Questions and Answers
Cancer Incidence and Mortality, 1973-1995, A Report for the U.S.
Kara Smigel (NCI)
Joann Schellenbach (ACS)
Sandra Smith (CDC)
"Cancer Incidence and Mortality, 1973-1995: A Report Card for the United States," is published in the March 15, 1998, issue of the journal CANCER, and findings were presented today at a news briefing by the ACS, NCI, and CDC to report to the nation on progress related to cancer prevention and control. The report is based on incidence data from NCI's Surveillance, Epidemiology and End Results (SEER) Program and mortality data from CDC's National Center for Health Statistics (NCHS).
In November 1996, the ACS, NCI and CDC announced the first sustained decline in the cancer death rate, a turning point from the steady increase observed throughout much of the century. At that time, the three agencies pledged to collaborate to further reduce cancer death rates throughout the country and to make regular reports to the nation on the progress against
The new report shows that after increasing 1.2 percent per year from 1973 to 1990, the incidence rate (rate of new cases) for all cancers combined declined an average of 0.7 percent per
year from 1990 to 1995, with the greatest decrease occurring after 1992, the year in which incidence rates peaked. The report shows that incidence rates declined for most age groups, for both men and women, and for most racial and ethnic groups, with the exception of black males for whom the incidence rate increased and Asian and Pacific Islander females whose rates
The overall cancer death rates declined on average by about 0.5 percent per year during 1990-95. The decline in mortality was greater for men than for women. Almost all racial and ethnic groups are included in this downturn, except for Asian and Pacific Islander females.
"We realize that the declines in cancer incidence and deaths have not been seen for all Americans and that our collective efforts must be directed at reaching populations with a disproportionate cancer burden," said James S. Marks, M.D., director, National Center for Chronic Disease Prevention and Health Promotion, CDC.
The report shows trends in 23 cancer sites. During 1990-95, the four leading cancer sites were lung, prostate, breast and colon-rectum, which account for over half of newly diagnosed cases. These four sites were also the top causes of cancer death.
Both the rate of new lung cancer cases and lung cancer deaths are rising for women, in contrast to a drop in both incidence and mortality for men.
After increasing rapidly from 1973-90, breast cancer incidence was level from 1990 to 1995. Mortality, also previously on the rise, has dropped over the past five years, but only for white and Hispanic women. Breast cancer death rates remained level for black women and may be on the rise for Asian and Pacific Islander women.
Prostate cancer incidence declined from 1990 to 1995 for white men and more recently for black men as well. Death rates from prostate cancer have decreased for all except Hispanic men. For cancer of the colon and rectum both incidence and mortality have declined for both males and females.
For many of the other top 10 cancer sites, both incidence and mortality declined from 1990-95 after almost 20 years of increasing rates. However, both incidence and mortality from
non-Hodgkin's lymphoma and melanoma skin cancer are on the rise. The previous decline in uterine cancer incidence has leveled off.
"These numbers are the best proof that we're on the right track," said Richard Klausner, M.D., director, National Cancer Institute. "However, it is not a time for complacency. This is a time to rededicate and redouble our efforts."
"We must seize the opportunity to build, and build significantly, on this trend," agreed John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society. "The rate of this downturn must be accelerated by better collaboration and coordination of our work, and elimination of duplication and overlap."
Incidence data in the report are based on new cases reported to selected state-wide and key metropolitan area cancer registries and mortality data are tabulated from 100 percent of death certificates filed in state vital statistics offices and compiled for the nation by NCHS/CDC. These data sources permit regular and consistent monitoring and provide the information necessary for cancer prevention and research.
The ACS, NCI and CDC expect to continue monitoring the occurrence of cancer in the United States and collaborating in presenting this data to the nation. The authors of this year's report card are Phyllis A. Wingo, Ph.D., MS, (ACS); Lynn A.G. Ries, MS, and
Brenda K. Edwards, Ph.D., (NCI); Harry M. Rosenberg, Ph.D., (National Center for Health Statistics, CDC), and Daniel S. Miller, M.D., MPH, (National Center for Chronic Disease Prevention and Health Promotion, CDC).
For more information:
American Cancer Society: http://www.cancer.org
National Cancer Institute: information for patients, public, and the mass
media, http://rex.nci.nih.gov or NCI's main website, http://www.nci.nih.gov
Centers for Disease Control and Prevention: http://www.cdc.gov/nccdphp/dcpc