Annual Report to the Nation Finds Cancer Incidence and Death Rates on the Decline: Survival Rates Show Significant Improvement
The nation's leading cancer organizations report that Americans'
risk of getting and dying from cancer continues to decline and survival
rates for many cancers continue to improve. The "Annual Report
to the Nation on the Status of Cancer, 1975-2001*" finds overall
observed cancer incidence rates dropped 0.5 percent per year from
1991 to 2001, while death rates from all cancers combined dropped
1.1 percent per year from 1993 to 2001. According to the report's
authors, the new data reflect progress in prevention, early detection,
and treatment; however, not all segments of the U.S. population
have benefited equally from the advances.
First issued in 1998, the "Annual Report to the Nation"
is a collaboration among the American Cancer Society (ACS), the
Centers for Disease Control and Prevention (CDC), the National Cancer
Institute (NCI), and the North American Association of Central Cancer
Registries (NAACCR). It provides updated information on cancer rates
and trends in the United States.
"This new report clearly shows we've made considerable gains
in reducing the burden of cancer in the United States," said
John R. Seffrin, Ph.D., chief executive officer of the American
Cancer Society. "The first ever drop in lung cancer incidence
rates in women is remarkable proof that we are making a difference
in the number one cancer killer, and is powerful evidence that our
successful efforts must continue."
The percentage of patients who have survived more than five years
after being diagnosed with cancer has increased over the past two
decades. According to NCI Director Andrew C. von Eschenbach, M.D., "these survival statistics are a reason
for optimism, as they show us that we are on the right track to
reaching the NCI Challenge Goal to eliminate the suffering and death
due to cancer. We are committed to even greater advances in survivorship
research at NCI. We are directing and conducting research on long-term
follow-up of childhood cancer survivors, healthy behaviors for all
survivors, and unique issues faced by cancer survivors from underserved
Death rates from all cancers combined have been decreasing since
the early 1990s. Death rates decreased for 11 of the top 15 cancers
in men, and eight of the top 15 cancers in women. Lung cancer deaths
rates among women leveled off for the first time between 1995 and
2001, after continuously increasing for many decades.
Among men, cancer incidence rates have recently declined for seven
of the top 15 cancer sites: lung, colon, oral cavity, leukemia,
stomach, pancreas, and larynx. Incidence rates increased only for
melanoma and cancers of the prostate, kidney, and esophagus. When
a process known as delay adjustment is taken into account, some
of these trends change (please refer to the Report to the Nation
Q&A**, question #14, for an explanation of delay adjustment).
For the first time, lung cancer incidence rates among women are
on the decline. Incidence rates decreased for five additional cancers
out of the top 15 in women (colon, cervix, pancreas, ovary, and
oral cavity). Only breast, thyroid, bladder, and kidney cancer and
melanoma rates are rising among women.
This year's report highlights trends in cancer survival by comparing
five-year survival rates of cancer patients diagnosed in two time
periods: 1975-1979 and 1995-2000. Between those time periods, survival
substantially improved for most of the top 15 cancers in both men
and women, and the top ten sites in children.
For men, large gains in cancer survival rates (more than 10 percent)
were seen in cancers of the prostate, colon and kidney, and non-Hodgkin
lymphoma, melanoma, and leukemia. Modest gains (5 percent to 10
percent) were found for cancers of the bladder, stomach, liver,
brain, and esophagus.
For women, large gains in cancer survival rates were seen for colon,
kidney, and breast cancers and non-Hodgkin lymphoma. Modest gains
were found for bladder, oral cavity, stomach, brain, esophageal,
and ovarian cancers and melanoma and leukemia.
Limited survival improvement was noted for the most fatal forms
of cancer in adults including cancers of the lung, pancreas, and
liver, which are characterized by late stage at diagnosis and relatively
poor survival rates even when these cancers are diagnosed at a localized
stage. There was also little or no gain in several cancers that
already have high survival rates, including larynx, thyroid, and
Childhood cancers showed some of the largest improvements in cancer
survival during the past 20 years, with an absolute survival rate
increase of 20 percent in boys and 13 percent in girls. The current five-year survival rate of over
75 percent confirms substantial progress made since the early 1960s,
when childhood cancers were nearly always fatal.
"Cancer is a devastating disease that impacts so many people.
But the good news is there is hope and these data show we are winning
the battle as people with cancer are living longer and more healthier
lives than ever before," said CDC Director Julie Gerberding,
M.D. "But we can't become complacent. We must renew our efforts
to make sure people make healthy choices to prevent cancer, that
they are properly screened for cancer, and that they receive the
appropriate treatment when they have cancer."
The report identifies wide variations in survival associated with
race and ethnicity. In every racial and ethnic population, with
the exception of Asian/Pacific Islander (API) women, the risk of
cancer death from all cancer sites combined was higher than the
risk of death for non-Hispanic white patients. Black men were at higher risk of dying
of 12 cancers compared to white men, with the increased risk ranging
from 9 percent (lung cancer) to a high of 67 percent (oral cavity).
Black women experienced higher risks of death from 12 cancers, with
the increase ranging from 7 percent (lung cancer) to 82 percent
(corpus uterus and melanoma). Additionally, non-Hispanic white and
API patients tended to have higher survival rates than other racial
and ethnic groups except for patients with brain cancer and leukemia.
"Increased efforts by NAACCR and its partners will continue
to expand information for a broader spectrum of underserved populations,
including not only racial groups other than white and black, but
also U.S. Latinos, rural populations, and areas defined by socioeconomic
indicators," said NAACCR Director Holly L. Howe, Ph.D. "With
this information, we will be able to more accurately address the
cancer burden and disparities in these populations."
The authors of the report emphasize that reaching all segments of
the population with high-quality prevention, early detection, and
treatment services could reduce cancer incidence and mortality even
further. In addition, they point out that "leaders in the scientific
community forecast an era of unprecedented progress in cancer research."
For these research advances to impact cancer incidence and death
rates, it will be critical that all partners with a stake in
impacting cancer control help to expedite the translation of these
research discoveries to widespread and equitable delivery of preventive
and clinical services.
For more information, visit the following Web sites:
Cancer online: http://interscience.wiley.com/cancer/report2004
CDC (Division of Cancer Prevention and Control): http://www.cdc.gov/cancer
CDC (National Center for Health Statistics' mortality report):
and the SEER Homepage: http://www.seer.cancer.gov.
Click on the icon "1975-2001 Report to the Nation."
President's Cancer Panel report on survivorship (issued June 4,
* The report was published online June 3, 2004, in Cancer. The article, "Annual Report to the Nation on the Status of Cancer, 1975-2001, with a Special Feature Regarding Survival," will appear in the July 1, 2004, print issue (Vol. 101, Issue 1). The authors of this year's report are Ahmedin Jemal, Ph.D. (ACS), Limin X. Clegg, Ph.D. (NCI), Elizabeth Ward, Ph.D. (ACS), Lynn A.G. Ries, M.S. (NCI), Xiaocheng Wu, M.D. (NAACCR), Patricia M. Jamison (CDC), Phyllis A. Wingo, Ph.D. (CDC), Holly L. Howe, Ph.D. (NAACCR), Robert N. Anderson, Ph.D. (CDC), and Brenda K. Edwards, Ph.D. (NCI).
** Questions and Answers about this Report can be found at http://www.cancer.gov/newscenter/pressreleases/ReportNation2004QandA