Cancer Ranks No. 2 Among Causes of Premature Death

Cancer, the nation’s No. 2 killer, is also the second leading cause of “years of potential life lost”--stealing years from younger Americans who otherwise would have lived longer, according to a new study released Thursday by the federal Centers for Disease Control.

“The idea was to look at mortality from a different perspective,” said Dr. Matthew Zack, a medical epidemiologist with the chronic disease control division of CDC’s center for environmental health. “Instead of looking at the total numbers of deaths, we looked at the causes of death of the very young.”

Order of Killers Shifts

The order of the top killers shifts when viewed this way, he said. Injuries, which rank fourth overall behind heart disease, cancer and vascular diseases, such as stroke, jump to first place because they tend to strike younger people, he said.

“Causes of death that occur in young ages tend to predominate, such as children being hit by cars, or motor vehicle injuries by teen-agers and young adults,” he said.

He added: “Cancer is second in terms of both rankings because there are several cancers that affect people at young ages.”

In 1984, cancer accounted for 1.8 million years of potential life lost if the victims had survived to age 65, or 15% of the total years lost from all causes, according to data obtained from the federal National Center for Health Statistics, the agency said.

“Because over one-third of cancer deaths occur among persons under 65 years of age, cancer retains its importance as a cause of death when ranked either by summary death rates--which emphasize mortality at older ages--or by years of potential life lost, which emphasizes mortality at younger ages,” the agency said.

Data from 1983 indicates that the highest rates were among black men, followed by black women, white men and white women, the CDC said.

“About 85% of the U.S. population is white, so of the total, the largest percent is still among white males and white females,” Zack said.

“But if you correct for the number of persons, then the rates are much higher for black males and black females.”

Highest Among Blacks

In 1983, for example, cancer accounted for 43% of the total years of potential life lost among white men and 41% among white women, the CDC said. Black men, however, had the highest rates--1,130 per 100,000 persons--followed by black women, with 937 per 100,000, the CDC said. The figure was 889 for white men and 842 for white women, it said.

“For almost all cancers, except those with notably poor survival rates, whites have a better chance of survival after diagnosis than blacks,” the agency said. Further, the CDC said, white patients have tended to be “somewhat older” at diagnosis than blacks and to have higher percentages of cancers diagnosed while “localized”--before the cancer has spread.

“This may reflect a variety of things,” Zack said. “Whites, when they notice something wrong, may go to doctors more quickly than blacks, so the cancer is caught at an earlier stage. Blacks may not have the same access to medical care as whites. They also may not be as able to afford cancer screening tests, or they may not be as accessible to them.”

When calculated as “years of potential life lost,” respiratory-system cancers in 1983 accounted for 24% of all years of potential life lost because of cancers, the CDC said, followed by a category that it designated as “other, unspecified sites,” at 19%. Digestive-system cancers ranked third, at 17%, followed by breast cancer, at 12%.

These four categories accounted for more than 70% of the deaths from cancer among people under 65, the CDC said. However, when ranked according to “percentage of deaths,” the order “differed from that based on potential years of life lost.”

When viewed in total percentages, the CDC said, respiratory-system cancers accounted for 31% of all deaths; digestive system, 21%; breast cancer, 11%, and cancers of other, unspecified sites, 14%.

“The category cancers of ‘other and unspecified’ sites ranks higher than digestive-system cancers when ranked by years of potential life lost, but lower when ranked by death rates,” the CDC said. “Cancers of the bone, connective tissue, skin and nervous system--prevalent cancers of childhood and young adulthood--probably account for this difference.”