Cancer cases are expected to more than double between the years 2000 and 2030, says the director of the World Health Organization's International Agency for Research on Cancer.

This upward climb will occur primarily in poor countries due to an increase in population growth, longer life expectancy, more smoking, and a lack of health care in low and medium-resource countries.

"What's going to happen between now and 2030 is that the population is going to increase from about 6.5 billion to 8 billion in 2030," Dr. Peter Boyle reports. "So even if the risks remain constant at each five-year age group, because we've got more people around, we're going to have more cases of cancer.

It's the unfortunate successes for developed countries over the past 40 years, such as the export of cigarette smoking and alcohol consumption, that have doomed poorer countries, says Boyle.

Consider this definition of doom: By the year 2030, there will be 27 million cases of cancer, 17 million deaths caused by the disease, and 75 million people living with cancer.

In 1971, when it was evident cancer deaths were rising, President Nixon and Congress declared a war on cancer. Finally, after 35 years, it seems we are winning the war.

Experts say the absolute decline in cancer deaths is quite amazing -- because our population is both growing and aging, both of which could contribute to an increased cancer death rate. But prevention, early detection, and early treatment are working wonders and are saving lives for three of the most common cancers -- breast cancer, prostate cancer, and colorectal cancer. More and more men are also surviving lung cancer due to cessation of smoking more than 20 years ago. The female lung cancer death rate is not declining, however, due to continued high rates of smoking.

The highest drop in deaths among the major cancers was for colorectal cancer -- thanks to effective screening methods. Deaths dropped by 1,110 for men and 1,094 for women.

According to an American Cancer Society review of U.S. death certificates, cancer deaths declined by 369 between the years 2002 and 2003. Between 2003 to 2004, the decrease was 3,014 -- more than eight times greater.

Experts predict cancer deaths will continue to decline over the years -- although some expect the obesity epidemic, which increases risk for all cancers, to pop the cancer death rate back up in the long run.

A new year. A new law. Effective today, smokers are banned from lighting up in most public places in Washington DC .

Restaurants, bars, and indoor workplaces are now considered smoke-free in the District. The new law takes full effect today -- January 2, 2007.

More than half of the nation's population now lives in areas where smoking is banned in public places, according to the American Nonsmokers' Rights Foundation.

In 2006 alone, nine statewide bans were adopted by lawmakers. In total, 22 states have passed smoking bans. And 16 states have passed laws banning smoking in bars.

In addition to Washington DC, smoking bans also go into effect today in Bloomington and Normal, Illinois.

The earlier a cancer is detected, the greater the chances for cancer survival. One of the problems in surviving colon cancer is that people are reluctant to undergo colonoscopies, and therefore, colon cancer is not always detected in its earliest stages before symptoms develop.

Mount Sinai School of Medicine and EXACT Sciences Corporation are publishing study findings that show a DNA stool test can accurately predict colorectal cancer 88 percent of the time, regardless of where in the colon the cancer is located.

"This study confirms that stool-based DNA technologies can achieve high sensitivities for detecting colorectal cancer," stated Steven Itzkowitz, M.D., principal investigator and Professor and Associate Director of Gastroenterology at Mount Sinai School of Medicine. "For those individuals who are unwilling or unable to undergo colonoscopy, stool DNA testing offers a valuable and patient-friendly screening option. These results also underscore that as new markers and technologies are developed and validated, they can readily be incorporated into existing stool DNA tests to improve cancer detection and, ultimately, patient outcomes."

According to statistics, colorectal cancer is the second leading cause of cancer deaths in the U.S. and more than half of the over 80 million people over the age of 50 have never been screened. I agree with the researchers who suggest that it is time to develop new non-invasive technologies for colorectal screening.

Laws were established in an attempt to improve women's health by allowing women direct access to obstetricians or gynecologists. Managed-care plans were forced to allow women to make these appointments without having a referral from their primary care physicians. This gave women easier access to get screened for breast and cervical cancer. It was thought that this approach would increase the likelihood of the women getting the preventative tests.

A study was conducted to compare health care utilization among privately insured women before and after passage of direct-access legislation in various states. The study, published in the current issue of Health Services Research, found that there is no evidence for a strong consistent relationship between direct-access legislation and screening rates for breast or cervical cancer.

So it's not working according to lead author Laurence Baker, Ph.D., of the Center for Health Policy at Stanford University. "Good health care requires much more than having these laws in place. Maybe direct access legislation isn't the right way to go about this at all. Consumer and provider education may be better ways of improving population health. Covering preventive care for uninsured individuals is also key." said Baker.

Each month, about 22,000 women log on to the National Cancer Institute (NCI) web site and answer seven questions to determine their risk of developing invasive breast cancer. The Gail Model, named for the NCI's chief biostatistician, Mitchell H. Gail, generates a five-year risk and a lifetime risk for each woman who answers each of these seven questions.

• Does the woman have a medical history of any breast cancer or of any ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS)? Note: This assessment tool cannot accurately predict risk for a woman who already has a medical history of breast cancer.
  
• What is the woman's age? Note: This tool only calculates risk for women ages 35 and older.
  
• What was the woman's age at the time of her first menstrual period?
  
• What was the woman's age at the time of her first live birth of a child?
  
• How many of the woman's first-degree relatives -- mother, sisters, daughters -- have had breast cancer?
  
• Has the woman ever had a breast biopsy? How many breast biopsies has the woman had? Has the woman had at least one breast biopsy with atypical hyperplasia?
• What is the woman's race/ethnicity?

A simple drop-down answer menu is provided for each question, and explanations for each question are available. Upon completion of the short survey, the Gail Model spits out a five-year breast cancer risk and a lifetime breast cancer risk with comparisons to the general population of women.

While this is only an assessment -- based on statistics that do not always take into account individual differences -- it is still a helpful tool. Because it's clear that women can minimize breast cancer risk with behavior changes and sometimes medication. And generating a personal rating on risk is a rating worth knowing. It's also worth knowing that this tool was designed for use by health professionals. If you are not a health professional, consider discussing your results with your doctor.