Cancers of the stomach, lung and breast: mortality trends and control strategies.

Mortality trends for the three most common tumours--stomach, lung and breast cancer--were evaluated for nine countries. Stomach cancer is decreasing sharply and consistently in the countries studied. However, virtually all of this decline can be attributed to improvements in food preservation techniques and the resulting change in diet, rather than any action of the medical community. Lung cancer is rapidly increasing in most countries, especially in women, and is likely to become the dominant cancer worldwide by the end of this century. So far, only comprehensive tobacco-control programmes in the United Kingdom and Finland have succeeded in reversing the upward trend in lung-cancer mortality. Breast-cancer death rates are generally rising, although some recent, but probably short-term, declines have been seen. Effectiveness of the currently available approaches for each of the common cancers is summarized in Table 1. Because about half of worldwide mortality from cancer occurs in developing countries and resources in these countries are severely limited, care needs to be taken in the selection of proper priorities (18). The most effective tool we have at this time to deal with these tumours is the control of tobacco for the prevention of lung cancer. Comprehensive national programmes, consisting of legislative and education measures, are needed. The greatest decrease in breast-cancer mortality is likely to be the result of early detection and prompt treatment of the disease; public awareness of the value of early detection is an important factor here. Fortunately, mortality from stomach cancer is decreasing on its own, as little can be done to control this disease otherwise.(ABSTRACT TRUNCATED AT 250 WORDS)