In its biannual update on progress in the battle against cancer, the National Cancer Institute said Thursday that Americans are increasing their use of screening tests to catch some cancers early, when they are more treatable.
They are also smoking less, being more careful in the sun and consuming less alcohol and fats, though obesity remains a problem.
"The overall message of the report remains positive," NCI Director Andrew C. von Eschenbach said. "The evidence that I have seen convinces me that we are poised to make dramatic gains against cancer in the near future."
The report said 488.6 new cases of cancer were diagnosed for every 100,000 Americans in 2002, very similar to the rate of 488.1 a year earlier.
At the same time, though, the death rate for all cancers was 193.6 per 100,000, down from 195.7 a year earlier and continuing a steady downward trend.
For the four most common cancers the death rates were:
The report charts progress against goals set for reducing cancer rates and deaths by 2010. The first report was issued in 2001.
This year's update noted a continuing rise in lung cancer death rates in women, but it said the rate was not increasing as rapidly as in the past.
The Cancer Institute, a part of the National Institutes of Health, said there have been continuing increases in the incidence of cancers of the breast in women and of prostate and testis in men, as well as leukemia, non-Hodgkin lymphoma, myeloma, melanoma of skin, and cancers of the thyroid, kidney and esophagus.
There have been some improvements in behavior aimed to prevent cancers, including reductions in smoking and declines in alcohol and fat consumption, the Institute said in its report. Some of the same data were included in the institute's annual report issued in October.
Smoking by youths, which had been growing in the 1990s, has been declining since 1997, the report said. Youths are starting to smoke later, with average age for first use of cigarettes at 15.4 in 2003, up from 14.9 a decade earlier. And the percentage of high schoolers who smoked cigarettes fell from 30.5 percent to 21.9 percent in the same period.
The use of screening tests for breast and cervical cancers is high and remained stable between 2000 and 2003. As of 2003, 69.7 percent of women over 40 had a mammogram in the last two years, up from just 29 percent in 1987. And 79.2 percent had a pap test for cervical cancer, up from 73.7.
However, the Institute said, screening for colorectal cancer remains low. Just 43.4 percent of adults over 50 had an endoscopy as of 2003, though that was up from 27.3 percent in 1987.
People are doing slightly more to protect themselves from the sun, with 60.6 percent of people 18 and over saying they had taken steps to prevent sun exposure, compared with 53.6 percent in 1992.
Spending on cancer treatment continues to rise along with total health care spending.
The report noted that blacks and people with low socio-economic status have the highest rates of both new cancers and cancer deaths.