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serves as  evidence of a  cancer epidemic since total numbers of cancer
deaths are increasing. This is wrong and should not be tolerated.
The cancer rates actually are more complicated than this because there are
deaths from all types of cancer. Another factor is that if one examines age-
adjusted cancer rates, as expected, there is a continuous increase with age no
matter what category one chooses to examine. For example, the 1998 rate of
cancer deaths per 100,000 is tabulated in Table 4.4.
TABLE 4.4. 1998 rate of cancer deaths per 100,000 people
Age Group Males Females
15-24 5.2 3.7
25-44 23.6 28.3
45-64 * 260.1 216.5
> 65 1,424.9 913.5
* Cancer is the leading cause of death in this age bracket.
60 CHAPTER 4
Note the dramatic increase for people older than 65. We are dealing with a
disease that affects the aged. It is interesting that if this analysis were done 100
years ago, this category would almost be nonexistent because few people lived
that long and cancer was never diagnosed as it wasn t discovered! The pri-
mary cancer with which we are dealing is lung or respiratory cancer through
about 70 years of age, after which cancer of the digestive and reproductive
systems start taking their toll. In a 1988 study by the National Cancer
Institute, using data in addition to these simple census figures, the age adjust-
ed mortality rate for all cancers (except lung) has been steadily declining since
1950, except for those individuals greater than 85 years of age. One has to die
of something, and cancer will play the role of Longfellow s Reaper for many
decades to come. As mentioned earlier, 85 years is a benchmark age after
which decreases in mortality seem difficult to lower for the population as a
whole. However, some individuals do beat the odds as evidenced by the pop-
ulation explosion in centenarians.
There is uniform agreement that the primary cause of cancer in the United
States is lung cancer due to smoking. If one breaks the preceding cancer rates
into types of malignancies, there has been a steady increase in lung cancer for
all categories tabulated. Smoking (and thus lung cancer) is the reason for the
slight increase noted in total cancer rates. Consistent with this, the rate of
lung disease, categorized as  chronic obstructive pulmonary diseases and
allied disorders, is increasing. If lung cancer is removed from the tabulation,
the rates of cancer stabilize or decrease as in the NCI study. I could go on and
on comparing rates of different types of cancers for example, increased
colon cancer but decreased stomach cancer. In 1993, the 4 major causes of
new cancer, accounting for 55% of the total cancer, were lung, breast, colon,
and prostate. I do not feel that this continued type of analysis would add any-
thing new to our discussion. There is no cancer epidemic!
There have been numerous epidemiologic studies specifically designed to
probe the incidence of cancer by taking into account patterns of smoking and
chronic alcohol consumption. Study after study indicate that these two factors
significantly increase the rate of cancer in our society. There is also consensus
that our rates of skin cancer and melanoma are increasing because of expo-
sure to ultraviolet radiation primarily from the sun. The public widely
acknowledges that asbestos is a major cause of cancer, and this is true.
Occupational exposure, such as manufacturing, mining, or installation of a
specific filament type of fiber, is a risk. Ship builders in World War II were at
risk. However, the data shows that the significant factor which must be pres-
ent for the most common type of asbestos-induced lung cancer to occur
interstitial fibrosis is concurrent smoking. The other type of cancer
mesotheliomas will occur typically with occupational asbestos exposure.
These types of interrelationships hold for numerous other cancers and toxi-
VEGGIE AND FRUIT CONSUMPTION IN THE AGE OF THE CENTENARIANS 61
cologic problems. Recall that the liver is a primary defense organ that metab-
olizes and eliminates foreign chemicals from our body. If one destroys the
liver by chronic alcohol consumption, it cannot perform its function and con-
sequently is more susceptible to other insults if one manages to survive the
primary disease.
Some may argue that the reason our life expectancy is increased is not
because of a decreased incidence of disease but rather because the miracles of
modern medicine can now cure disease and postpone death. This would sug-
gest that, contrary to all the data above, the incidence of cancer is actually
increasing, but modern medicine has  found the cure, and thus we are no
longer dying from it. There are two components of this hypothesis which
must be addressed. First, modern medicine has made significant progress in
eliminating most causes of infectious disease (except for AIDS) and in taming
heart or cardiovascular disease and its complications, for example hyperten-
sion. This has allowed people to live longer and get more cancer, as funda-
mentally, cancer is often a disease of aging. The body s ability to regulate cell
growth is lost, and cells grow unabated. Unfortunately, the second part of the [ Pobierz całość w formacie PDF ]

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