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Progress against cancer: are we winning the war?

The conclusion of two biostatisticians that 'with respect to cancer as a whole we have lost ground' was based on the rise in the age-standardized mortality from cancer. Trends in mortality at all ages combined may be misleading, as the effect of recent progress may be obscured by the effect of changes in the distant past on the incidence of cancer in old age. Recent progress is best assessed by examining trends at young ages, which can be affected only by relatively recent changes in treatment, behaviour, and the environment. These trends are mostly encouraging, but a few indicate a need for preventive action or research.