Marci McCurlie, photographed in Toronto on May 8, 2012, smoked for 10 years before quitting with the help of the services provided by the Canadian Cancer Society's smoking cessation program.
While cancer remains the country's biggest killer, the mortality rate – essentially an average Canadian's risk of dying of cancer – has fallen markedly over the past generation.
The cancer death rate dropped 21 per cent in men and nine per cent in women between 1988 and 2007, according to new data from the Canadian Cancer Society.
In men, mortality fell for the four major cancer killers: lung, colorectal, prostate and pancreas. For women, it was the same story, with one notable exception: Colorectal, breast and pancreas cancer deaths dropped, but lung cancer deaths have soared. In the last couple of years, however, lung cancer deaths have stabilized in women too.
The decrease in cancer deaths is due principally to fewer Canadians smoking, along with more early detection and improved treatments, Gillian Bromfield, director, cancer control policy at the CCS, said in an interview.
"Without these changes, if smoking rates had remained the same, for example, we would have seen 100,000 more cancer deaths over the past 20 years," she said.
Slightly more men than women die of cancer: 52 per cent versus 48 per cent.
The gender gap, however, is closing, due largely to smoking patterns. Historically, far more men than women have smoked, but the decline in smoking has been more rapid in men than in women. Young women are also more likely to become new smokers.
An estimated 186,400 new cases of cancer will be diagnosed in Canada this year (a figure that does not include 81,300 cases of non-melanoma skin cancer), according to the CCS projections. More than two-thirds of people diagnosed with cancer survive five years or more.
There will be approximately 75,700 cancer deaths in 2012.
Lung cancer is, by far, the biggest cancer killer, with 20,100 deaths, followed by colorectal cancer, 9,200, breast cancer 5,200, pancreatic cancer, 4,300, and prostate cancer, 4,000.
While those numbers are significant, the report shows that the mortality rate dropped for most major cancers over the past two decades. Specifically:
- Lung cancer deaths up 34 per cent in women, but down 30 per cent in men;
- Prostate cancer, 34 per cent decrease;
- Breast cancer, 32 per cent reduction;
- Colorectal cancer deaths down 24 per cent in men, 16 per cent in women;
- Pancreatic cancer, 14 per cent decline in men, two per cent in women.
Despite these improvements, the overall number of cancer cases diagnosed and number of cancer deaths are rising steadily due to population growth and aging. Cancer is principally a disease of aging, although individual risk depends on a combination of genetics, environmental factors and triggers.
Two-thirds of cancer deaths occur in people over the age of 50.
While there has been significant progress, more can still be done, Ms. Bromfield said, noting that about half of all cancer deaths are preventable, principally through lifestyle changes like smoking cessation.
"I grew up thinking that smoking was pretty cool," said Marcie McCurlie, who started at age 16. She kept at it for a decade before quitting her pack-a-day habit for good earlier this year.
"I started to realize that smoking was aging me. It gives you wrinkles. I had asthma and I was getting sick all the time," Ms. McCurlie said. "My doctor was a big influence in getting me to quit, and I feel a lot healthier now."
David Hammond, an associate professor of public health at the University of Waterloo in Waterloo, Ont., said there have been significant declines in smoking rates – to 17 per cent today from 50 per cent – and it is reflected in the mortality statistics.
"But there are still 4.7 million Canadians who smoke, so we've got a long way to go."
Dr. Hammond said the key is prevention – ensuring young people don't start smoking in the first place.
He said many initiatives have been taken, such as outlawing smoking in workplaces and bars, and graphic illustrations on cigarette packages, but government could – and should go further – by mandating plain packaging and outlawing flavoured tobacco that appeals to young people.
Dr. Hammond said there is a need for far more support for people who are trying to quit smoking and a crackdown on contraband tobacco, because high prices are one of the best disincentives to new smokers.
The full report is available at: cancer.ca/Canada-wide.aspx?sc_lang=en
Editor's note: The lung cancer mortality rate in Canadian women increased 34 per cent between 1988 and 2007. Incorrect information appeared in an earlier version of this online story.
André Picard