Annals of Oncology 11: 903-907, 2000.
News
General decline of cancer incidence
in US
The rate of new cancer cases and deaths for all
cancers combined declined between 1990 and 1997 in
the US, according to a new report by NCI and the
American Cancer Society, which was published in the
May 15, 2000 issue of Cancer. This tendency has already
been commented on by Richard Klausner, director of
NCI, in February during a hearing in the American
Congress. He was reported to say "these findings
underscore the remarkable progress we have made
against cancer". In fact the report shows that the
incidence rate for all cancers combined declined on
average 0.8% per year between 1990 and 1997. The
greatest incidence decrease, with a rate of 1.3% per
year, occurred after 1992, the year in which incidence
rates peaked. This trend seems to reverse a pattern of
increasing incidence rates which has been going on
from 1973 to 1992 (Cancer Lett, May 19, Vol 26 (20)).
Four cancer sites - lung, prostate, breast, and colon
and rectum - represent slightly more than half of all
new cancer cases. The published data show that
incidence and mortality are decreasing for prostate
cancer while breast cancer incidence has remained
steady. In contrast to that, breast cancer death rates
have declined about 2% per year since 1990 and even
more so since 1995. Lung cancer mortality continues
to increase for females but has been declining for men
since 1990. Incidence and death rates for non-Hodgkin's
lymphoma among women are continuing to increase
while the pattern is less clear for men. The most
surprising element in the report was the decline in
overall incidence of colorectal cancer, a decline which
seemingly began already around 1985. Mortality of
colorectal cancer is also declining, mainly in men. The
authors of the reports suggest that screening and
advances in treatment have helped reduce mortality
from the disease despite the still low use of screening
test procedures for colorectal cancer.
overall level of responsiveness; the distribution of
responsiveness; and the distribution of financial contributions. According to WHO'S director-general, Gro
Harlem Brundtland "the main message from this report is that the health and well-being of people around
the world depend critically on the performance of the
health systems that serve them" (Lancet 355: 2223,
June 24). The report shows wide variation in the performance of health systems, even among countries
with similar levels of income and health expenditure.
France, e.g., spent 9.8% of its gross domestic product
on health vs. only about 6% in the UK which has a
lower rating. Even though the United States outspent
everyone, at 14% of GDP, it was ranked only 24th in
the overall index, mainly because many Americans do
not have health insurance coverage. In addition to the
uninsured population, the US rating was dragged down
by its low level of healthy life expectancy. Healthy life
expectancy is 70 in the US, which is 4.5 years lower
than countries like France, Austria and Japan (Herald
Tribune, 21 June, p. 1).
France first in health care
France and Council of Europe
against gene-patenting law
Just around the time when France - after having won
the world soccer championship in 1998, was winning the
European title, the WHO (World Health Organisation)
published for the first time a ranking of the health
systems of its 191 member countries. This major analysis of the performance of health care systems found
that France provides the best overall care. WHO assess
the systems using five indicators: the overall level of
health; the distribution of health in the population; the
France is on a collision course with the European
Union over an EU directive that many researchers
believe would allow raw DNA sequences of human
genes to be patented. On 7 June, French justice minister Elisabeth Guigou told the National Assembly that
the directive - which must be enacted by each of the
15 EU member nations by 30 July - contradicts French
bioethics laws, which forbid the patenting of any part
of the human body (Science 288: 2115, 23 June). The
Gro Harlem Brundtland