In the fight against cancer we seem to have turned the corner. For the first time comprehensive surveys indicate a small but steady decline in cancer mortality rates over a 5-year period (1990 to 1995).1 These improvements have resulted from advances in cancer prevention, early diagnosis, and treatment. The contribution of treatment is most easily quantified for children with cancer, most of whom are treated at cancer centers and on research protocols. For adults, improvements in survival suggest a significant impact of treatment in certain solid tumors, such as breast cancer, and in the hematologic malignancies.
Progress in prevention and screening is somewhat easier to document. Antismoking efforts have had some success among adult males, although women and teens seem less influenced by these interventions. In the field of cancer screening, Papanicolaou tests have dramatically lowered the incidence of cervical cancer in screened populations. Similarly, mammography is effective in