

Ed Holtum, coordinator for electronic-based services at Hardin Library, is one of the UI professionals helping ensure that Healthy Iowans 2010 team members can easily access and share information on cancer and the other public health areas within the project. "We've developed a web site, established a listserv and will provide other training and resources," Holtum said.