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Cancer Trends Progress Report – 2007 Update

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Director's Message

One of the National Cancer Institute's important duties is communicating our nation's progress against cancer to the public. This 2007 update to the Cancer Trends Progress Report is an important part of that dissemination process. Here you will find a website that provides up-to-date information on a range of cancer control topics—from disease prevention to the impact of deaths from cancer—and data that track the successful application of cancer research into practice.

The Cancer Trends Progress Report – 2007 Update draws on data from numerous federal departments and agencies, including the Environmental Protection Agency, the Department of Agriculture, and several offices and agencies within the Department of Health and Human Services, including the Centers for Disease Control and Prevention, the Office of Disease Prevention and Health Promotion, the Substance Abuse and Mental Health Administration, and the National Institutes of Health's National Institute on Alcohol Abuse and Alcoholism. The content, design, and production of this report are the results of a collaboration of federal and state agency partners, consumer advocates, the American Cancer Society, and others.

As the report details, cancer mortality continues a gradual decline that began in the mid-1990s. Since that time, many preventive and early detection practices have improved. Screening rates for colorectal, breast, and cervical cancers are rising, albeit modestly. The smoking rate among adolescents appears to be heading downward, however there was no decrease in the most recent two year data collection period. Adult cigarette smoking prevalence has been slowly declining since 1991, with some evidence of a steeper decline for females than males. However, overall prevalence has not declined since 2004.

We are beginning to achieve a significant reduction in the rate of recurrence following surgery for common solid tumors, such as breast and colorectal cancers. Clinical trials of post-surgical, adjunctive chemotherapy for men and women with breast or colorectal cancers that involve regional lymph nodes at the time of initial diagnosis and treatment demonstrate major improvements in overall survival for patients receiving multi-agent systemic chemotherapy. Importantly, refinements in treatment programs, thanks to several new, more effective drugs, have led to substantively better survival rates for both of these diseases over the past five years. Based on further recent improvements in the treatment of advanced breast and colorectal cancers with antiangiogenic therapies, monoclonal antibodies, and molecularly targeted drugs, our ability to significantly decrease the risk of relapse for these diseases after primary surgery should only continue to improve.

The Human Genome Project has opened up new vistas of cancer research, enabling us to systematically identify all important inherited and acquired genetic alterations that contribute to a person's cancer risk and how, if cancer occurs, it will behave. We are diligently working to understand how these genetic changes affect our ability to prevent and treat this disease. These kinds of studies point to a time when risk will be calculated based on the individual patient. And, new imaging techniques and technologies are peering deep inside the inner workings of the cancer cell, providing insight into tumor biology, along with the capacity to learn—in real time—if a small molecule therapy is reaching, and saturating, its molecular target.

These advances are happening at a pace never before seen. Reports like this one will help to get that message to the patients, policymakers, and health care providers who join researchers on cancer's front lines.

There is, of course, much work left to be done. More intense research and more-effective interventions are needed for several cancers whose death rates are on the rise, including esophageal cancer and non-Hodgkin lymphoma.

There are unacceptable disparities in cancer incidence and outcomes among major racial and ethnic groups. We need more-reliable and more-accurate ways to assess models, and enhance the delivery of quality care to all. The recently launched NCI Community Cancer Centers Program (NCCCP) is researching how best to bring state-of-the-art care and early phase research to all Americans, in the communities where they live.

We at NCI, along with our Cancer Trends Progress Report partners, hope that you will find this report to be a valuable reference tool and a stimulus for action. We must not forget that the numbers in this report reflect the lives and struggles of millions of our fellow citizens. NCI remains committed to its vital work, on behalf of each one of them.

John E. Niederhuber, M.D.
Director, National Cancer Institute

National Cancer InstituteDepartment of Health and Human ServicesNational Institutes of