Overall cancer incidence and mortality rates are declining in the United States, according to a report issued by the National Cancer Institute.
These reductions are attributed mostly to decreases in both incidence and mortality for lung, prostate, and colorectal cancer in men, and breast and colorectal cancer in women. For all types of cancers combined, new diagnoses dropped an average of almost 1% per year from 1999 to 2006, and deaths from cancer declined an average of 1.6% per year from 2001 to 2006.
In terms of gender, cancer rates overall are still higher for men than for women, although cancer incidence and mortality decreased more in men. In particular, for colorectal cancer—the second-leading cause of cancer deaths in the United States—overall rates are declining, but the rising incidence in men and women under age 50 years is worrisome, the report said.
The researchers also found that incidence rates in men have declined for cancers of the oral cavity, stomach, and brain, but have risen for kidney/renal, liver, and esophageal cancers, as well as for leukemia, myeloma, and melanoma. In women, incidence rates have decreased for uterine, ovarian, cervical, and oral-cavity cancers, but have increased for lung, thyroid, pancreatic, bladder, and kidney cancers, as well as for non–Hodgkin's lymphoma, melanoma, and leukemia.
Among racial and ethnic groups, cancer mortality rates were highest in blacks and lowest among Asian/Pacific Islanders. In addition, death rates from pancreatic cancer increased among whites but decreased among blacks.
The report also included a special section on colorectal cancer, with an emphasis on strategies to reduce its mortality rate. The authors modeled projections of colorectal cancer rates and found that by getting more patients to adopt lifestyle changes such as quitting smoking and by increasing the use of colonoscopy and other screening techniques, overall colorectal cancer mortality could be cut in half by 2020.
The report was written by researchers from the NCI, the Centers for Disease Control and Prevention, the American Cancer Society, and the North American Association of Central Cancer Registries. It was published online in the journal Cancer (2009, Dec. 7 [doi:10.1002/cncr.24760]).
Information on newly diagnosed invasive cancers was obtained from population-based cancer registries that participate in the NCI's Surveillance, Epidemiology, and End Results program and/or the CDC's National Program of Cancer Registries.
All participating cancer registries also belong to the NAACCR. The cause of death is based on death certificate information reported to state vital statistics offices.
For most states, population estimates as of July 1 of each year were used to calculate annual incidence and death rates; these estimates are presumed to reflect the average population of a defined geographic area for a calendar year, the authors noted.
“The continued decline in overall cancer rates documents the success we have had with our aggressive efforts to reduce risk in large populations, to provide for early detection, and to develop new therapies that have been successfully applied in this past decade,” Dr. John E. Niederhuber, NCI director, said in a statement. “Yet, we cannot be content with this steady reduction in incidence and mortality. We must, in fact, accelerate our efforts to get individualized diagnoses and treatments to all Americans and our belief is that our research efforts and our vision are moving us rapidly in that direction.”