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Cancer Statistics, 2006 TABLE 5 Trends in Cancer Incidence and Death Rates for Selected Cancers by Sex, US, 1975 to 2002 Line Segment 1 Line Segment 2 Line Segment 3 Line Segment 4 Year APC* Year APC* Year APC* Year APC* All sites Incidence Male and female 1975–1983 0.9† 1983–1992 1.8† 1992–1995 -1.7 1995–2002 0.3 Male 1975–1989 1.3† 1989–1992 5.2† 1992–1995 -4.7† 1995–2002 0.2 Female 1975–1979 -0.2 1979–1987 1.5† 1987–2002 0.3† Death Male and female 1975–1990 0.5† 1990–1993 -0.3 1993–2002 -1.1† Male 1975–1979 1.0† 1979–1990 0.3† 1990–1993 -0.4 1993–2002 -1.5† Female 1975–1992 0.5† 1992–2002 -0.8† Lung & bronchus Incidence Male and female 1975–1982 2.5† 1982–1991 1.0† 1991–2002 -0.7† Male 1975–1982 1.5† 1982–1991 -0.4 1991–2002 -1.8† Female 1975–1982 5.5† 1982–1990 3.5† 1990–1998 1.0† 1998–2002 -0.5 Death Male and female 1975–1980 3.0† 1980–1990 1.8† 1990–1994 -0.1 1994–2002 -0.9† Male 1975–1978 2.4† 1978–1984 1.2† 1984–1991 0.3† 1991–2002 -1.9† Female 1975–1982 6.0† 1982–1990 4.2† 1990–1995 1.7† 1995–2002 0.3† Colon & rectum Incidence Male and female 1975–1985 0.8† 1985–1995 -1.8† 1995–1998 1.1 1998–2002 -1.8† Male 1975–1986 1.1† 1986–1995 -2.1† 1995–1998 1.0 1998–2002 -2.5† Female 1975–1985 0.3† 1985–1995 -1.8† 1995–1998 1.5 1998–2002 -1.5† Death Male and female 1975–1984 -0.5† 1984–2002 -1.8† Male 1975–1978 0.8 1978–1984 -0.4 1984–1990 -1.3† 1990–2002 -2.0† Female 1975–1984 -1.0† 1984–2002 -1.8† Female breast Incidence 1975–1980 -0.4 1980–1987 3.7† 1987–2002 0.4† Death 1975–1990 0.4† 1990–2002 -2.3† Prostate Incidence 1975–1988 2.6† 1988–1992 16.5† 1992–1995 -11.2† 1995–2002 1.7† Death 1975–1987 0.9† 1987–1991 3.1† 1991–1994 -0.6 1994–2002 -4.0† *APC, annual percent change based on rates age-adjusted to the 2000 standard population. †The APC is significantly different from zero. Note: Trends were analyzed by Joinpoint Regression Program, version 3.0, with a maximum of three joinpoints (ie, four line segments). Trends in incidence are based on rates adjusted for delay in reporting. Source: Ries LAG, Eisner MP, Kosary CL, et al. 3 leading cause of cancer death in women in 1987. Lung cancer is expected to account for 26% of all cancer deaths among females in 2006. Table 3 provides the estimated number of cancer deaths in 2006 by state for selected cancer sites. Regional Variations in Cancer Rates Table 4 depicts cancer incidence for select cancers by state. Rates vary widely across states. For example, among the cancers listed in Table 4, the largest variation in the incidence rates (in proportionate terms) occurred in lung cancer in which rates (cases per 100,000 population) ranged from 42.3 in men and 21.5 in women in Utah to 138.2 in men and 72.3 in women in Kentucky. In contrast, the variation in female breast cancer incidence rates was small, ranging from 116.6 cases per 100,000 populations in New Mexico to 149.5 cases in Washington. Factors that contribute to the state variations in the incidence rates include differences in the prevalence of risk factors, access to and utilization of early detection services, and completeness of reporting. For example, the state variation in lung cancer incidence rates reflects differences in smoking prevalence; Utah ranks lowest in adult smoking prevalence and Kentucky highest. Downloaded from caonline.amcancersoc.org by guest on September 27, 2006 (©American Cancer Society, Inc.) 116 CA A Cancer Journal for Clinicians
CA Cancer J Clin 2006;56:106–130 TABLE 6 Fifteen Leading Causes of Death, United States, 2003 †Rates are per 100,000 population and age-adjusted to the 2000 US standard population. Note: Percentages may not total 100 due to rounding. Symptoms, signs, and abnormalities, events of undetermined intent, and pneumonitis due to solids and liquids were excluded from the cause of death ranking order. Source: US Mortality Public Use Data Tape, 2003, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006. Trends in Cancer Incidence and Mortality Figures 2 to 5 depict long-term trends in cancer incidence and death rates for all cancers combined and for selected cancer sites by sex. Table 5 shows incidence and mortality patterns for all cancer sites and for the four most common cancer sites based on joinpoint analysis. Trends in incidence were adjusted for delayed reporting. Delay-adjusted cancer incidence rates stabilized in men from 1995 to 2002 and increased in women by 0.3% per year from 1987 to 2002. Death rates for all cancer sites combined decreased by 1.5% per year from 1993 to 2002 in males and by 0.8% per year in females from 1992 to 2002. Mortality rates have continued to decrease across all four major cancer sites in men and in women, except for female lung cancer in which rates continued to increase by 0.3% per year from 1995 to 2002 (Table 5). The incidence trends are mixed, however. Lung cancer incidence rates are declining in men and have leveled off after increasing for many decades in women. The lag in the temporal trend of lung cancer incidence rates in women compared to men reflects historical differences in cigarette smoking between men and women; cigarette smoking in women peaked about 20 years later than in men. Colorectal cancer incidence rates have decreased from 1998 through 2002 in both males and in females. Prostate and female breast cancer incidence rates have continued to increase, although at a slower rate than in previous years. The continuing increase may be attributable to increased screening through prostate-specific antigen (PSA) testing for prostate cancer and mammography for breast cancer. Use of postmenopausal hormone therapy and increased prevalence of obesity may also be factors influencing the increase in female breast cancer incidence. 14 Changes in the Recorded Number of Deaths from Cancer from 2002 to 2003 A total of 556,902 cancer deaths were recorded in the United States in 2003, the most recent year for which actual dates are available. About 369 fewer deaths were recorded in 2003 than in 2002, the first decrease since national mortality record keeping was instituted in 1930. Cancer accounted for about 23% of all deaths, ranking second only to heart disease (Table 6). When cause of death is ranked Downloaded from caonline.amcancersoc.org by guest on September 27, 2006 (©American Cancer Society, Inc.) Volume 56 Y Number 2 Y March/April 2006 117
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