WASHINGTON - More Americans are surviving cancer for five years or more and deaths from cancer overall are steadily declining, according to the latest annual report on cancer published Thursday in the journal Cancer.

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For the first time, fewer women are being diagnosed with lung cancer, the joint report from the American Cancer Society, Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries finds.

Not everyone is reaping the gains: Minorities still are more likely than whites to die from cancer, says the report.

Cancer remains the second leading cause of death in the United States behind heart disease. This year 1.368 million Americans will learn they have cancer and 563,700 will die of it.

The “Annual Report to the Nation on the Status of Cancer, 1975-2001” finds that cancer rates dropped 0.5 percent per year from 1991 to 2001, while death rates from all cancers combined dropped 1.1 percent per year from 1993 to 2001.

This is due to better prevention, screening that catches cancer early enough to treat it, and better therapies.

Drop in lung cancer among women
Most striking in this latest tally is what’s happening with the No. 1 cancer killer: Rates of female lung cancer diagnoses have declined about 2 percent a year since 1998, years after men began a similar improvement.

Smoking became common among men long before women, and the resulting lung cancer consequently struck men sooner.

Lung cancer remains the nation’s top-killing malignancy for both sexes, and the second most common cancer. But it slowly declined among men starting in the early 1990s as older smokers died and fewer young men took up the habit — a pattern doctors expect to eventually see in women.

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The report says female death rates from lung cancer have leveled off, remaining virtually unchanged since 1995, the report says.

“The first-ever drop in lung cancer incidence rates in women is remarkable proof that we are making a difference in the number one cancer killer, and is powerful evidence that our successful efforts must continue,” said John Seffrin, chief executive officer of the American Cancer Society.

Nonetheless about 174,000 Americans will be diagnosed with lung cancer this year and 160,000 will die of it.

The report builds on one issued by the American Cancer Society alone in January, which also showed overall cancer diagnosis and death rates dropping across the United States.

Survival milestone
The report’s other new finding: More people are living at least five years after a diagnosis of most types of cancer.

Five-year survival is a major milestone for cancer patients, and the scientists found significant gains over the past two decades in how often that milestone was met.

The joint report compares five-year survival rates of cancer patients diagnosed between 1975 and 1979 to those diagnosed between 1995 and 2000.

For men, survival rates improved the most — more than 10 percent — for cancers of the prostate, colon and kidney, and for melanoma and leukemia.

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For women, the biggest survival improvements came in colon, kidney and breast cancers.

What does that mean? Today, 99.3 percent of men diagnosed with prostate cancer will live five years, up from 70 percent in the 1970s. Five-year survival for breast cancer is 88 percent, up from 75 percent in the 1970s.

But that survival is strongly connected to how early cancer is caught, stressed co-author Brenda Edwards of the NCI’s cancer-control division.

The report found that patients with the most deadly forms such as lung, pancreatic or liver cancers were only a little more likely to survive.

The racial gap
When looking at all cancers combined, black men are 26 percent more likely to die of a malignancy than white men, and Hispanic men are 16 percent more likely than non-Hispanic whites, said the Cancer Society’s Jemal.

Black women are 52 percent more likely to die of cancer than white women, and Hispanic women 20 percent more likely, he said.

Much of the disparity reflects minorities’ poorer access to cancer prevention and early detection services, Jemal said.

But notable differences remain even when scientists examine people diagnosed at the same stage of cancer, said NCI’s Edwards.

Black women were more likely to die of breast cancer, even though that disease is more common among whites.

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Access to the best treatment options probably plays a role, as may additional illnesses patients have that complicate cancer treatment, Edwards said. “It’s not one simple story as to what is our national cancer burden,” she cautioned.

Added Jemal: “We know much about cancer. We need to apply everything about cancer control equally to all populations.”

And almost every racial and ethnic minority was more likely than whites to die of cancer.

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