medhp-sec'ers,
The National Institute of Health (NIH) has posted the
following press release "Annual Report Shows
Continuing Decline in U.S. Cancer Incidence and Death
Rates; Special Section Focuses on Colorectal Cancer"
which may be of special interest for those involved with
radiation oncology and patient relations:
----------
National Cancer Institute
National Institutes of Health
EMBARGOED FOR RELEASE
4 p.m. EDT
Sunday, May 14, 2000
CONTACTS:
National Cancer Institute
(301) 496-6641
American Cancer Society
(212) 382-2169
Centers for Disease Control and Prevention
(770) 488-5131
North American Association of Central Cancer
Registries
(217) 698-0800
Press Release
Annual Report Shows Continuing Decline in
U.S. Cancer Incidence and Death Rates; Special
Section Focuses on Colorectal Cancer
The rate of new cancer cases and deaths for all cancers
combined as well as for most of the top 10 cancer sites
declined between 1990 and 1997 in the United States,
according to a new report released today by the
National Cancer Institute (NCI), the American Cancer
Society (ACS), the North American Association of
Central Cancer Registries (NAACCR), and the Centers
for Disease Control and Prevention (CDC), including the
National Center for Health Statistics (NCHS). A special
section of the report focusing on colorectal cancer
shows declines in incidence rates despite low use of
screening tests for the disease.
The "Annual Report to the Nation on the Status of
Cancer, 1973-1997, with a Special Section on
Colorectal Cancer" is published in the May 15, 2000
issue of Cancer*.
"These findings underscore the remarkable progress
we've made against cancer," said NCI Director Richard
D. Klausner, M.D. At a February 2000 hearing before
the House Subcommittee on Labor-HHS-Education
Appropriations, Klausner noted that "the leveling off of
cancer deaths in the population in the past few years
despite the increase in the size of the American
population is encouraging."
The report shows that the incidence rate -- the number
of new cancer cases per 100,000 persons per year -- for
all cancers combined declined on average 0.8 percent
per year between 1990 and 1997. Using a new
statistical technique called joinpoint analysis,
researchers described changing trends over successive
segments of time, and the amount of increase or
decrease within each time period, as opposed to
relying on overall trends. Thus, the greatest incidence
decrease, at a rate of 1.3 percent per year, occurred
after 1992, the year in which incidence rates peaked.
This trend reversed a pattern of increasing incidence
rates from 1973 to 1992.
"Cancer death rates have been falling since 1991 and
since 1995 that decline has been even more rapid," said
John R. Seffrin, Ph.D., chief executive officer, American
Cancer Society. "This gives us great hope that in the
new millennium, our dreams of conquering cancer are
closer than ever to becoming a reality." Cancer mortality
declined 0.8 percent for the period from 1990 to 1997.
By far, the greatest decline in cancer incidence rates
has been among men, who overall have higher rates of
cancer than women. The report analyzed data for white,
black, Asian/Pacific Islander, American Indian/Alaska
Native, and Hispanic populations and noted large
differences in cancer incidence by race and ethnicity,
with incidence rates highest for blacks for the top four
cancer sites except for breast cancer.
Four cancer sites -- lung, prostate, breast, and colon
and rectum -- accounted for slightly over half of all new
cancer cases and were also the leading causes of
cancer deaths for every racial and ethnic group. Trends
for those primary sites show that rates are going down
for prostate cancer incidence and mortality.
Breast cancer incidence rates have shown little change
in the 1990s, while breast cancer death rates have
declined about 2 percent per year since 1990 and have
dropped sharply since 1995.
Incidence trends in lung cancer increased from 1973
until 1991, but have since declined. Lung cancer
mortality continues to increase for females but has
been declining for men since 1990.
Incidence and death rates for non-Hodgkin's lymphoma
among women are continuing to increase, while
incidence rates for melanoma for both sexes combined
have continued to rise about 3 percent annually since
1981, but death rates have been approximately level
since 1989.
The report includes a special section on colorectal
cancer, which for the first time incorporates data from
selected state and regional cancer registries
participating in NAACCR's annual Call-For-Data. This
annual Call covers 49 percent of the U.S. population.
According to Holly L. Howe, Ph.D., executive director
of NAACCR, "with the support of its partners, NAACCR
has been able to help many cancer registries achieve
uniform and high quality standards. These standards
make it possible to assemble data from multiple
registries, leading to a better understanding of cancer
incidence patterns across the United States."
Colorectal cancer has the third highest incidence of
any cancer site for U.S. men, ranks second to breast
cancer for Hispanic, American Indian/Alaska Native,
and Asian/Pacific Islander women, and ranks third for
white and black women. The report shows that overall
incidence increased until 1985 and then began
decreasing steadily at an average rate of 1.6 percent
per year. Like incidence, deaths from colorectal
cancer rank third after lung and prostate cancer for
men and third after lung and breast cancer for women.
The report also examined long-term trends in mortality
from 1950 to 1997. For women, mortality rates have
been declining since at least 1950 while rates for men
remained fairly level from 1950 to 1980, then began
declining in the 1980s. The latest five-year relative
survival rate for colorectal cancer was 61 percent and
varied by stage. When colorectal cancer is detected in
the earliest stage of the disease, Stage I, the survival
rate was 96 percent rate whereas survival for Stage IV
was only 5 percent.
The prevalence of colorectal cancer screening by either
fecal occult blood testing (FOBT), sigmoidoscopy, or
proctoscopy, was based on data collected through the
National Health Interview Survey (NHIS) and the
Behavioral Risk Factor Surveillance System (BRFSS).
Based on BRFSS results, the use of FOBT by people
age 50 and older was 21.0 percent in women and 18.4
percent in men; 35.2 percent of men had either a
sigmoidoscopy or proctoscopy whereas only 26.8
percent of women had either procedure. Although
screening rates were low, data from the NHIS showed
gradual and modest increases in the use of screening
procedures for colorectal cancer from 1987 to 1998. The
percentage of people who reported FOBT two years
before the interview increased from 30 percent in 1992
to 33 percent in 1998, with rates varying by income and
education.
According to James S. Marks, M.D., director, National
Center for Chronic Disease Prevention and Health
Promotion, CDC, "The findings of this Report underscore
the need to improve rates of colorectal cancer screening.
This is one cancer where screening clearly has benefits
by saving lives. In response to low screening rates, CDC
and its federal partners are pleased to join together in
the broad-based educational campaign called Screen
for Life."
The authors of the report suggest that screening and
advances in treatment have helped reduce mortality
from the disease. They also found that incidence and
mortality varied somewhat from state to state.
Incidence and mortality rates among black men and
women were higher than among persons of other racial
and ethnic groups, a disparity which could be reduced
in the future, perhaps through better screening
utilization and access to care.
The report is based on incidence data from SEER and
NAACCR and mortality data from the NCHS. The
special section on colorectal cancer incorporates data
from selected state and regional registries participating
in NAACCR. The ACS, NCI, NAACCR, CDC, and NCHS
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 are Lynn A.G.
Ries, M.S. (NCI), Phyllis A. Wingo, Ph.D., M.S.
(ACS), Daniel S. Miller, M.D., M.P.H. (CDC),
Holly L. Howe, Ph.D. (NAACCR), Hannah K.
Weir, Ph.D. (CDC), Harry M. Rosenberg, Ph.D.
(NCHS), Sally W. Vernon, Ph.D. (University of
Texas), Kathleen Cronin, Ph.D. (NCI), and
Brenda K. Edwards, Ph.D. (NCI).
# # #
For more information, visit the following Web sites:
SEER Homepage:
http://www.seer.cancer.gov
(This site contains all data points for
graphs in the manuscript as well as
supplementary data and charts.)
National Cancer Institute:
http://www.cancer.gov
American Cancer Society:
http://www.cancer.org
CDC's Division of Cancer Prevention and Control:
http://www.cdc.gov/cancer
CDC's National Center for Health Statistics:
http://www.cdc.gov/nchs
NAACCR:
http://www.naaccr.org/
HHS press releases are available on the World
Wide Web at:
http://www.hhs.gov
# # #
For more information about cancer, visit NCI's Web site
for patients, public, and the mass media at:
http://www.cancer.gov .
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The above may be viewed on the NCI Web site at
URL:
http://rex.nci.nih.gov/INTRFCE_GIFS/MASSMED_INTR_DOC.htm
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