Non-Hodgkin Lymphoma Is Focus of New "Cancer in Iowa" Report
This year, an estimated 6,300 Iowans will die from cancer and 16,000 new cancers will be diagnosed, according to a report released by the State Health Registry of Iowa, based in the Department of Epidemiology at the University of Iowa College of Public Health.
Compared to projections for 2007, estimated deaths in 2008 will decrease by 100, while estimated new cancer cases will increase by 300.
"With Iowa's aging population and slight overall population increase, we are estimating a small increase in the absolute number of new cancers compared to last year and a slight decrease in the number of cancer deaths," said Charles Lynch, MD, PhD, UI professor of epidemiology and medical director of the registry.
"The development of new cancers is strongly influenced by genetic factors and environmental exposures. However, dying from cancer is strongly influenced not only by the number of new cancers but also by the extent of the disease at the time of diagnosis and treatment effectiveness. Earlier cancer detection and better treatments are leading to reductions in overall cancer mortality," Lynch added.
The "Cancer in Iowa: 2008" report provides other statistics and focuses on non-Hodgkin lymphoma, which is expected to be the sixth most-common cancer in Iowa this year. The State Health Registry participates in research on this form of lymphoma and others, including collaborations involving The University of Iowa, Mayo Clinic, and the National Cancer Institute (NCI) through a Specialized Center for Research Excellence (SPORE) in lymphoma, based at the UI.
The annual report is based on data from the Iowa Department of Public Health and the Iowa Cancer Registry, including county-by-county statistics.
The three most common types of estimated cancer deaths for women and men remain unchanged from previous years and account for nearly half of all cancer deaths. For women, leading cancer deaths will be lung (24 percent), breast (14 percent) and colorectum (11 percent). For men, leading cancer deaths will be lung (30 percent), prostate (11 percent) and colorectum (9 percent).
In 2008, the most common cases of newly diagnosed cancer in women will be breast (28 percent), lung (13 percent) and colorectum (12 percent). The most common types of new cancer cases in men will be prostate (25 percent), lung (14 percent) and colorectum (11 percent). These projections follow the trends of past years.
"Fortunately, Iowans can reduce their chances of being diagnosed with many types of cancer through smoking cessation, physical exercise, healthy eating and reducing alcohol use," Lynch said. "Early detection through screenings and appropriate self-exams also plays a positive role in reducing cancer mortality and, when pre-cancerous lesions are removed, reducing the number of new cancers as well."
More than 150 hospitals, clinics and medical laboratories across Iowa, as well as referral facilities in neighboring states, contribute data to the State Health Registry of Iowa. The registry is one of 17 registries nationwide that currently are funded to provide data to the National Cancer Institute. Iowa's registry staff includes 50 members, half of whom are located throughout the state and help collect data from many facilities. The registry has been gathering cancer incidence and follow-up data for the state since 1973.
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Non-Hodgkin Lymphoma Is Focus of New "Cancer in Iowa" Report
Non-Hodgkin lymphoma is one of the most rapidly increasing types of cancer diagnosed in the United States with new diagnoses having more than doubled since the 1970s. However, over the past 10 years, mortality rates have begun to decline, indicating that progress is being made in its treatment.
According to the newly issued State Health Registry of Iowa "Cancer in Iowa: 2008" report, non-Hodgkin lymphoma will cause an estimated 270 cancer deaths in Iowa in 2008, accounting for 4.3 percent of cancer deaths in both men and women. This year in Iowa, there will be an estimated 740 new cases (340 women and 400 men), making non-Hodgkin lymphoma the sixth most common cancer in Iowa.
"The exact causes of non-Hodgkin lymphoma are not known, and there are no routine or simple screening methods," said Charles Lynch, MD, PhD, medical director of the registry, which is based in the Department of Epidemiology at the University of Iowa College of Public Health. "Certain risk factors have been shown to be associated with the disease, including a weak immune system, some types of viruses and bacteria, environmental risk factors like pesticides, and occupations such as farming."
"Although Iowa is a farming state, its rates of non-Hodgkin lymphoma are close to the national average," added Lynch, who also is a UI professor of epidemiology. "This indicates that farming is not a major risk factor for this disease."
Non-Hodgkin lymphoma originates in a subset of white blood cells called lymphocytes, which are part of the body's immune system. The disease can occur in people of all ages and swell lymph nodes, create masses, and cause weight loss and fatigue.
"Non-Hodgkin lymphoma is a spectrum of diseases that share similarities but also can be separated into subtypes that are increasingly being found to have unique risk factors and to respond to different therapies," Lynch said.
Some subtypes of non-Hodgkin lymphoma are among the most aggressive of all cancers, while other subtypes are so slow growing, they do not even need immediate treatment, noted George Weiner, MD, director of the Specialized Program for Research Excellence (SPORE) in lymphoma research at the UI and head of Holden Comprehensive Cancer Center at the UI.
The UI's lymphoma SPORE, funded by the National Cancer Institute, is one of only three lymphoma SPORE grant programs in the country. Experts at Mayo Clinic work with the UI as part of the UI SPORE grant. More than 2,000 patients participate in the SPORE.
"A primary goal of the SPORE is to understand how lymphoma treatments work and how to improve them," Weiner said "We are making significant progress in the treatment of non-Hodgkin lymphoma due partly to figuring out how to use the immune system to fight this cancer.
Anti-lymphoma monoclonal antibodies are extremely helpful in treating many lymphoma patients, but not in others, Weiner said. One project supported by the SPORE focuses on understanding these differences by exploring in detail how antibodies direct the patient's own immune system to attack the lymphoma. Another is evaluating how inborn differences in the immune system impact on how well the antibodies work.
"This SPORE research is leading to new approaches to using current antibodies and to the design of stronger antibodies that we hope will be better than those currently available. This research could have an impact on other cancers, as well," Weiner said.
More than 150 hospitals, clinics and medical laboratories across Iowa, as well as referral facilities in neighboring states, contribute data to the State Health Registry of Iowa. The registry is one of 17 registries nationwide that currently are funded to provide data to the National Cancer Institute. Iowa's registry staff includes 50 members, half of whom are located throughout the state and help collect data from many facilities. The registry has been gathering cancer incidence and follow-up data for the state since 1973. |
