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Cancer trends in the USA

ATLANTA, GEORGIA. The annual report on the status of cancer in the United States has just been released. The report is a joint effort of the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries. Overall cancer incidence rates were essentially stable between 1995 and 2000, but may be increasing slightly if allowing for reporting delays. Overall cancer death rates have remained steady from 1998 to 2000. More than half of all cancer diagnoses and deaths involve lung cancer, breast cancer, prostate cancer or colorectal cancer (cancer of the colon or rectum).

Lung cancer
Lung cancer incidence and mortality have been declining among men since 1991, but have increased among women. This is no doubt due to the fact that smoking control programs have been far more effective among men than among women. The average annual death rate from lung cancer was 56.8 per 100,000 for men and 40.7 for women (1996-2000). Lung cancer rates were lowest in Utah, the state with the lowest adult prevalence of smoking (13%) and the highest in Kentucky, the state with the highest adult smoking prevalence (31%).

Breast cancer
The incidence of female breast cancer has increased continually since 1986 particularly among white women. Death rates, however, have decreased steadily since the early 1990s possibly due to the more extensive use of mammography screenings. The average annual death rate from breast cancer (1996- 2000) was 27.7/100,000 with slightly higher rates observed among black women.

Prostate cancer
The incidence of prostate cancer has increased by 2.3% per year since 1994 and more recently by 3.0% per year among white men and by 2.3% per year among black men. Death rates, on the other hand, have been steadily declining and now stand at 32.9/100,000 (30.2 among white men and 73.0 among black men). Some experts argue that the increased use of PSA testing is responsible for the decline in mortality; however, the subject of screening for cancers is a highly controversial one. Dr. M.J. Quinn of the UK National Cancer Intelligence Centre points out that the use of the prostate specific antigen (PSA) test for screening purposes is not recommended by the US Preventive Services Task Force or in the European Code Against Cancer. He is clearly opposed to the use of PSA testing for screening purposes and points out that it may lead to unnecessary biopsies and dangerous treatments without any proven reduction in mortality.

Cancer of the colon and rectum
The incidence of colorectal cancer has stabilized since 1995 for both men and women and death rates have declined. Overall mortality rate for the period 1996-2000 was 21.2 per 100,000, but was particularly high among black men at 34.6/100,000.

The report concludes that overall cancer incidence and death rates began to stabilize in the mid to late 1990s, but have lately shown signs of increasing again.
Weir, Hannah K, et al. Annual report to the nation on the status of cancer, 1975-2000, featuring the uses of surveillance data for cancer prevention and control. Journal of the National Cancer Institute, Vol. 95, September 3, 2003, pp. 1276-99 Quinn, MJ. Cancer trends in the United States – A view from Europe. Journal of the National Cancer Institute, Vol. 95, September 3, 2003, pp. 1258-61

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