BETHESDA, Maryland—Newly released data show that the nation’s mortality rate for all cancers combined, which declined between 1994 and 1998, remained stable from 1998 through 2000. However, the mortality rate for the four leading malignancies in the United States—lung, female breast, prostate, and colorectal—continued to decline in the late 1990s, according to the "Annual Report to the Nation on the Status of Cancer, 1975-2000."
Mortality for cancer of the lung and bronchus dropped 25% for both sexes of all ages and races in the 5-year span 1996 to 2000, followed by prostate (19.8%), breast (17.6%), and colorectal (11.8%). Death rates for the four cancers declined in most states as well as nationally.
The overall cancer incidence essentially continued to plateau at the level reached in the mid-1990s, although a slight increase occurred between 1995 and 2000 that was not statistically significant. The newest data show that an increase in breast cancer incidence among women and prostate cancer in men offset a continuing long-term decrease in the incidence of male lung cancer.
The annual report on cancer statistics is a collaborative effort of the American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute, and the North American Association of Central Cancer Registries. The 2003 report includes incidence data from 34 statewide cancer registries that cover 68% of the US population, up from 55% in 2002. Mortality data came from state vital statistics offices consolidated by CDC’s National Vital Statistics System.
Each year, the report highlights the cancer statistics related to the four major cancers, which account for about 50% of the nation’s cancer burden. Findings include:
Lung: Mortality continued to decrease among men, and the rate of increase slowed among women.
Breast: Death rates continued to decline in spite of a gradual increase in the rate of new diagnoses. The decline is attributed, at least in part, to the increase in screening mammography and improved access to treatment. However, death rates remained substantially lower for white women than for black women. The highest rate of increase in breast cancer incidence since the late 1970s has occurred in the 65 to 74 age group.
Prostate: Mortality has declined since 1994. However, incidence has risen since 1995—as the result of an increase in the diagnosis of localized disease—at an annual rate of 3.0% for white men and 2.3% for black men. The incidence of other stages of prostate cancer has continued to drop.
Colorectal: Death rates began declining for both whites and blacks in the 1970s, and in the mid-1980s the decrease accelerated. However, white men and women continued to show a greater decrease in mortality than black men and women. Incidence rates have remained stable since 1996 for all men and women.
The incidence of other cancers between 1995 through 2000—for both sexes and all ages and races—included declines in oral cavity and pharynx (9.3%), leukemia (7.3%), cervix (6.0%), corpus and uterus (4.9%), non-Hodgkin’s lymphoma (4.8%), pancreas (4.1%), stomach (3.4%), ovary (1.9%), and brain (0.8%). Cancer with increased incidence for the same period included melanoma (4.4%) and urinary bladder (4.5%).
While most cancers showed a drop in mortality, the rate for pancreatic cancer rose 7.3%.
Both incidence and mortality rates varied considerably among racial and ethnic groups. For example, lung cancer incidence and mortality rates per 100,000, respectively, were 63.2 and 56.7 for whites; 81.2 and 66.4 for blacks; 43.2 and 28.5 for Asians and Pacific Islanders; 33.1 and 37.2 for American Indians and Alaskan Natives; and 33.2 and 25.8 for Hispanics.
For female breast cancer, incidence ranged from 140.8 for whites to 58.0 for American Indians and Alaska Natives, and mortality ranged from 35.9 for blacks to 12.5 for Asians and Pacific Islanders.
Prostate cancer incidence ranged from 272.1 for blacks down to 53.6 in American Indians and Alaska Natives, while mortality ranged from 73.0 in blacks to 13.9 in Asians and Pacific Islanders.
