Why Are Lung Cancer Deaths Increasing?

[Marat]

Despite the fact that diagnostic technology has greatly improved over the last 60 years and the percentage of the population smoking cigarettes -- a major cause of lung cancer -- has vastly declined during that same period, in the United States in 1950 18,000 people died of lung cancer, while in 2004 in the U.S. 160,000 people died of lung cancer. Since the U.S. population approximately doubled during that period, that means that the cancer death rate has more than quadrupled over that period. Five year survival rate for those diagnosed with lung cancer has remained stable for the last 20 years, and even for other cancers, the five year survival rate has just edged up by a few percentage points, so that much of this improvement may just represent the fact that the survival rate has increased because we have started measuring earlier -- thanks to improved detection methods -- the unchanged length of the natural evolution to cancer death.

 

So what has gone wrong with the 'war on cancer'?

[John Cuthber]

Is that a serious question?

Did you not realise that, in 1950 a lot of people didn't live long enough to get lung cancer?

[swansont]

The death rate always has to add to 100%, so as John Cuthber implied, the question is ill-formed. In 1950, the death rate from heart disease was higher than it is today, tuberculosis and polio have basically vanished. People have to die of something else.

[Marat]

We've doubled the population since 1950; the cigarette smoking rate among adults has declined from 42% in 1965 to 21% in 2006; elaborate devices such as MRIs and CT scans have been invented to catch developing cancers early; health-conscious consumers have cut their consumption of carcinogenic foods such as smoked meat; and yet the annual number of cancer deaths has more than quadrupled?! The factors cited are inadequate to explain away all of that massive increase in spite of factors which should instead logically have caused a huge decrease in the cancer death rate by now..

[alpha2cen]

Till now we have not find a method curing lug cancer, as I know, we only know patients lifetime delay a little longer.

So it is no meaning to find the lug cancer early. Only what we provide some meaning about the finding is it's usefulness for research of curing lug cancer for the future patient.

I think lug cell is very complicate than other cell, very thin layer for mass transfer, and very advanced immune system is operated than any other organs in our body. So the cancer which pierces the immune system is not easy to cure.

Edited January 20, 2011 by alpha2cen

[swansont]

Let's try this again, with this example: Let's say 50% of people died of heart attacks by age 50 in 1950. These days, they don't — if they have one they often survive it, and die later in life. But this is a zero-sum game. If heart attacks only comprise 25% of deaths today, other causes must have increased, because 100% of people who died, died. (Cue Jim Carroll Band) Something has to make up for that 25%, so a cause of death that was 5% in 1950 could possibly become 30% today, just by virtue of being how you die if you make it past age 50.

 

In reality there are multiple causes that have been reduced, which extend our life spans. But it's just a matter of rearranging the statistics. Looking at death rates doesn't tell you what you are claiming it does.

[John Cuthber]

Is this

"The factors cited are inadequate " an argument from incredulity?

If not, please show some supporting numbers.

[Marat]

Cancers are mainly diseases of aging, but the American life expectancy has not increased all that much between 1950 and today, changing only from 69 years at birth in 1950 to 77 years at birth in 2001, so that the life expectancy in 1950 was 90% of what it is now. So the assumption that there has been some massive decline of deaths from other causes which has been filled up by a more than four-fold increase of lung cancer deaths doesn't seem possible to fit into that extra 10% of lifespan measuring the reduced death rate from non-lung cancer deaths. The supposed decline in tuberculosis deaths cannot clear up space for the expansion of the proportion of lung cancer deaths, since in America in 1950 only 33,000 people died of tuberculosis, which was by then already well under control because of improved nutrition, hygiene, and BCG treatment.

 

But since the main driver of lung cancer deaths is cigarette smoking, and that has declined dramatically between 1950 and today, there seems no logical reason why lung cancer should be filling up the space left by declines in other causes of death.

[Ringer]

But you have to look at the deaths per capita, not raw number of deaths. The total population has went from around 158,000,000 in 1950 to 283,000,000 in 2000. And those extra eight years can do a lot when one gets older. In my opinion the lack of other deaths and the population growth more than make a satisfactory answer to why there are so many lung cancer deaths.

[Marat]

I'm looking at the per capita rate, which as I noted in the OP is more than four times higher today than in 1950. The death rate for some other causes is declining, such as nonsudden cardiac death (down 69% from 1950 to 1999) and sudden cardiac death (down 49% from 1950 to 1999), but why has the outcome for cardiac diseae improved with earlier diagnosis and intervention, better diet, change in lifestyle, etc., while lung cancer has become so much worse a problem?

[lemur]

I think lug cell is very complicate than other cell, very thin layer for mass transfer, and very advanced immune system is operated than any other organs in our body. So the cancer which pierces the immune system is not easy to cure.

I wonder if the susceptibility of lung tissue to all sorts of carcinogens could have been spuriously attributed to cigarette smoking. Certainly, smoking can be correlated with job-related exposure to carcinogens like asbestos and fiberglass, just because people who work with these kinds of materials tend to smoke more (I think - I could be wrong). Anyway, there are numerous other possibilities for lung-susceptibility. Now since I said this, I want my cut of the wrongful-conviction lawsuits of the tobacco companies and the large settlements they will be demanding back from the government(s).

[Ringer]

From the Center for Disease Control:

Death Trends²

In the United States, deaths from lung cancer have—

 

• Decreased significantly by 2.0% per year from 1994 to 2006 among men.
• Remained level from 2003 to 2006 among women.
• Decreased significantly by 1.8% per year from 1997 to 2006 among white men.
• Decreased significantly by 0.1% per year from 1997 to 2006 among white women.
• Decreased significantly by 2.9% per year from 1997 to 2006 among African American men.
• Remained level from 1997 to 2006 among African American women.
• Decreased significantly by 1.5% per year from 1997 to 2006 among Asian/Pacific Islander men.
• Decreased significantly by 0.8% per year from 1997 to 2006 among Asian/Pacific Islander women.
• Decreased significantly by 3.3% per year from 1997 to 2006 among American Indians/Alaska Native men.
• Decreased significantly by 2.6% per year from 1997 to 2006 among American Indians/Alaska Native women.
• Decreased significantly by 3.0% per year from 1997 to 2006 among Hispanic men.
• Decreased significantly by 0.8% per year from 1997 to 2006 among Hispanic women.

 

The incidence has also decreased since the 90's

Incidence Trends²

In the United States, incidence of lung cancer has—

 

• Decreased significantly by 1.8% per year from 1991 to 2006 among men.
• Increased significantly by 0.4% per year from 1991 to 2006 among women.
• Decreased significantly by 1.8% per year from 1997 to 2006 among white men.
• Increased significantly by 0.2% per year from 1997 to 2006 among white women.
• Decreased significantly by 2.7% per year from 1997 to 2006 among African American men.
• Remained level from 1997 to 2006 among African American women.
• Decreased significantly by 3.2% per year from 1997 to 2006 among American Indians/Alaska Native men.
• Remained level from 1997 to 2006 among American Indians/Alaska Native women.
• Decreased significantly by 2.0% per year from 1997 to 2006 among Asian/Pacific Islander men.
• Remained level from 1997 to 2006 among Asian/Pacific Islander women.
• Decreased significantly by 2.5% per year from 1997 to 2006 among Hispanic men.
• Decreased significantly by 0.7% per year from 1997 to 2006 among Hispanic women.

 

If I remember correctly this would correlate well with the decrease in smoking since the 90's.

[alpha2cen]

Lug cancer problem is not easy.

Generally speaking, cancer is caused by environmental factor plus genetic factor.

Incident trends of the lug cancer is very important for determining government policy.

If the incident trends increase, the government policy is something wrong.

Such that, the government failed to control the air quality.

The result is not appear immediate, it takes some time, i.e., father's fault makes sun's misfortune.

If this years lug cancer incident trend decrease, it is the result of past past government's good efforts.

Today happiness is the results of half of my efforts and half of my ancestors efforts.

[swansont]

Cancers are mainly diseases of aging, but the American life expectancy has not increased all that much between 1950 and today, changing only from 69 years at birth in 1950 to 77 years at birth in 2001, so that the life expectancy in 1950 was 90% of what it is now. So the assumption that there has been some massive decline of deaths from other causes which has been filled up by a more than four-fold increase of lung cancer deaths doesn't seem possible to fit into that extra 10% of lifespan measuring the reduced death rate from non-lung cancer deaths. The supposed decline in tuberculosis deaths cannot clear up space for the expansion of the proportion of lung cancer deaths, since in America in 1950 only 33,000 people died of tuberculosis, which was by then already well under control because of improved nutrition, hygiene, and BCG treatment.

 

But 33,000 still represents >2% of the deaths. If you eliminate that, something else has to increase to take its place.

 

But since the main driver of lung cancer deaths is cigarette smoking, and that has declined dramatically between 1950 and today, there seems no logical reason why lung cancer should be filling up the space left by declines in other causes of death.

 

Personal incredulity isn't an argument. Do all smokers die of lung cancer? What if the ones who didn't die of lung cancer used to die of something else, but that cause of death has been dramatically reduced, and now those people live long enough to get lung cancer?

[Marat]

I state an argument -- that since the main cause of lung cancer deaths, cigarette smoking, has declined dramatically, it should not be lung cancer mortality which is increasing so dramatically (more than four-fold) to fill the gap created by the much smaller declines in other leading causes of death (e.g., cardiac disease, decreasing not four-fold over that same time but only by circa 50%) -- and you reply by saying that personal incredulity is not an argument. I am incredulous as a result of that argument, not as a substitute for it.

[swansont]

I state an argument -- that since the main cause of lung cancer deaths, cigarette smoking, has declined dramatically, it should not be lung cancer mortality which is increasing so dramatically (more than four-fold) to fill the gap created by the much smaller declines in other leading causes of death (e.g., cardiac disease, decreasing not four-fold over that same time but only by circa 50%) -- and you reply by saying that personal incredulity is not an argument. I am incredulous as a result of that argument, not as a substitute for it.

 

You are claiming there is no logical reason, and there is. What you haven't done is present relevant statistic for the argument. I don't know if they even exist, but what you need to know, at a minimum, is how many smokers there are, how long it typically takes for lung cancer to manifest itself and what other ways there are for smoker to die. A smoker who dies of a different cause at a young age does't get the chance to die of cancer. Reduce the mortality from those causes and all else being the same the mortality from cancer will increase. That's basic statistics of the zero-sum situation.

 

Your claim that declines in other causes of death are too small is not something you have supported at all, and isn't supported by basic math The numbers have to add up to 100%. instead of asserting this, show the numbers. Where are you getting them? 18,000 deaths in 1950 is barely 1% of all deaths. Heart disease was 37%. In 1998, that dropped to 31%, so lung cancer could have sextupled just based on that, and there is no statistical mystery.

http://www.cdc.gov/nchs/data/dvs/lead1900_98.pdf