Death Rates From Cancer Still Inching Down

Death rates from cancer are continuing to inch down, researchers reported.   Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.   "There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.   But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.   Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types - lung, colorectal, breast and prostate cancers - because of treatment advances and better screening.   The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.   Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.   Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.   But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.   Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.   Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.     Revalidation - this is a system of checks that started in December 2012 which makes it compulsory for all doctors practicing in the UK to show that they are keeping up to date and are fit to practice. The revalidation is based on an annual review (appraisal) and feedback from colleagues and patients.   The Process Of Revalidation will occur every five years and will apply to all doctors in all UK settings, including locums and those who work in the private sector.   Dame Sally Davies, Chief Medical Officer, has become one of the first UK doctors to be revalidated after receiving confirmation from the GMC this week.   Chief Medical Officer Dame Sally Davies said "I am delighted to have confirmation of my revalidation from the GMC. Being revalidated was an incredibly useful experience, and allowed me to reflect on my own practice and approach. All feedback is useful to doctors - and for many it is about improving their already high standards. This is the biggest change to medical regulation in over a hundred years, but must importantly the process provides huge reassurance to patients and the public."   According to the General Medical Council, the United Kingdom is the first country worldwide to introduce such a comprehensive system across the nation's healthcare system.   Language competence - UK hospital and medical agencies are not allowed to test the language skills of the doctors who come in from other European Union countries to determine whether they can communicate properly (whether their English is good enough to work). Britain has interpreted EU law as meaning that health care professionals who qualify in any of the European Union's 27 nations "must" be free to work elsewhere, with no restriction whatsoever.   According to the British Medical Association's director of professional activities, Dr Vivienne Nathanson:   "It is clear that doctors who have qualified overseas are more likely to be subject to disciplinary action. However, more research is needed to understand why this is the case. The UK is still short of doctors and so we must ensure that those who come from overseas are given adequate support to be able to practise medicine in the UK.   It is critical that all doctors that work in the UK have appropriate clinical and communication skills as well as an understanding of UK law and culture and of how the NHS works." ul screening measures such as a Papanicolaou test, HPV polymerase chain reaction testing, or both may be daunting to achieve, but there is meaningful hope that prevention efforts will ameliorate the effects of HPV-related oropharyngeal cancer."