5 Cancer Statistics 2006 Presentation

Editor's Notes

• #2: The American Cancer Society presents Cancer Statistics 2006.
• #3: Cancer accounts for nearly one-quarter of deaths in the United States, exceeded only by heart diseases. In 2003, there were 556,902 cancer deaths in the US.
• #4: Compared to the rate in 1950, the cancer death rate decreased slightly in 2003, while rates for other major chronic diseases decreased substantially during this period.
• #5: Lung cancer is, by far, the most common fatal cancer in men (31%), followed by colon & rectum (10%), and prostate (9%). In women, lung (26%), breast (15%), and colon & rectum (10%) are the leading sites of cancer death.
• #6: From 2002 to 2003, the number of recorded cancer deaths decreased by 778 in men, but increased by 409 in women, resulting in a net decrease of 369 total cancer deaths, the first such decrease since 1930, when nationwide mortality data began to be compiled.The decrease in the number of Americans dying from cancer is a result of declining cancer death rates outpacing the impact of growth and aging of the population.
• #7: The death rate from all cancers combined has decreased by 1.5% per year since 1993 among men and by 0.8% per year since 1992 among women. Compared to the peak rates in 1990 for men and 1991 for women, the cancer death rate for all sites combined in 2002 was 14.3% lower in men and 7.2% lower in women.
• #8: Most of the increase in cancer death rates for men prior to 1990 was attributable to lung cancer. However, since 1990, the age-adjusted lung cancer death rate in men has been decreasing. Stomach cancer mortality has decreased considerably since 1930. Death rates from prostate and colorectal cancers have also been declining.
• #9: Lung cancer is currently the most common cause of cancer death in women, with the death rate more than two times what it was 25 years ago. In comparison, breast cancer death rates were virtually unchanged between 1930 and 1990, and have since decreased on average 2.3% per year. The death rates for stomach and uterine cancers have decreased steadily since 1930; colorectal cancer death rates have been decreasing for over 50 years.
• #10: Overall, cancer death rates are higher in men than women in every racial and ethnic group. African American men and women have the highest rates of cancer mortality. Asian and Pacific Islander men and women have the lowest cancer death rates, about half the rate of African American men and women, respectively. Note: Rates for populations other than white and African American may be affected by problems in ascertaining race/ethnicity information from medical records. This is likely to result in reported death rates that are lower than true death rates.
• #11: African Americans have higher cancer death rates than whites for numerous cancer sites. Death rates for myeloma and cancers of the prostate, larynx, stomach, oral cavity, esophagus, liver, small intestine, colon and rectum, lung and bronchus, and pancreas are all higher in African-American men than in white men.
• #12: Death rates are higher in African American women than white women for many cancer sites, including myeloma and cancers of the stomach, cervix, esophagus, larynx, uterus, small intestine, pancreas, colon & rectum, liver, breast, urinary bladder, gallbladder, and oral cavity.
• #13: Overall, cancer death rates are higher in African-American men than white men and in African-American women than white women. However, the cancer death rate is declining faster in African-American men than white men.
• #14: Now we will turn our attention to the number of new cancers anticipated in the US this year. It is estimated that almost 1.4 million new cases of cancer will be diagnosed in 2006. Cancers of the prostate and breast will be the most frequently diagnosed cancers in men and women, respectively, followed by lung and colorectal cancers both in men and in women.
• #15: This slide shows trends in cancer incidence for all sites combined, for the years 1975-2002. Incidence rates stabilized in men from 1995 to 2002 and increased in women by 0.3% per year from 1987 to 2002.
• #16: Between 1988 and 1992, prostate cancer incidence rates increased dramatically due to earlier diagnosis with prostate-specific antigen (PSA) blood testing, after increasing steadily from 1975 to 1988. Incidence rates for both lung and colorectal cancers in men have declined in recent years.
• #17: In women, breast cancer incidence rates increased rapidly in the 1980s due to increased use of mammography and have increased gradually since that time. During the most recent time period (1998-2002), incidence rates of lung cancer have leveled off, while rates of colorectal cancer have decreased.
• #18: Overall, cancer incidence rates are higher in men than women. Among men, African Americans have the highest incidence followed by white, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan Natives. Racial differences in cancer incidence among women are less pronounced; white women have the highest incidence rates followed by African American, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan Native women. Note: Rates for populations other than white and African American may be affected by problems in ascertaining race/ethnicity information from medical records. This is likely to result in reported incidence rates that are lower than true incidence rates. In addition, populations covered by SEER cancer registries may not be representative of these populations in other parts of the country. For example, American Indians/Alaskan Natives in the Southwestern areas covered by SEER have much lower rates of smoking and lung cancer than American Indians/Alaskan Natives in the Northern plains states.
• #19: Cancer incidence rates are consistently higher in African-American men than white men. In contrast, cancer incidence rates are generally higher in white women than African-American women, although the difference is not as great.
• #20: The next four slides look at the lifetime probability of developing cancer and relative survival rates of cancer.
• #21: Approximately one in three women in the United States will develop cancer over her lifetime. The leading sites are breast, lung, and colon and rectum.
• #22: The 5-year relative survival rate from cancer is 66% for whites and 56% for African Americans (taking normal life expectancy into consideration). For many sites, survival rates in African Americans are 10% to more than 20% lower than in whites. This is due, in part, to African Americans being less likely to receive a cancer diagnosis at an early, localized stage, when treatment can improve chances of survival. Additional factors that contribute to the survival differential include unequal access to medical care and a higher prevalence of coexisting medical conditions and other risk factors.
• #23: The survival rates for all cancers combined and for certain site-specific cancers have improved significantly since the 1970s, due, in part, to both earlier detection and advances in treatment. Survival rates markedly increased for cancers of the prostate, breast, colon, rectum, and for leukemia. With new treatment techniques and increased utilization of screening, there is hope for even greater improvements in the not-too-distant future.
• #24: The next series of slides look at the burden of cancer among our nation's children. Cancer-related mortality has been decreasing in children ages 0-14 steadily for more than 2 decades.
• #25: Leukemia is the most common cancer among children ages 0-14 years and comprises approximately 30% of all childhood cancers. Acute lymphocytic leukemia is the most common form of leukemia in children. Cancer of the brain/other nervous system is the second most common incident cancer in both boys and girls.
• #26: Leukemia also accounts for the most cancer deaths in children, and comprises roughly a third of cancer deaths among boys and girls 0-14 years. Cancers of the brain/other nervous system are the second leading cause of cancer death in children 0-14.
• #27: The 5-year relative survival rate for all three age groups increased significantly between the mid 1970s and late 1990s. For example, the 5-year relative survival rate increased from 55.1% in 1974-76 to 79.2% in 1995-2001 for cases diagnosed among children 10-14 years old.
• #28: The last set of slides describes at the prevalence of cancer risk factors, such as tobacco use and physical inactivity, and the prevalence of cancer screening, such as use of mammography.
• #29: The reduction in cigarette consumption has been associated with a decrease in adult smoking prevalence in both men and women since 1965. The difference in cigarette smoking across gender narrowed from 1965 to 1985, a result of smoking becoming more popular among women and higher rates of quitting among male smokers following the Surgeon General’s Report.
• #30: In recent years, there have been increased efforts by states to implement comprehensive tobacco control programs. Between 1990 and 2003, tobacco consumption has declined from 133 to 79 packs per capita in the United States, with even greater declines among states with strong tobacco control programs.
• #31: Reduction in cigarette smoking among youth is an important factor in reducing prevalence and addiction in adulthood. Smoking among high school students increased from 1991 to 1997 and then began to decline. It is thought that the increase in smoking from 1991 to 1997 was due to aggressive youth targeted marketing and promotions; tobacco companies greatly increased their expenditures and promotions during that period. The subsequent decline is thought to be due to increased price of cigarettes as well as tobacco control efforts. Patterns were similar for Whites, African Americans, and Hispanics and for males and females.
• #32: The American Cancer Society recommends that individuals eat five or more servings of vegetables and fruits a day for cancer prevention. Fruit and vegetable consumption may protect against cancers of the mouth and pharynx, esophagus, lung, stomach, and colon and rectum. However, there has been little improvement in consumption since the mid-1990s. Less than one in four adults was eating the recommended servings in 2003.
• #33: The American Cancer Society recommends that adults engage in at least moderate physical activity for 30 or more minutes on 5 or more days of the week. However, similar to trends in nutrition, there has been little change in leisure-time physical activity during the 1990s. Almost one-fourth of adults do not engage in any leisure-time physical activity. Even more striking is that almost half of adults with less than a high school education do not participate in any leisure-time physical activity. It should be noted that leisure-time physical activity, as presented in this graph, does not reflect job-related physical activity for the currently employed population. While there has been little change in leisure-time physical activity since the early 1990s, data from other sources illustrates long-term social changes that have contributed to reduced total physical activity in US adults. For example, the number of trips outside the home made by walking has decreased by 42% between 1975 and 1995.
• #34: Regular physical activity has many important health benefits, including reducing risk factors for cardiovascular disease, cancer, and other chronic diseases. Today however, the prevalence of students attending physical education (PE) class daily is significantly lower than it was in 1991. Given the dramatic rise in the prevalence of overweight among teens (it has tripled since 1980), schools are increasingly being identified as an opportunity to increase physical activity among students.
• #35: People who become overweight in childhood and adolescence are more likely to be overweight or obese as adults. With at least half of the overweight children becoming overweight adults, future adult populations are at increased risk for developing cancer and other serious chronic diseases. The prevalence of overweight children and adolescents has increased since the 1970s, with the most dramatic increases occurring in the late 1980s and 1990s. In fact, over the past three decades the proportion of overweight children has doubled among 2-5 year olds and tripled among 6-19 year olds.
• #36: Obesity has reached epidemic proportions in the United States. The percentage of adults age 20 to 74 who are obese increased from 1960 to 2002 with the largest increases occurring in the 1990s. Similar trends were observed among men and women.
• #37: This slide highlights the obesity epidemic as mentioned in the previous slide. In 2004, over 50% of the adults in all states, including District of Columbia, were overweight or obese, compared to just 12 states in 1992.
• #38: The American Cancer Society states that women aged 40 and older should have an annual mammogram and clinical breast exam (CBE) as part of a periodic health exam. Women should know how their breasts normally feel and report any changes to their health care provider. A breast self-examination (BSE) is an option for women starting in their 20s.
• #39: The prevalence of women reporting a mammogram within the past year increased from 50% in 1991 to 64% in 2000, and has since declined to 58% in 2004. During this time, mammogram utilization varied considerably by educational attainment. The prevalence of women with less than a high school education reporting a recent mammogram was approximately 9 percentage points lower than the prevalence for all women. Even more striking is that the prevalence for women with no health insurance is approximately 25 percentage points lower than the prevalence for all women.
• #40: The American Cancer Society cervical cancer screening guidelines state that women should begin screening approximately three years after she begins having vaginal intercourse, but no later than 21 years of age. Screening should be done every year with regular Pap tests or every two years using liquid-based tests. At or after age 30, women who have had three normal tests in a row may get screened every 2-3 years. Women 70 and older who have had three or more consecutive normal Pap tests in the last 10 years may choose to stop cervical cancer screening.
• #41: This graph shows that the prevalence of women who have had a Pap test within the past three years has remained high, and has increased during the late 1990s. Throughout the decade, the prevalence among women with less than a high school education as well as the prevalence among women with no health insurance was approximately 10 percent lower than the percentage for all women.
• #42: The American Cancer Society recommends that beginning at age 50, men and women should receive a fecal occult blood test (FOBT) every year, or a flexible sigmoidoscopy (FSIG) every five years, or an annual FOBT and FSIG every five years (preferred to either method alone), or a double-contrast barium enema every five years, or a colonoscopy every ten years.
• #43: In 2004, approximately 19% of US adults 50 and older had a fecal occult blood test (FOBT) in the previous year. Adults with less than a high school education are less likely to report a recent FOBT. The prevalence for adults with no health insurance is approximately 10 percentage points lower than the prevalence for all adults.
• #44: While there has been a downward trend during recent years in the use of FOBT, the prevalence of flexible sigmoidoscopy (FSIG) or colonoscopy increased from 1999 to 2004. Adults with less than a high school education were less likely to report FSIG or colonoscopy than all adults. Even more striking is that the prevalence for adults with no health insurance is approximately 26 percentage points lower than the prevalence for all adults. Continuing efforts are needed to address health system barriers to colon cancer screening, to encourage health care practitioners to promote screening to their patients, and to raise awareness among eligible adults about the importance of getting screened for CRC.
• #45: The prostate-specific antigen (PSA) test and the digital rectal exam (DRE) should be offered annually, beginning at age 50, to men who have a life expectancy of at least 10 years.
• #46: This graph shows that the percentage of men who have had a PSA test within the past year decreased by 6 percentage points from 2001. Men with less than a high school education and men with no health insurance were less likely to report a PSA test than all men 50 and older.
• #47: This graph shows that the percentage of men who have had a DRE within the past year decreased by approximately seven percentage points from 2001. Men with less than a high school education and men with no health insurance were less likely to report a DRE than all men 50 and older. The American Cancer Society suggests that men speak with their physician to make an informed decision on prostate cancer screening.
• #48: The vast majority of skin cancers are the result of unprotected and excessive ultraviolet radiation exposure. The American Cancer Society estimates that UV exposure is associated with more than one million cases of basal and squamous cell cancers and 62,190 cases of malignant melanoma in 2006. Sunburns, a short-term consequence of unprotected or excessive UV exposure, were reported more frequently by men than women. Variations by race, ethnicity, and gender were observed with the highest prevalence of sunburns among white non-Hispanic males and females.
• #49: Adolescence is a period of heightened unprotected sun exposure. Sunburn during childhood and intense intermittent unprotected sun exposure increases the risk of melanoma and other skin cancers. 72% of youth reported getting sunburned during the summer months. Sunburn prevalence varied by race and sun sensitivity.