Iowa cancer researchers expect slight dip in cases

IOWA CITY - Iowa is expecting a slight dip in cancer diagnoses this year, mostly due to recent advice against routine screening for prostate cancer in men of a certain age.

National cancer groups have said benefits to the simple blood test often don't outweigh the risks, prompting fewer doctors to screen for the cancer and thus diagnose the cancer, said Chuck Lynch, medical director and principal investigator of the State Health Registry of Iowa.

The state registry, based in the University of Iowa College of Public Health, released its 'Cancer in Iowa: 2015” report Friday showing an expected 16,900 new cancer cases this year - down from 17,400 cases projected last year. Prostate cancer diagnoses account for most of that difference, dropping from the 2014 projection of 2,200 to 1,700 this year, according to the new report.

But the number of cancer deaths in Iowa is expected to remain static at about 6,400. And the deadliest cancers in Iowa should continue to be lung, prostate, breast and colorectal cancer, accounting for nearly half the cancer fatalities, according to the report.

Although skin melanoma isn't among the most deadly cancers in Iowa, it's one of the fastest growing cancers in Iowa and is the fifth most common cancer among men and women.

About 570 cases of skin melanoma were projected in 2004 - accounting for about 3.8 percent of that year's expected new cancers - while about 840 cases are anticipated this year, or about 5 percent of the total new cancers, according to health registry data.

The annual age-adjusted incidence of invasive skin melanoma has quadrupled from 6.5 cases per 100,000 people in the 1974 to 1976 span to 24.5 cases per 100,000 people in the 2010 to 2012 span, experts said Friday.

Factors contributing to the rise include increased exposure to ultraviolet rays, heightened public awareness and reporting changes, said Mary Charlton, assistant professor of epidemiology at the UI College of Public Health.

'We're also seeing increased awareness and surveillance by health care providers, which is a positive as early detection is the key to better survival rates,” Charlton said.

Skin melanoma caught before it spreads has a five-year survival rate of 100 percent. Rates decrease dramatically - down to 13 percent - when it spreads to organs, according to Charlton.

Experts believe up to 90 percent of skin melanoma is caused by UV exposure, and people who've had one or more severe, blistering sunburns are at heightened risk, Charlton said. Studies also show artificial UV radiation - like in tanning booths - increases the risk of melanoma.

Artificial tanning before age 35 ups the chances of getting skin cancer by 59 percent, and every tanning session adds 2 percent to the risk, Charlton said.

Iowa is one of just nine states without age restrictions on minors tanning. Legislation has been proposed this year that would restrict tanning bed use to those 18 and older, although similar proposals failed last year and in 2013.

Charlton said Iowa holds campaigns urging teens not to tan for prom - and during other times of year the practice is popular - and to wear sunscreen for specific events, like RAGBRAI.

And George Weiner, director of the UI Holden Comprehensive Cancer Center, said researchers have made major advances in melanoma therapy involving both genetics and a person's own immune system.

Such forms of treatment previously would have been 'inconceivable,” Weiner said, adding that prevention still is the best way to reduce melanoma.

'If we applied all we already know, the need for (treatment) would be much less,” he said.

Jennifer Schlichting said she's proof of that. The assistant research scientist for the UI cancer center one year ago coincidently was working on a melanoma research paper when her doctor noticed a spot worth watching on her shoulder.

Schlichting decided to have it removed and learned they had caught the melanoma early. That kept her treatment limited to the removal and put her prognosis at 100 percent. But the diagnosis has changed her life.

'I keep my shoulders covered,” she said, adding that she gets regular full-body skin checks. 'And I make sure my two kids protect themselves with sunscreen and clothing.”