Cancer Rates
Continue to Decline Despite Booming Senior Citizen Population
First ever
decrease in death from lung cancer for women; men see small increase in
prostate cancer rate
Cancer
Primarily
A Disease of
Aging
"The actual number of people dying from cancer (sometimes called
the count) can be influenced by several factors, including the
growth in the number of older people in the United States
(cancer is primarily a disease of aging) and the increase in
size of the population.'" - Annual Cancer Report, NAACCR,
NCI, CDC, ACS
April 1, 2011 Senior citizens, the favorite
targets for a variety of cancers, should be pleased with news released
yesterday that rates of death from all cancers continued to decline for
men and women in the latest report on the period between 2003 and 2007.
And, despite the growth in the elderly population, the overall rate of
new cancers diagnosed decreased almost one percent a year during this
period.
Rates of death in the United States from all
cancers for men and women continued to decline between 2003 and 2007,
the most recent reporting period available, according to the latest
Annual Report to the Nation on the Status of Cancer. The report also
finds that the overall rate of new cancer diagnoses for men and women
combined decreased an average of slightly less than 1 percent per year
for the same period.
The drop in cancer death rates continues a trend
that began in the early 1990s, according to the latest Annual Report to
the Nation on the Status of Cancer.
On of the most encouraging findings in the report
is that for the first time lung cancer death rates decreased in women,
more than a decade after rates began dropping in men.
One finding, however, was not the best of news for
senior men - there was a very small uptick in prostate cancer rates, and
if these rates were excluded from the analysis, there would be a
continued decline in overall male incidence rates. Overall cancer
incidence rates in men were essentially unchanged.
The report is co-authored by researchers from the
North American Association of Central Cancer Registries (NAACCR), the
National Cancer Institute (NCI), part of the National Institutes of
Health, the Centers for Disease Control and Prevention, and the American
Cancer Society. It appeared online March 31, 2011, in the Journal of the
National Cancer Institute, and in print on May 4, 2011.
Of special note, childhood cancer incidence rates
(rates of new diagnoses) continued to increase while death rates in this
age group decreased. Childhood cancer is classified as cancers occurring
in those 19 years of age or younger.
In the Special Feature section of the report, the
authors explore the diversity of brain tumors and other nervous system
cancers beyond those that are identified as malignant, including those
that are borderline and benign. The researchers analyzed data between
2004 and 2007 and found that in adults, non-malignant tumors were about
twice as common as malignant tumors.
Our new data show that non-malignant brain tumors
are far more common than malignant brain tumors, and affect different
population groups. Brain tumors have a far-reaching effect on our
families and friends, yet they are difficult to study due to their
diversity, said Betsy Kohler, executive director, NAACCR. We hope that
the collection of both malignant and non-malignant brain tumors by
central cancer registries will continue to provide a significant source
of information and insight to researchers.
Other highlights from the report show that, in men,
incidence rates have declined for cancers of the lung, colon and rectum,
oral cavity and pharynx, stomach, and brain (malignant only) while rates
have risen for kidney, pancreas and liver cancers, as well as melanoma
of the skin.
In women, incidence rates decreased for breast,
lung, colorectal, uterine, cervical, bladder, and oral cavity cancers,
but increased for kidney, pancreas, and thyroid cancers as well as for
leukemia and melanomas of the skin.
"It is gratifying to see the continued steady
decline in overall cancer incidence and death rates in the United States
the result of improved methods for preventing, detecting, and treating
several types of cancer," said Harold Varmus, M.D., NCI director.
"But the full repertoire of numbers reported today
also reflects the enormous complexity of cancer, with different trends
for different kinds of cancers, important differences among our diverse
people, and different capabilities to prevent, detect, and treat various
cancers. Moreover, as our population continues to age, we have an
obligation to discover and deliver better ways to control all types of
cancers."
Among racial/ethnic groups, cancer death rates were
highest among black men and black women, but this group also showed the
largest decline for the period between 1998 and 2007 compared with other
racial groups. For new cancers, black men had the highest incidence
rates in the 2003 to 2007 period studied. Among women, white women had
the highest overall incidence rates.
Breast cancer was the most commonly diagnosed
cancer among women regardless of race or ethnicity. The differences and
fluctuations in death rates by racial/ethnic group, sex, and cancer site
may reflect differences in risk behaviors, socioeconomic status, and
access to and use of screening and treatment.
As we work towards reducing the cancer burden in
the population as a whole, it is important that we apply what we know
about prevention, detection and treatment of cancer to populations at
highest risk, said John R. Seffrin, Ph.D., chief executive officer of
the American Cancer Society.
While it's promising that mortality gaps are
closing for some racial/ethnic groups, continued efforts are needed to
prevent the avoidable deaths that these gaps represent.
Despite the drop in lung cancer deaths among women
nationwide, lung cancer still kills more people than any other type of
cancer.
Lung cancer can become a rare disease if states
support well-funded tobacco control programs, said CDC Director Thomas
Frieden, M.D. Aggressive ad campaigns that show the impact of smoking,
combined with higher cigarette prices and strong state laws that protect
nonsmokers from secondhand smoke, will decrease the number of adult
smokers and save lives."
In the Special Feature section, the authors note
that non-malignant tumors make up two-thirds of all adult brain tumors
and one-third of childhood brain tumors, with meningiomas being the most
common type of brain and other nervous system tumor in the U.S. Changes
in diagnostic techniques, including the introduction of computed
tomography, or CT, scans in the 1970s and magnetic resonance imaging, or
MRI, in the 1980s, have led to less invasive methods for diagnosing
brain tumors, but also have had a strong influence on incidence rates
over the past decades. Newer molecular studies have improved
classification of brain tumors for treatment and prognostic purposes.
Of note in the discussion of trends in malignant
brain tumor incidence is the relative stability of long-term trends for
tumors of neuroepithelial tissue, which arise from glial (support) cells
in the brain and other tissues. Incidence rates for glioblastoma, the
most common, as well as highly fatal, form of these malignant tumors,
increased from 1980 through 1991, likely due to increasing use of
aggressive diagnostic procedures in elderly patients, but since
1991 the rates have been stable.
The report notes that the relatively low variation
in incidence and mortality rates over the past several decades for brain
cancers suggest that external risk factors in the environment do not
play a major roles in this disease.
Key Questions and Answers About Cancer Report
What is happening with long-term incidence
trends for the top 15 cancers?
Among men, incidence rates of melanoma, and cancers
of the liver, kidney, and pancreas increased in the five-year period
from 2003 through 2007. Incidence rates decreased for lung, oral
cavity, brain, stomach, and colorectal cancers. Rates were stable for
cancers of the bladder, and esophagus, as well as for non-Hodgkin
lymphoma, myeloma, and leukemia. Prostate cancer incidence rates were
stable with a non-statistically significant increase of 3.0 percent per
year during the period from 2005 through 2007.
Among women, incidence rates of melanoma, and
cancers of the kidney, thyroid, leukemia, and pancreas increased during
the period from 2003 through 2007. Incidence rates decreased for cancers
of the breast, lung, colorectum, uterus, cervix, bladder and oral
cavity. Rates were stable for ovary and brain/nervous system cancers.
What is happening with incidence trends for
breast cancer?
Breast cancer incidence rates, which increased 1.1
percent per year from 1992 through 1999, declined an average of 1.8
percent per year from 1999 through 2007. When examining incidence data
for each year, the authors note that the decline in incidence does not
continue after 2003.
The factors that influence breast cancer incidence
are complex, including changes in reproductive risk, obesity, the
prevalence of mammography screening, and others. Recent reports suggest
that the decrease in breast cancer incidence may be related to the rapid
discontinuation of hormone replacement therapy, a known risk factor for
breast cancer, as well as to a decline in mammography screening
prevalence.
A paper published Feb. 28, 2011, in Cancer
Epidemiology, Biomarkers and Prevention (CEBP), examined trends in
breast cancer incidence from 2000 through 2007. The research showed a
decrease in breast cancer incidence rates from 2002 through 2003, but
that this decline abated after 2003.
What is happening with cancer mortality trends
overall?
Based on long-term mortality trends, overall cancer
death rates have continued to decrease since the early 1990s among both
men and women and decreased an average 1.6 percent per year between 2003
and 2007. For 2003 through2007, this decline was slightly more
pronounced among men (1.9 percent per year) than women (1.5 percent per
year). For children up to age 20, cancer death rates have declined since
the 1970s. Death rates are the best indicator of progress against
cancer.
What is happening with death rates for the top
15 cancers among men and women?
Among men, death rates decreased for 10 of the top
15 sites for both a five-year and 10-year period, including lung,
prostate, colorectal, kidney, stomach, brain (malignant), and oral
cavity cancers, as well as non-Hodgkin lymphoma, myeloma, and leukemia.
Although colorectal cancer death rates declined for more than two
decades, the most recent decline, from 2005 through 2007, was not
statistically significant. Death rates for cancer of the liver and
melanoma have increased, and an upturn in deaths due to cancer of the
pancreas was reported during the most recent five-year time period.
Among women, death rates decreased for 11 of the
top 15 cancers, including breast, ovary, and bladder, colorectal, brain
(malignant), stomach, and kidney, as well as non-Hodgkin lymphoma,
leukemia, and myeloma. Lung cancer death rates decreased in the recent
five-year period, from 2003 through 2007, following long-term increases
during the period from 1975 through 2003.
In contrast, after decreasing from 1975 through
1997, the death rates for uterine cancer increased from 1997 through
2007. The pattern for ovarian cancer mortality has been inconsistent
over time; however, rates decreased between 2003 and 2007. After many
years of decreasing, cervical cancer death rates for the most recent
five-year period do not show a statistically significant decrease. Death
rates for pancreatic and liver cancer have increased since at least the
late 1970s in women.
If cancer death rates continue to fall, does
that mean the number of people dying from cancer will also continue to
fall?
Not necessarily. The data described in the report
are rates (number of deaths per 100,000 persons in the United States)
and are adjusted for age, so they are comparable across various factors,
such as race, time, and region. The actual number of people dying from
cancer (sometimes called the count) can be influenced by several
factors, including the growth in the number of older people in the
United States (cancer is primarily a disease of aging) and the increase
in size of the population.
Therefore, while the cancer death rate may go down
in a given year, if there is an increase in the size and the overall age
of the U.S. population that same year, the actual count of the number of
cancer deaths could go up.
Information Sources:
The North American Association of Central Cancer
Registries, Inc. (NAACCR, Inc.), is a professional organization that
develops and promotes uniform data standards for cancer registration;
provides education and training; certifies population-based registries;
aggregates and publishes data from central cancer registries; and
promotes the use of cancer surveillance data and systems for cancer
control and epidemiologic research, public health programs, and patient
care to reduce the burden of cancer in North America.
The National Cancer Institute (NCI) leads the
National Cancer Program and the NIH effort to dramatically reduce the
burden of cancer and improve the lives of cancer patients and their
families, through research into prevention and cancer biology, the
development of new interventions, and the training and mentoring of new
researchers. For more information about cancer, visit the NCI Web site
at
http://www.cancer.gov or call NCI's Cancer Information Service at
1-800-4-CANCER (1-800-422-6237).
CDC's Division of Cancer Prevention and Control is
a leader in nationwide efforts to ease the burden of cancer. CDC works
with national cancer organizations, state health agencies, and other key
groups to develop, implement, and promote effective strategies for
preventing and controlling cancer.
The American Cancer Society saves lives and creates
a world with less cancer and more birthdays by helping you stay well,
helping you get well, by finding cures and fighting back. As the
nation's largest non-governmental investor in cancer research,
contributing about $3.4 billion, we turn what we know about cancer into
what we do. To learn more or to get help, call 1-800-227-2345 or visit
www.cancer.org
The National Institutes of Health (NIH) The
Nation's Medical Research Agency includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and Human
Services. It is the primary federal agency for conducting and supporting
basic, clinical and translational medical research, and it investigates
the causes, treatments, and cures for both common and rare diseases. For
more information about NIH and its programs, visit
www.nih.gov.
