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Death rates for most cancers in decline

Copyright © 2016 Albuquerque Journal

Death rates for most types of cancer have declined for a decade or more, but rates of liver and pancreatic cancers remain on the rise, Dr. Douglas Lowy, acting director of the National Cancer Institutes, said Friday in Albuquerque.

Colorectal cancer death rates are declining nationally but remain stubbornly high among Native Americans, pointing to a need for better screening in underserved areas, Lowy told researchers at the University of New Mexico Comprehensive Cancer Center.

The incidence of liver cancer increased an average of 2.3 percent each year from 2008 to 2012, according to the Centers for Disease Control and Prevention. Liver cancer incidence rates are highest among Native American men.

One explanation for the increase in liver cancer is a high prevalence of hepatitis C, a key risk factor for liver cancer, Lowy said.

Hepatitis C infects an estimated 3 million people in the U.S., and up to 35,000 in New Mexico.

Safe and effective antiviral drugs, particularly Harvoni, have revolutionized the treatment of hepatitis C in recent years. But Harvoni’s retail cost of $94,000 for a 12-week course of treatment essentially rations who gets the drug, Lowy said.

“My hope and optimistic expectation is that in a few years, the price of (hepatitis C) drugs will have gone down,” Lowy said in an interview. Over time, the drugs will cut the rate of new infections of hepatitis C, and should lower rates of liver cancer, he said.

Other solutions could be as simple as taking a low-dose aspirin each day, Lowy said. Taking a low-dose aspirin for five years or longer has been shown to reduce the incidence of colorectal and other cancers.

New guidelines are likely to emerge later this year recommending people take daily low-dose aspirin to reduce risk of colorectal and other cancers, he said.

Colon and rectal cancers remain a vexing problem for Native Americans.

Colorectal cancer declined 3.6 percent from 2008 to 2012 in the U.S., but declined only 1.9 percent for Native Americans, according to the most recent Report to the Nation on the Status of Cancer.

Effective screening techniques, such as colonoscopy, help explain declining rates of colon and rectal cancer in the U.S., Lowy said. Colonoscopy uses an optical device to inspect the inner lining of the large intestine for tumors and polyps.

The data shows that Native Americans need better access to colorectal screening, but solutions are likely to vary by region, he said.

“There are different problems or bottlenecks for different populations,” Lowy said. Research is needed to identify barriers to access, he said. “There’s probably one set of problems for those living on reservations versus those who live in cities.”

An audience member who identified herself as a former fellow at the National Institutes of Health told Lowy that she had been one of only three Native American post-doctorates at the NIH, and said the agency needs to train more Native Americans health professionals.

Lowy said later that federal agencies need to offer more training opportunities in regions where Native Americans live, particularly west of the Mississippi River. At present, most training is offered in Eastern states, he said.

Lowy, who was named last year as acting director of the National Cancer Institute, met with community and political leaders in New Mexico on Friday. The purpose of his trip was to learn more about challenges and opportunities for fighting cancer in New Mexico, UNM said in a statement.

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