Cancer in North America

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Rate of Cancer Highest in North America

North America leads the world in the rate of cancers diagnosed in adults, followed closely by Western Europe and Australia and New Zealand, according to a recent estimate of worldwide cancer rates.

The study found that 1.5% of the North American population aged 15 years and older -- more than 3 million people -- had been diagnosed with at least one of 25 different cancers within the past 5 years. The results only include individuals diagnosed in the past 5 years because people who live longer are considered to be cured.

About 1.2% of the population of Western Europe, or nearly 4 million people, had been diagnosed with cancer between 1986 and 1990, while just over 1% of the population of Australia and New Zealand -- about 200,000 people -- had been diagnosed over the same period.

Japan was next in line with 1% of the population diagnosed with cancer within the past 5 years, followed by Eastern Europe with 0.7% of adults living with cancer, and Latin America and the Caribbean countries with 0.4% of the population diagnosed with cancer, according to the report.

The researchers suggest that higher cancer rates in nations with higher income reflect longer life expectancies in older adults, who are more susceptible to cancer.

Most of the difference is explained by different demographic patterns with high-income countries having long life expectancy in age groups when the risk of the disease is highest.

In other findings, cancer rates were similar for men and women living in developed countries. In developing nations, however, more women lived with cancer for at least 5 years, suggesting that men are more frequently stricken with cancers that do not respond well to treatment, such as liver, esophagus and stomach cancers.

Breast cancer was the most common type of cancer diagnosed in women regardless of country. In men and women living in developed nations, colorectal cancer was the second leading cause of cancer, followed by cancer of the lung, bladder and stomach in men.

The study did not include the most common types of skin cancer, which are extremely prevalent and rarely life threatening, but did include melanoma, a relatively rare and dangerous type of skin cancer.

International Journal of Cancer January 2002;97:72-81

COMMENT by DR. SAMUEL S. EPSTEIN:

A report from the World Health Organization's International Agency for Research on Cancer (IARC), published in the current issue of the International Journal of Cancer, confirms that the crude prevalence of overall and organ-specific cancers in men and women is higher in developed than in developing nations. Among developed nations, the highest prevalence is in the U.S., followed by Western Europe, Australia and New Zealand. It should be stressed that incidence is the major determinant of crude cancer prevalence, so that regional and national variations reflect variations in risk, and thus avoidable causes of cancer. That the U.S. invidiously leads the world in this respect is troubling, and is in inverse relationship to the massive public and private funding of the U.S. cancer establishment, the National Cancer Institute, and American Cancer Society, compared to relatively low funding in other developed nations and regions.

Illustratively, funding for the U.S. National Cancer Institute has increased exponentially from $170 million in 1971 to current levels of $4.2 billion. Thus, the IARC report is an indictment of the indifference of the U.S. cancer establishment to cancer prevention, in sharp contrast to fixation on damage control -- screening, diagnosis and treatment -- besides molecular biology, and their disproportionately high funding.

S. Epstein, M.D.emeritus Professor Environmental and Occupational MedicineUniversity of Illinois School of Public Healthand Chairman, Cancer Prevention Coalitionwww.preventcancer.com