Have we reduced the risk of getting cancer or of dying from cancer? An update.

We have examined trends in cancer mortality, incidence and survival in the United States to update our earlier work and respond to criticisms. [Bailar, J.C., Smith, E.M.: New Engl. J. Med. 314, 1226 (1986).] Here we concentrate on the years 1975-1984, and show that overall cancer mortality has increased, incidence has increased and case survival is virtually unchanged. This generally unfavorable picture is scarcely changed when lung cancer is excluded from the trends. While trends for individual cancers have been mixed, overall progress in both curative treatment and prevention has been minimal. This evaluation does not deny the marked progress in treating some uncommon forms of cancer, improved palliation, reduced extent or severity of treatment, or benefits of cancer research that can be applied in other areas of medicine. While our finding of limited progress is not new, we believe that it requires increased attention in setting the course of future research initiatives, demonstration programs, medical training and clinical practice.