|
Progress Shown in Death Rates From Four
Leading Cancers
Decline in Overall Mortality Has Slowed for lung, breast, prostate,
colorectal
Sept. 4, 2003 - Death rates from the four most
common cancers - lung, breast, prostate, and colorectal - continued to
decline in the late 1990s according to new data from the "Annual
Report to the Nation on the Status of Cancer, 1975-2000." For all
cancers combined, the death rate began to stabilize in the late 1990s,
showing neither an increase nor a decrease, while the incidence rate
(newly diagnosed cases) began to stabilize in the middle of the
decade.
The report concludes that further reductions in
cancer can be achieved but will require strong federal, state, local,
and private partnerships to apply evidence-based cancer control
measures - such as screening for colorectal cancer - that reach all
segments of the population. Analyses of the findings, including new
data from the states, also highlight the need for improved delivery of
quality cancer care, as well as the development of more effective
treatment and screening strategies.
Cancer incidence rates for all types of cancers
combined increased from the mid-1970s through 1992, declined from 1992
to 1995, and then stabilized from 1995 to 2000 (there was a slight
increase from 1995 to 2000, but it was not statistically
significant*). In this most recent time period, an increase in breast
cancer in women and prostate cancer in men was offset by a long-term
decrease in lung cancer in men.
Overall death rates increased through 1990,
stabilized through 1994, and declined from 1994 through 1998 before
becoming stable from 1998 through 2000. There were continuing small
declines in death rates for men, but death rates for women have been
stable through the late 1990s.
"This report shows that we have made some
progress in reducing the burden of cancer in the United States, but
much still needs to be done to reach the Healthy People 2010 goals
-- including wider application of what science has shown to be
effective in preventing, screening, and treating cancer," said Centers
for Disease Control and Prevention (CDC) Director Julie L. Gerberding,
M.D. "The state-specific information featured in this year's report
will help states understand and address the cancer burden in their
communities."
The death rate from lung cancer, the leading
cancer killer, continues to decrease among white and black men, while
the rate of increase has slowed among women, reflecting reductions in
tobacco smoking.
"The steep decline in lung cancer rates in men
and the recent slowing of an increase in rates in women demonstrate
that we can move the trend in the number one cancer killer in the
right direction," said John R. Seffrin, Ph.D., chief executive officer
of the American Cancer Society (ACS). "Further progress will require
rigorous application of strategies that we know are effective in
reducing tobacco use."
Death rates from breast cancer continue to fall
despite a gradual, long-term increase in the rate of new diagnoses.
Declining breast cancer death rates and rising breast cancer incidence
rates during the 1990s have been attributed, in part, to increased use
of mammography screening. This report notes that higher rates of
late-stage disease in some population groups and geographic areas may
reflect delayed access to care, often among women who lacked health
insurance and among recent immigrants.
Prostate cancer death rates have been declining
since 1994, while incidence rates have been rising since 1995, with a
3.0 percent per year increase in white men and a 2.3 percent per year
increase in black men. Clarification of the risks and benefits of
prostate specific antigen (PSA) screening, including potential impact
on mortality, awaits the conclusion of two randomized clinical trials
now in progress.
Colorectal cancer death rates have also been
declining for both whites and blacks. Rates began declining in the
1970s, with steeper declines beginning in the mid-1980s. Meanwhile,
colorectal cancer incidence rates stabilized beginning in 1996 for all
men and women.
The authors of the report are encouraged by the
recent continuing declines in death rates from the four leading
cancers - lung, breast, prostate, and colorectal - declines that were
observed nationally and in most states. "Biomedical research has
dramatically enhanced our understanding of cancer and given us more
effective strategies for cancer control," said Andrew C. von
Eschenbach, M.D, Director of the National Cancer Institute (NCI),
which is part of the National Institutes of Health. "These declines in
death rates from four leading cancers are the dividends of those
advances. During this period of unprecedented growth in cancer
knowledge, technology, and resources, the NCI is committed to
accelerating these trends, and extending them to other cancers,
through the discovery, development and delivery of effective
interventions."
The report examined recent patterns of cancer
among whites, African Americans, Asian and Pacific Islanders, American
Indians/Alaska Natives, and Hispanics. From 1992 through 2000, the
most recent time period for which data are available, cancer rates
among each of these groups differed considerably, but showed
encouraging declines in some of the most prevalent cancers.
This year's report includes incidence data from
34 statewide cancer registries that cover 68 percent of the U.S.
population. This marks an increase from previous years when data
covered only 55 percent of the U.S. population. Holly L. Howe, Ph.D.,
executive director of the National American Association of Central
Cancer Registries(NAACCR), noted, "The larger number of states in this
year's report, with registries that are providing high-quality data to
produce meaningful incidence rates, is very encouraging. High quality
at the state level is crucial because cancer control planning takes
place first and foremost at the local and state levels."
The "Annual Report to the Nation on the Status of
Cancer, 1975-2000, Featuring the Uses of Surveillance Data for Cancer
Prevention and Control" is published in the Sept. 3, 2003 (Vol. 95,
No. 17, pages 1276-1299), issue of the Journal of the National
Cancer Institute**. The report is by the CDC, the ACS, the NCI,
and the NAACCR.
Additional background on this report can be found
at:
http://www.cancer.gov/newscenter/pressreleases/2003ReportQandA and
http://www.cancer.gov/newscenter/pressreleases/ReportFactSheet.
Please note that there is an erratum for the
Report, which can be found at:http://seer.cancer.gov/report_to_nation/1975_2000/supplemental.html.
# # #
* For an explanation of how this non-significant
increase was derived, please see question 17 in the Q&A on this
report, which can be found at
http://www.cancer.gov/newscenter/pressreleases/2003ReportQandA.
** The authors of this year's report are Hannah
K. Weir, Ph.D. (CDC), Michael J. Thun, M.D. (ACS), Benjamin F. Hankey,
Ph.D. (NCI), Lynn A.G. Ries, M.S. (NCI), Holly L. Howe, Ph.D. (NAACCR),
Phyllis A. Wingo, Ph.D. (CDC), Ahmedin Jemal, Ph.D. (ACS), Elizabeth
Ward, Ph.D.(ACS), Robert N. Anderson, Ph.D., (NCHS), and Brenda K.
Edwards, Ph.D. (NCI).
|
