During 1998, approximately 564,800 people died of cancer, a much-feared disease that is the second-leading cause of death in the United States. Put into perspective, this means that each day of the year more than 1,500 people die of one of the multiple types of cancer that affect humans. While cancer deaths pose an ominous threat, it is important to note that although more than 2.5 million people will be diagnosed with cancer in a year, and many will experience emotional and physical pain, nearly 4 in 10 will be alive 5 years after diagnosis. Many will be considered “cured,” meaning that they have no subsequent cancer in their systems 5 years after diagnosis and can expect to live a long and productive life.
When adjusted for normal life expectancy (factors such as dying of heart disease, accidents, etc.), a relative 5-year survival of 56 percent is seen for all cancers. Some cancers that only a few decades ago presented a very poor outlook are often cured today: acute lymphocytic leukemia in children, Hodgkins disease, Burkitts lymphoma, Ewings sarcoma (a form of bone cancer), Wilms’ tumor (a kidney cancer in children), testicular cancer, and osteogenic (bone) sarcoma are among the most remarkable indicators of progress in treatment techniques.
Variations in Rates
While it is true that cancer strikes people of all ages, races, cultures, and socioeconmic levels, it is equally true that some Americans are at greater risk (see the Health in a Diverse World box). For instance, the National Cancer Institute (NCI) estimates that black Americans have greater incidence and mortality rates than white Americans do for most cancers. In 1994, the incidence rates were 454 per 100,000 for blacks and 394 for whites. In addition, blacks are about 30 percent more likely to die of cancer than are whites. Cancer sites for which blacks have significantly higher incidence and mortality rates include the esophagus, uterus, cervix, stomach, liver, prostate, and larynx. Researchers at the NCI believe that these differences are due more to blacks’ lower average socioeconomic status and generally more limited access to health care than to any inherent physical characteristics. Some findings indicate that some cancers may simply manifest themselves in different races.
Cancer incidence and mortality rates within other minority groups, such as Hispanics, are often lower (sometimes by as much as 25 percent or more) than those of white or black Americans. Due to Hispanics’ low average socioeconomic status; we might expect that they would have cancer rates similar to those of blacks. But Hispanics seem to be “protected” from high rates. Why is this so? No one knows for sure, but the answer may lie in differences in various groups’ diets, exercise patterns, or other culturally influenced behaviors. Because cancer risk is strongly associated with lifestyle and behavior, differences in ethnic and cultural groups can provide clues to factors involved in the development of cancer. Culturally influenced values and belief systems can also affect whether or not a person seeks care, participates in screenings, or follows recommended treatment options. Socioeconomic factors such as lack of health insurance or lack of transportation to major treatment centers can lead to late diagnosis and poor survival prospects.