Female athletes using special program saw all injuries cut by a third, researchers say
FRIDAY, Dec. 12 (HealthDay News) -- A good warm-up program may dramatically reduce sports injuries, a new report says.
A study by the Norwegian School of Sport Sciences found that focusing on strength improvement, balance, core stability and muscular awareness cut injuries by a third among almost 1,900 teenage female football players; severe injuries fell by almost half.
The study is published online in BMJ.
Study participants either did traditional warm-up exercises or the "11+" program, which consists of slow and speed running, strength and balance improvement exercise, and movements that focus on core stability, hip control and knee alignment. The 11+ also emphasized the importance of internal muscular awareness.
The authors concluded by calling for the program to be implemented as a key element of coaching, education and training in football.
While the number of lower leg injuries between the groups were statistically similar, many fewer severe injuries, overuse injuries and overall injuries occurred in players in the 11+ group. The results might have been even more favorable but not all 11+ participants kept up with the program all season.
In an accompanying editorial, John Brooks, an injury expert for the Rugby Football Union, called for people to adopt a warm-up program like the 11+ regardless of what sport or levels they play at, citing the lower incidence of severe injuries.
Monday, December 15, 2008
Regimens: Acupuncture Provides Headache Relief
Acupuncture for the Management of Chronic Headache: A Systematic Review (Anesthesia and Analgesia)
In 1998, the National Institutes of Health accepted acupuncture as a useful alternative treatment for headaches, but warned that there were not enough clinical trials to draw firm conclusions about its efficacy. Now a systematic review of studies through 2007 concludes that acupuncture provides greater relief than either medication or a placebo.
The report, which appears in the December issue of Anesthesia and Analgesia, reviewed 25 randomized controlled trials in adults that lasted more than four weeks. In seven trials comparing acupuncture with medication, researchers found that 62 percent of 479 patients had significant response to acupuncture, and only 45 percent to medicine.
Fourteen of the studies, with a total of 961 patients, compared acupuncture with a placebo, a treatment in which patients were led to believe they were getting acupuncture. Of these, 53 percent found some pain relief with acupuncture, compared with 45 percent who felt better with the placebo. In four studies comparing acupuncture with massage, the massage worked better than acupuncture, but those studies were too small to draw statistically significant conclusions.
“People who get acupuncture prefer it to medication, because of the potential side effects of drugs,” said Dr. Tong J. Gan, a co-author of the review and a professor of anesthesiology at Duke. “This is an alternative treatment that is starting to move into the mainstream.”
In 1998, the National Institutes of Health accepted acupuncture as a useful alternative treatment for headaches, but warned that there were not enough clinical trials to draw firm conclusions about its efficacy. Now a systematic review of studies through 2007 concludes that acupuncture provides greater relief than either medication or a placebo.
The report, which appears in the December issue of Anesthesia and Analgesia, reviewed 25 randomized controlled trials in adults that lasted more than four weeks. In seven trials comparing acupuncture with medication, researchers found that 62 percent of 479 patients had significant response to acupuncture, and only 45 percent to medicine.
Fourteen of the studies, with a total of 961 patients, compared acupuncture with a placebo, a treatment in which patients were led to believe they were getting acupuncture. Of these, 53 percent found some pain relief with acupuncture, compared with 45 percent who felt better with the placebo. In four studies comparing acupuncture with massage, the massage worked better than acupuncture, but those studies were too small to draw statistically significant conclusions.
“People who get acupuncture prefer it to medication, because of the potential side effects of drugs,” said Dr. Tong J. Gan, a co-author of the review and a professor of anesthesiology at Duke. “This is an alternative treatment that is starting to move into the mainstream.”
Wednesday, December 10, 2008
UN: Accidents Kill 800,000 Kids A Year
POSTED: 5:30 am HST December 10, 2008
U.N. officials said simple things like seat belts, childproof medicine caps and fences around pools could save hundreds of thousands of children's lives every year.
A report released Wednesday by the World Health Organization and UNICEF at a conference in Vietnam counts more than 800,000 children who die each year from burns, drowning, car crashes and other accidents. Most of those deaths occur in developing countries.
"Child injuries are an important public health and development issue. In addition to the 830,000 deaths every year, millions of children suffer non-fatal injuries that often require long-term hospitalization and rehabilitation," WHO Director-General Dr. Margaret Chan said in a news release.
Chan said the costs to treat such injuries can throw a family into poverty.
"Children in poorer families and communities are at increased risk of injury because they are less likely to benefit from prevention programs and high-quality health services," she said.
The report said with more safety measures in place, countries could prevent half of those deaths. Suggestions include seatbelt and helmet laws, water heater controls and safer designs for nursery furniture and toys. The report also recommends various traffic safety improvements.
The report said such steps have been taken in many high-income countries and have reduced child injury deaths by up to 50 percent over the last 30 years.
The report found that the top five causes of injury deaths are:
Road crashes: They kill 260,000 children a year and injure about 10 million. They are the leading cause of death among 10- to 19-year-olds and a leading cause of child disability.
Drowning: It kills more than 175,000 children a year. Every year, up to 3 million children survive a drowning incident. Due to brain damage in some survivors, non-fatal drowning has the highest average lifetime health and economic impact of any injury type.
Burns: Fire-related burns kill nearly 96,000 children a year and the death rate is 11 times higher in low- and middle-income countries than in high-income countries.
Falls: Nearly 47,000 children fall to their deaths every year, but hundreds of thousands more sustain less serious injuries from a fall.
Poisoning: More than 45,000 children die each year from unintended poisoning.
Distributed by Internet Broadcasting Systems, Inc. The Associated Press contributed to this report. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
U.N. officials said simple things like seat belts, childproof medicine caps and fences around pools could save hundreds of thousands of children's lives every year.
A report released Wednesday by the World Health Organization and UNICEF at a conference in Vietnam counts more than 800,000 children who die each year from burns, drowning, car crashes and other accidents. Most of those deaths occur in developing countries.
"Child injuries are an important public health and development issue. In addition to the 830,000 deaths every year, millions of children suffer non-fatal injuries that often require long-term hospitalization and rehabilitation," WHO Director-General Dr. Margaret Chan said in a news release.
Chan said the costs to treat such injuries can throw a family into poverty.
"Children in poorer families and communities are at increased risk of injury because they are less likely to benefit from prevention programs and high-quality health services," she said.
The report said with more safety measures in place, countries could prevent half of those deaths. Suggestions include seatbelt and helmet laws, water heater controls and safer designs for nursery furniture and toys. The report also recommends various traffic safety improvements.
The report said such steps have been taken in many high-income countries and have reduced child injury deaths by up to 50 percent over the last 30 years.
The report found that the top five causes of injury deaths are:
Road crashes: They kill 260,000 children a year and injure about 10 million. They are the leading cause of death among 10- to 19-year-olds and a leading cause of child disability.
Drowning: It kills more than 175,000 children a year. Every year, up to 3 million children survive a drowning incident. Due to brain damage in some survivors, non-fatal drowning has the highest average lifetime health and economic impact of any injury type.
Burns: Fire-related burns kill nearly 96,000 children a year and the death rate is 11 times higher in low- and middle-income countries than in high-income countries.
Falls: Nearly 47,000 children fall to their deaths every year, but hundreds of thousands more sustain less serious injuries from a fall.
Poisoning: More than 45,000 children die each year from unintended poisoning.
Distributed by Internet Broadcasting Systems, Inc. The Associated Press contributed to this report. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Nature and Nurture Contribute to Overeating
By Peggy Peck, Executive Editor, MedPage Today
Published: December 10, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco Earn CME/CE credit
for reading medical news
DUNDEE, Scotland, Dec. 10 -- The likelihood of craving a couple of calorie-laden burgers and a cupcake or two instead of consuming a simple rice cake may be determined by a genetic mutation associated with obesity, found investigators here.
The effect of the mutation in a subset of children appears to involve control of both the amount of food consumed and the desire to consume dense, high calorie foods, researchers reported in the Dec. 11 issue of the New England Journal of Medicine.
Children who carried a variant of rs9939609, a fat mass and obesity-associated (FTO) gene, consumed more food at test meals than controls (P =0.006) and were also more likely to choose a burger over a rice cake, according to Colin N.A. Palmer, Ph.D., of the University of Dundee's Biomedical Research Institute at Ninewells Hospital and Medical School and colleagues. Action Points
--------------------------------------------------------------------------------
Explain to interested patients that this study suggested that a genetic variant controls both appetite and the types of food consumed.
Explain to interested patients that maintaining normal weight should be a goal regardless of age.
Explain to interested patients that current guidelines recommend a mix of diet and exercise for weight control.
And while total and resting energy expenditures were increased in children who were carriers of the A allele, resting energy expenditure was "identical to that predicted for the age and weight of the child, indicating that there is no defect in metabolic adaptation to obesity," they wrote.
The findings emerged from a study of 2,726 Scots children ages four to 10 who had genotyping and height and weight measurement.
A sub-sample of 97 children who had the A allele variant of rs9939609 were also assessed for adiposity, energy expenditure, and food intake.
"In the total study group, the A allele of rs9939609 was associated with significantly increased weight (P =0.003) and BMI (P =0.003)," they wrote.
And in the subset of 97 children there were similar associations for weight (P =0.049) and BMI (P =0.03) and there was also an association with anthropometric skinfold values (P =0.03).
On the basis of the skinfold measurements, "children who carried the A allele had an estimated fat mass that was 1.78 kg greater than that of non-carriers (P =0.01) and an estimated lean mass that was less than 400 g greater than that of non-carriers ( P =0.46).
The authors said that their data "suggest that the [fat mass and obesity-associated] gene influences the 'input' side of the energy-balance equation," a finding already reported in animal studies.
Thus the key to preventing obesity in people with this genotype, which occurred in 0.385% of the population studied, would be "moderate and controlled restriction of energy intake."
In an editorial, Rudolph L. Leibel, M.D., of Columbia University in New York, wrote that the frequency of the rs9939609 A allele has been estimated as "0.45 in Europeans, 0.52 in West Africans, and 0.14 in Chinese."
And even though the "locus accounts for only a small proportion of differences in BMI in the entire population, it plays a substantial role -- in these people, in these environments -- in conveying the risk of actually becoming overweight or obese."
Although Dr. Leibel said it was too soon to consider genetic screening for obesity risk, but said the data from the school children in Scotland underscore the "important role the environment plays in enabling or resisting such susceptibility."
The study was supported by a grant from the U.K. Biotechnology and Biological Sciences Research Council.
Dr. Palmer had no disclosures. Dr Leibel disclosed consulting fees fro Arisaph, Centocor, Genaera, ImClone, and Merck.
Primary source: New England Journal of Medicine
Source reference:
Cecil JE et al "An obesity-associated FTO gene variant and increased energy intake in children" N Eng J Med 2008: 359: 2558-66.
Additional source: New England Journal of Medicine
Source reference:
Leibel R L "Energy in, energy out, and the effects of obesity-related genes" N Engl J Med 2008; 359: 2603-04.
Additional Obesity Coverage
Earn CME/CE credit
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Published: December 10, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco Earn CME/CE credit
for reading medical news
DUNDEE, Scotland, Dec. 10 -- The likelihood of craving a couple of calorie-laden burgers and a cupcake or two instead of consuming a simple rice cake may be determined by a genetic mutation associated with obesity, found investigators here.
The effect of the mutation in a subset of children appears to involve control of both the amount of food consumed and the desire to consume dense, high calorie foods, researchers reported in the Dec. 11 issue of the New England Journal of Medicine.
Children who carried a variant of rs9939609, a fat mass and obesity-associated (FTO) gene, consumed more food at test meals than controls (P =0.006) and were also more likely to choose a burger over a rice cake, according to Colin N.A. Palmer, Ph.D., of the University of Dundee's Biomedical Research Institute at Ninewells Hospital and Medical School and colleagues. Action Points
--------------------------------------------------------------------------------
Explain to interested patients that this study suggested that a genetic variant controls both appetite and the types of food consumed.
Explain to interested patients that maintaining normal weight should be a goal regardless of age.
Explain to interested patients that current guidelines recommend a mix of diet and exercise for weight control.
And while total and resting energy expenditures were increased in children who were carriers of the A allele, resting energy expenditure was "identical to that predicted for the age and weight of the child, indicating that there is no defect in metabolic adaptation to obesity," they wrote.
The findings emerged from a study of 2,726 Scots children ages four to 10 who had genotyping and height and weight measurement.
A sub-sample of 97 children who had the A allele variant of rs9939609 were also assessed for adiposity, energy expenditure, and food intake.
"In the total study group, the A allele of rs9939609 was associated with significantly increased weight (P =0.003) and BMI (P =0.003)," they wrote.
And in the subset of 97 children there were similar associations for weight (P =0.049) and BMI (P =0.03) and there was also an association with anthropometric skinfold values (P =0.03).
On the basis of the skinfold measurements, "children who carried the A allele had an estimated fat mass that was 1.78 kg greater than that of non-carriers (P =0.01) and an estimated lean mass that was less than 400 g greater than that of non-carriers ( P =0.46).
The authors said that their data "suggest that the [fat mass and obesity-associated] gene influences the 'input' side of the energy-balance equation," a finding already reported in animal studies.
Thus the key to preventing obesity in people with this genotype, which occurred in 0.385% of the population studied, would be "moderate and controlled restriction of energy intake."
In an editorial, Rudolph L. Leibel, M.D., of Columbia University in New York, wrote that the frequency of the rs9939609 A allele has been estimated as "0.45 in Europeans, 0.52 in West Africans, and 0.14 in Chinese."
And even though the "locus accounts for only a small proportion of differences in BMI in the entire population, it plays a substantial role -- in these people, in these environments -- in conveying the risk of actually becoming overweight or obese."
Although Dr. Leibel said it was too soon to consider genetic screening for obesity risk, but said the data from the school children in Scotland underscore the "important role the environment plays in enabling or resisting such susceptibility."
The study was supported by a grant from the U.K. Biotechnology and Biological Sciences Research Council.
Dr. Palmer had no disclosures. Dr Leibel disclosed consulting fees fro Arisaph, Centocor, Genaera, ImClone, and Merck.
Primary source: New England Journal of Medicine
Source reference:
Cecil JE et al "An obesity-associated FTO gene variant and increased energy intake in children" N Eng J Med 2008: 359: 2558-66.
Additional source: New England Journal of Medicine
Source reference:
Leibel R L "Energy in, energy out, and the effects of obesity-related genes" N Engl J Med 2008; 359: 2603-04.
Additional Obesity Coverage
Earn CME/CE credit
for reading medical news
Add Your Knowledge™
Contribute your own thoughts, experience, questions, and knowledge to this story for the benefit of all MedPage Today readers.
Login to post an Add Your Knowledge™ comment.
Disclaimer
Email:
CME Spotlights | See Complete List
--------------------------------------------------------------------------------
MedPage Today Tools
Guide to Biostatistics
Important epidemiologic concepts and common biostatistical terms to help clinicians translate medical research into everyday practice.
--------------------------------------------------------------------------------
News Feed Widget for Your Website
Place a free, customizable RSS news feed widget on your website or blog. We've created over one-hundred widgets in each of our medical specialties. more about widgets
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Physical therapist
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Family Nurse Practitioner
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Hospital Physical Therapist
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Relient Health
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Scranton, PA
Marywood University
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Annual Report to the Nation Finds Declines in Cancer Incidence and Death Rates
Special Feature Reveals Wide Variations in Lung Cancer Trends across States
A new report from the nation's leading cancer organizations shows that, for the first time since the report was first issued in 1998, both incidence and death rates for all cancers combined are decreasing for both men and women, driven largely by declines in some of the most common types of cancer. The report notes that, although the decreases in overall cancer incidence and death rates are encouraging, large state and regional differences in lung cancer trends among women underscore the need to strengthen many state tobacco control programs. The findings come from the "Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use and Tobacco Control" online Nov. 25, 2008, and appearing in the Dec. 2, 2008, Journal of the National Cancer Institute.
Although cancer death rates have been dropping since the publication of the first Annual Report to the Nation 10 years ago, the latest edition marks the first time the report has documented a simultaneous decline in cancer incidence, the rate at which new cancers are diagnosed, for both men and women. Based on the long-term incidence trend, rates for all cancers combined decreased 0.8 percent per year from 1999 through 2005 for both sexes combined; rates decreased 1.8 percent per year from 2001 through 2005 for men and 0.6 percent per year from 1998 through 2005 for women. The decline in both incidence and death rates for all cancers combined is due in large part to declines in the three most common cancers among men (lung, colon/rectum, and prostate) and the two most common cancers among women (breast and colon/rectum), combined with a leveling off of lung cancer death rates among women.
"The drop in incidence seen in this year's Annual Report is something we've been waiting to see for a long time," said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society (ACS). "However, we have to be somewhat cautious about how we interpret it, because changes in incidence can be caused not only by reductions in risk factors for cancer, but also by changes in screening practices. Regardless, the continuing drop in mortality is evidence once again of real progress made against cancer, reflecting real gains in prevention, early detection, and treatment."
The new report shows that, from 1996 through 2005, death rates for all cancers combined decreased for all racial and ethnic populations and for both men and women, except for American Indian/Alaska Native men and women, for whom rates were stable. The drop in death rates has been steeper for men, who have higher rates, than for women. Death rates declined for 10 of the top 15 causes of cancer death among both men and women. However, death rates for certain individual cancers are increasing, including esophageal cancer for men, pancreatic cancer for women, and liver cancer for both men and women. Overall cancer death rates were highest for African-Americans and lowest for Asian American/Pacific Islanders.
Among men, incidence rates dropped for cancers of the lung, colon/rectum, oral cavity, and stomach. Prostate cancer incidence rates decreased by 4.4 percent per year from 2001 through 2005 after increasing by 2.1 percent per year from 1995 to 2001. In contrast, incidence rates increased for cancers of the liver, kidney, and esophagus, as well as for melanoma (2003-2005), non-Hodgkin lymphoma, and myeloma. Incidence rates were stable for cancers of the bladder, pancreas, and brain/nervous system, and for leukemia.
For women, incidence rates dropped for cancers of the breast, colon/rectum, uterus, ovary, cervix, and oral cavity but increased for cancers of the lung, thyroid, pancreas, brain/nervous system, bladder, and kidney, as well as for leukemia, non-Hodgkin lymphoma, and melanoma.
"While we have made progress in reducing the burden of cancer in this country, we must accelerate our efforts, including making a special effort to reach underserved cancer patients in the communities where they live," said National Cancer Institute (NCI) Director John Niederhuber, M.D. "This report gives us a better understanding of where we may need to redouble our efforts and try to find new ways of preventing or reducing the occurrence of kidney, liver, and other cancers that continue to show increases in both mortality and/or incidence."
The Special Feature section of the Report highlights wide variations in tobacco smoking patterns across the United States, which, coupled with differences in smoking behaviors in younger versus older populations, helps explain the delay in an expected decrease in lung cancer deaths among women and a slowing of the decrease in lung cancer deaths among men.
The report finds substantial differences in lung cancer death rate trends by state and geographic region. For example, lung cancer death rates dropped an average of 2.8 percent per year among men in California from 1996 through 2005, more than twice the drop seen in many states in the Midwest and the South. The geographic variation is even more extreme among women, for whom lung cancer death rates increased from 1996 through 2005 in 13 states and decreased only in three. The report also notes that, in five states (Pennsylvania, Illinois, Minnesota, Nebraska, and Idaho), lung cancer incidence among women showed an increasing trend, whereas the mortality trend was level.
"It's very promising to see the progress we are making in our fight against cancer," said Centers for Disease Control and Prevention (CDC) Director Julie Gerberding, M.D. "Unfortunately, tobacco use continues to plague our country, and it's the primary reason why lung cancer continues to rob too many people of a long, productive, and healthy life. We must recommit ourselves to implementing tobacco control programs that we know work if we are truly going to impact the staggering toll of tobacco on our society."
Variation in smoking prevalence among the states is influenced by several factors, including public awareness of the harms of tobacco use, social acceptance of tobacco use, local tobacco control activities, and tobacco industry promotional activities targeted in a geographic area. The 13 states where lung cancer death rates for women are on the rise have higher percentages of adult female smokers, low excise taxes, and local economies that are traditionally dependent on tobacco farming and production. In contrast, California, which was the first state to implement a comprehensive, statewide tobacco control program, was the only state in the country to show declines in both lung cancer incidence and deaths in women.
According to a U.S. Surgeon General's report, cigarette smoking accounts for approximately 30 percent of all cancer deaths, with lung cancer accounting for 80 percent of the smoking-attributable cancer deaths. Other cancers caused by smoking include cancers of the oral cavity, pharynx, larynx, esophagus, stomach, bladder, pancreas, liver, kidney, and uterine cervix and myeloid leukemia.
"We can see that, in areas of the country where smoking and tobacco use are entrenched in daily life, men and women continue to pay a price with higher incidence and death rates from many types of cancer. This type of geographic variation in smoking-related cancers is due to smoking behaviors, not regional environmental factors," said Betsy A. Kohler, M.P.H., executive director of the North American Association of Central Cancer Registries (NAACCR).
"The observed decrease in the incidence and death rates from all cancers combined in men and women overall and in nearly all racial and ethnic groups is highly encouraging," conclude the authors. "However, this must be seen as a starting point rather than a destination." They say a dual effort, combining better application of existing knowledge with ongoing research to improve prevention, early detection, and treatment will be needed to sustain and extend this progress into the future.
The study was conducted by scientists at the ACS, CDC, NCI, which is part of the National Institutes of Health, and the NAACCR.
To view the full report, go to: http://jnci.oxfordjournals.org.
For a Q&A on this Report, go to http://cancer.gov/newscenter/pressreleases/ReportNation2008QandA.
For Spanish translations of this press release and Q&A, go to http://cancer.gov/espanol/noticias/ReportNation2008SpanishRelease.
A new report from the nation's leading cancer organizations shows that, for the first time since the report was first issued in 1998, both incidence and death rates for all cancers combined are decreasing for both men and women, driven largely by declines in some of the most common types of cancer. The report notes that, although the decreases in overall cancer incidence and death rates are encouraging, large state and regional differences in lung cancer trends among women underscore the need to strengthen many state tobacco control programs. The findings come from the "Annual Report to the Nation on the Status of Cancer, 1975-2005, Featuring Trends in Lung Cancer, Tobacco Use and Tobacco Control" online Nov. 25, 2008, and appearing in the Dec. 2, 2008, Journal of the National Cancer Institute.
Although cancer death rates have been dropping since the publication of the first Annual Report to the Nation 10 years ago, the latest edition marks the first time the report has documented a simultaneous decline in cancer incidence, the rate at which new cancers are diagnosed, for both men and women. Based on the long-term incidence trend, rates for all cancers combined decreased 0.8 percent per year from 1999 through 2005 for both sexes combined; rates decreased 1.8 percent per year from 2001 through 2005 for men and 0.6 percent per year from 1998 through 2005 for women. The decline in both incidence and death rates for all cancers combined is due in large part to declines in the three most common cancers among men (lung, colon/rectum, and prostate) and the two most common cancers among women (breast and colon/rectum), combined with a leveling off of lung cancer death rates among women.
"The drop in incidence seen in this year's Annual Report is something we've been waiting to see for a long time," said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society (ACS). "However, we have to be somewhat cautious about how we interpret it, because changes in incidence can be caused not only by reductions in risk factors for cancer, but also by changes in screening practices. Regardless, the continuing drop in mortality is evidence once again of real progress made against cancer, reflecting real gains in prevention, early detection, and treatment."
The new report shows that, from 1996 through 2005, death rates for all cancers combined decreased for all racial and ethnic populations and for both men and women, except for American Indian/Alaska Native men and women, for whom rates were stable. The drop in death rates has been steeper for men, who have higher rates, than for women. Death rates declined for 10 of the top 15 causes of cancer death among both men and women. However, death rates for certain individual cancers are increasing, including esophageal cancer for men, pancreatic cancer for women, and liver cancer for both men and women. Overall cancer death rates were highest for African-Americans and lowest for Asian American/Pacific Islanders.
Among men, incidence rates dropped for cancers of the lung, colon/rectum, oral cavity, and stomach. Prostate cancer incidence rates decreased by 4.4 percent per year from 2001 through 2005 after increasing by 2.1 percent per year from 1995 to 2001. In contrast, incidence rates increased for cancers of the liver, kidney, and esophagus, as well as for melanoma (2003-2005), non-Hodgkin lymphoma, and myeloma. Incidence rates were stable for cancers of the bladder, pancreas, and brain/nervous system, and for leukemia.
For women, incidence rates dropped for cancers of the breast, colon/rectum, uterus, ovary, cervix, and oral cavity but increased for cancers of the lung, thyroid, pancreas, brain/nervous system, bladder, and kidney, as well as for leukemia, non-Hodgkin lymphoma, and melanoma.
"While we have made progress in reducing the burden of cancer in this country, we must accelerate our efforts, including making a special effort to reach underserved cancer patients in the communities where they live," said National Cancer Institute (NCI) Director John Niederhuber, M.D. "This report gives us a better understanding of where we may need to redouble our efforts and try to find new ways of preventing or reducing the occurrence of kidney, liver, and other cancers that continue to show increases in both mortality and/or incidence."
The Special Feature section of the Report highlights wide variations in tobacco smoking patterns across the United States, which, coupled with differences in smoking behaviors in younger versus older populations, helps explain the delay in an expected decrease in lung cancer deaths among women and a slowing of the decrease in lung cancer deaths among men.
The report finds substantial differences in lung cancer death rate trends by state and geographic region. For example, lung cancer death rates dropped an average of 2.8 percent per year among men in California from 1996 through 2005, more than twice the drop seen in many states in the Midwest and the South. The geographic variation is even more extreme among women, for whom lung cancer death rates increased from 1996 through 2005 in 13 states and decreased only in three. The report also notes that, in five states (Pennsylvania, Illinois, Minnesota, Nebraska, and Idaho), lung cancer incidence among women showed an increasing trend, whereas the mortality trend was level.
"It's very promising to see the progress we are making in our fight against cancer," said Centers for Disease Control and Prevention (CDC) Director Julie Gerberding, M.D. "Unfortunately, tobacco use continues to plague our country, and it's the primary reason why lung cancer continues to rob too many people of a long, productive, and healthy life. We must recommit ourselves to implementing tobacco control programs that we know work if we are truly going to impact the staggering toll of tobacco on our society."
Variation in smoking prevalence among the states is influenced by several factors, including public awareness of the harms of tobacco use, social acceptance of tobacco use, local tobacco control activities, and tobacco industry promotional activities targeted in a geographic area. The 13 states where lung cancer death rates for women are on the rise have higher percentages of adult female smokers, low excise taxes, and local economies that are traditionally dependent on tobacco farming and production. In contrast, California, which was the first state to implement a comprehensive, statewide tobacco control program, was the only state in the country to show declines in both lung cancer incidence and deaths in women.
According to a U.S. Surgeon General's report, cigarette smoking accounts for approximately 30 percent of all cancer deaths, with lung cancer accounting for 80 percent of the smoking-attributable cancer deaths. Other cancers caused by smoking include cancers of the oral cavity, pharynx, larynx, esophagus, stomach, bladder, pancreas, liver, kidney, and uterine cervix and myeloid leukemia.
"We can see that, in areas of the country where smoking and tobacco use are entrenched in daily life, men and women continue to pay a price with higher incidence and death rates from many types of cancer. This type of geographic variation in smoking-related cancers is due to smoking behaviors, not regional environmental factors," said Betsy A. Kohler, M.P.H., executive director of the North American Association of Central Cancer Registries (NAACCR).
"The observed decrease in the incidence and death rates from all cancers combined in men and women overall and in nearly all racial and ethnic groups is highly encouraging," conclude the authors. "However, this must be seen as a starting point rather than a destination." They say a dual effort, combining better application of existing knowledge with ongoing research to improve prevention, early detection, and treatment will be needed to sustain and extend this progress into the future.
The study was conducted by scientists at the ACS, CDC, NCI, which is part of the National Institutes of Health, and the NAACCR.
To view the full report, go to: http://jnci.oxfordjournals.org.
For a Q&A on this Report, go to http://cancer.gov/newscenter/pressreleases/ReportNation2008QandA.
For Spanish translations of this press release and Q&A, go to http://cancer.gov/espanol/noticias/ReportNation2008SpanishRelease.
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