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Dr. Jemal is Program Director for Cancer Occurrence, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Ms. Thomas is Manager, Surveillance Information Services, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Mr. Murray is Manager, Surveillance Data Systems, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
Dr. Thun is Vice President for Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
| ABSTRACT |
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| INTRODUCTION |
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| MATERIALS AND METHODS |
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Estimated New Cancer Cases
Because the United States has no nationwide cancer registry, precisely how many new cases of cancer are diagnosed each year in the United States and in all individual states is unknown. Consequently, we first estimated the number of new cancer cases occurring annually in the United States from 1979 through 1998 by using age-specific cancer incidence rates collected by NCI's SEER program2 coupled with population data reported by the US Census Bureau.3 We then forecasted the number of cancer cases expected to be diagnosed in the United States in the year 2002 using an autoregressive quadratic model fitted to the annual cancer case estimates.7
The observed trend in prostate cancer incidence was not compatible with the selected forecasting model, as rates increased greatly between 1988 and 1992, declined sharply between 1992 and 1995, and leveled off from 1995 to 1998.8,9 This trend likely reflects extensive use of prostate-specific antigen (PSA) screening in a previously unscreened population and the subsequent increase in cancer diagnoses at an early stage.10,11 We therefore assumed that the number of prostate cancer cases is approaching the pattern in effect prior to widespread use of PSA screening; and then estimated the number of new cases of prostate cancer for 2002 using a linear projection based on data from 1979 to 1989 and 1995 to 1998 only.
We could not use the methods mentioned above to estimate new cancer cases for individual states because complete cancer incidence and case counts are not available for many states. To derive these estimates, we relied on state cancer death statistical data and assumed that the ratio of cancer deaths to cancer cases was the same in each state as in the United States on the whole.
Estimated Cancer Deaths
We estimated the number of cancer deaths expected to occur in the United States and in each state in the year 2002 using underlying cause-of-death data from death certificates as reported to the National Center for Health Statistics.1 The recorded numbers of cancer deaths occurring annually from 1979 to 1999 in the United States and in each state were fitted with autoregressive quadratic models7 in order to forecast the number of cancer deaths expected to occur in 2002.
Other Statistics
We provide mortality statistics for the leading causes of deaths and deaths from cancer for 1999. Causes of death for 1999 mortality data were coded and classified according to ICD-10 rulings, replacing ICD-9 coding used for deaths that occurred from 1979 through 1998. Comparisons between the recorded number of deaths between 1998 and 1999 were adjusted for the change in ICD coding rules using a comparability ratio.12
This report also provides updated statistics on the probability of developing cancer,13 trends in cancer mortality and incidence, and five-year relative survival rates for selected cancer sites based on data from 1973 through 1998.2 Cancer incidence and death rates are standardized to the 1970 US standard population and expressed per 100,000 person-years. Death rates for 1999 are presented using both 1970 and 2000 US standard population for age standardization to illustrate the impact of the 2000 standard population on death rates.
| SELECTED FINDINGS |
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Expected Number of Cancer Deaths
Table 1 also shows the expected number of cancer deaths in 2002 for men, women, and both sexes combined. It is estimated that about 555,500 Americans will die from cancer, corresponding to 1,500 deaths per day. Cancers of the lung and bronchus, prostate, and colon and rectum in men, and cancers of the lung and bronchus, breast, and colon and rectum in women continue to be the most common causes of cancer deaths. These four cancers account for more than half of the total cancer deaths among men and women (Figure 1
). Lung cancer has surpassed breast cancer as the leading cause of cancer death in women since 1987 and is expected to account for about 25 percent of all female cancer deaths in 2002. The estimated number of cancer deaths in 2002 by state appears in Table 3
.
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Similar to trends in incidence, significant decreases in death rates for lung and bronchus cancer have occurred only among males (on average 1.8 percent per year during 1990 to 1998) (Figure 4
); the increase in lung cancer death rates among females has begun to slow recently (Figure 5
).
Breast cancer death rates among females declined annually by 1.6 percent from 1989 to 1995, and by 3.4 percent since then. Age-specific analysis revealed that breast cancer mortality declined in every age group except in African-American women, age 75 and older; the decline was more pronounced in females younger than 50 years old in both whites and African Americans.9 Colon and rectum cancer death rates have been decreasing by about 2 percent per year since 1984 in females and 1987 in males.8,9 Prostate cancer deaths peaked in 1991, and have decreased an average of 4.5 percent per year from 1994 through 1998.8,9
The Recorded Number of Deaths from Cancer and Other Causes in 1999
A total of 549,838 cancer deaths were recorded in 1999 in the United States, up by 8,306 deaths compared with 1998. Adjusting for changes in rules for selecting underlying cause of death reduced the increase in the number of cancer deaths to 4,624. Cancer deaths accounted for 23 percent of all deaths, ranking second only to death from heart disease (Table 4
). When deaths are categorized by age and sex, cancer is by far the leading cause of death among women aged 40 to 79 and among men aged 60 to 79 (Table 5
). In contrast, cancer ranks fifth as a cause of death among men aged 20 to 39.
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Lifetime Probability of Developing Cancer
The lifetime probability of developing cancer is higher for men (43.39 percent) than for women (38.25 percent) (Table 9
). However, because of breast cancer, women have a slightly higher probability of developing cancer before the age of 60.
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| CANCER OCCURRENCE BY RACE/ETHNICITY |
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From 1992 through 1998, cancer incidence rates decreased by 2 percent per year among Hispanics, by 1.7 percent for African Americans, and by 1.2 percent for whites, while rates remained relatively stable among American Indians/Alaska Natives and Asian/Pacific Islanders (data not shown). Similarly, the annual mortality rate for all cancer sites combined decreased 1.3 percent in African Americans, 1.2 percent in Asian/Pacific Islanders, 1.1 percent among whites, and 0.9 percent among Hispanics; and it leveled off in American Indians/Alaska Natives. For race- and sex-specific trends, African-American men showed the largest decrease in both incidence and mortality during the same calendar years.
Cancer Survival By Race
A poorer probability of survival once a cancer diagnosis is made contributes to the higher death rates among African-American men and women. African Americans are less likely than whites to be diagnosed with cancer at a localized stage, when the disease may be more easily and successfully treated, and are more likely to be diagnosed with cancer at a regional or distant stage of disease. This is true for most of the common cancer sites (Figure 6
). Furthermore, for nearly every cancer site, African Americans have lower five-year relative survival rates than whites at each stage of diagnosis (Figure 7
), suggesting the possible influences of differences in treatment, tumor pathology, and comorbid conditions.
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| CANCER IN CHILDREN |
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| LIMITATIONS AND FUTURE CHALLENGES |
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Our estimates are based on the most currently available cancer mortality and incidence data; however, these data are three and four years old, respectively, at the time that the estimates are calculated. Unanticipated changes that may have occurred in the three-or four-year interval between 1998 or 1999 and 2002 are not captured by our modeling efforts. Finally, our estimates of new cancer cases are based on incidence rates for the geographic locations that participate in the SEER program and, therefore, may not be representative of the entire United States.
For the 1999 mortality data, the underlying causes of deaths were coded and classified using ICD-10 coding rules, replacing ICD-9 coding designations used for deaths occurring between 1979 and 1998. Several important changes have taken place in selection and coding of primary sites of malignant neoplasm in ICD-10 codes, including the following two changes:
These coding changes will undoubtedly affect the temporal trends of various cancer mortalities. For the changes in the number of deaths from the most common cancer sites between 1998 and 1999, we have accounted for the change in ICD coding rules using a comparability ratio conversion method, and assumed that they are not influenced by sex.12
Despite these limitations, the American Cancer Society estimates do provide evidence of current patterns of cancer incidence and mortality in the United States. Such estimates will assist us in our continuing effort to reduce the public health burden of cancer.
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| Acknowledgments |
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| Footnotes |
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| REFERENCES |
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T. Tanaka, J. Huang, S. Hirai, M. Kuroki, M. Kuroki, N. Watanabe, K. Tomihara, K. Kato, and H. Hamada Carcinoembryonic Antigen-Targeted Selective Gene Therapy for Gastric Cancer through FZ33 Fiber-Modified Adenovirus Vectors. Clin. Cancer Res., June 15, 2006; 12(12): 3803 - 3813. [Abstract] [Full Text] [PDF] |
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U. K. Misra, R. Deedwania, and S. V. Pizzo Activation and Cross-talk between Akt, NF-{kappa}B, and Unfolded Protein Response Signaling in 1-LN Prostate Cancer Cells Consequent to Ligation of Cell Surface-associated GRP78 J. Biol. Chem., May 12, 2006; 281(19): 13694 - 13707. [Abstract] [Full Text] [PDF] |
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T. Aikawa, J. Gunn, S. M. Spong, S. J. Klaus, and M. Korc Connective tissue growth factor-specific antibody attenuates tumor growth, metastasis, and angiogenesis in an orthotopic mouse model of pancreatic cancer Mol. Cancer Ther., May 1, 2006; 5(5): 1108 - 1116. [Abstract] [Full Text] [PDF] |
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M. Kosugi, A. Miyajima, E. Kikuchi, Y. Horiguchi, and M. Murai Angiotensin II Type 1 Receptor Antagonist Candesartan as an Angiogenic Inhibitor in a Xenograft Model of Bladder Cancer. Clin. Cancer Res., May 1, 2006; 12(9): 2888 - 2893. [Abstract] [Full Text] [PDF] |
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B. R. Vuillemenot, J. A. Hutt, and S. A. Belinsky Gene Promoter Hypermethylation in Mouse Lung Tumors Mol. Cancer Res., April 1, 2006; 4(4): 267 - 273. [Abstract] [Full Text] [PDF] |
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S. A. Belinsky, K. C. Liechty, F. D. Gentry, H. J. Wolf, J. Rogers, K. Vu, J. Haney, T. C. Kennedy, F. R. Hirsch, Y. Miller, et al. Promoter hypermethylation of multiple genes in sputum precedes lung cancer incidence in a high-risk cohort. Cancer Res., March 15, 2006; 66(6): 3338 - 3344. [Abstract] [Full Text] [PDF] |
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H. Caldas, F. O. Jaynes, M. W. Boyer, S. Hammond, and R. A. Altura Survivin and Granzyme B-induced apoptosis, a novel anticancer therapy. Mol. Cancer Ther., March 1, 2006; 5(3): 693 - 703. [Abstract] [Full Text] [PDF] |
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W.-W. Jiang, E. Rosenbaum, E. Mambo, M. Zahurak, B. Masayesva, A. L. Carvalho, S. Zhou, W. H. Westra, A. J. Alberg, D. Sidransky, et al. Decreased Mitochondrial DNA Content in Posttreatment Salivary Rinses from Head and Neck Cancer Patients Clin. Cancer Res., March 1, 2006; 12(5): 1564 - 1569. [Abstract] [Full Text] [PDF] |
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G. Brandacher, A. Perathoner, R. Ladurner, S. Schneeberger, P. Obrist, C. Winkler, E. R. Werner, G. Werner-Felmayer, H. G. Weiss, G. Gobel, et al. Prognostic Value of Indoleamine 2,3-Dioxygenase Expression in Colorectal Cancer: Effect on Tumor-Infiltrating T Cells Clin. Cancer Res., February 15, 2006; 12(4): 1144 - 1151. [Abstract] [Full Text] [PDF] |
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J. S. Schleypen, N. Baur, R. Kammerer, P. J. Nelson, K. Rohrmann, E. F. Grone, M. Hohenfellner, A. Haferkamp, H. Pohla, D. J. Schendel, et al. Cytotoxic Markers and Frequency Predict Functional Capacity of Natural Killer Cells Infiltrating Renal Cell Carcinoma Clin. Cancer Res., February 1, 2006; 12(3): 718 - 725. [Abstract] [Full Text] [PDF] |
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J. R. McWhirter, A. Kretz-Rommel, A. Saven, T. Maruyama, K. N. Potter, C. I. Mockridge, E. P. Ravey, F. Qin, and K. S. Bowdish Antibodies selected from combinatorial libraries block a tumor antigen that plays a key role in immunomodulation PNAS, January 24, 2006; 103(4): 1041 - 1046. [Abstract] [Full Text] [PDF] |
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C. Tournigand, A. Cervantes, A. Figer, G. Lledo, M. Flesch, M. Buyse, L. Mineur, E. Carola, P.-L. Etienne, F. Rivera, et al. OPTIMOX1: A Randomized Study of FOLFOX4 or FOLFOX7 With Oxaliplatin in a Stop-and-Go Fashion in Advanced Colorectal Cancer--A GERCOR Study J. Clin. Oncol., January 20, 2006; 24(3): 394 - 400. [Abstract] [Full Text] [PDF] |
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P Veit, C Kuhle, T Beyer, H Kuehl, C U Herborn, G Borsch, H Stergar, J Barkhausen, A Bockisch, and G Antoch Whole body positron emission tomography/computed tomography (PET/CT) tumour staging with integrated PET/CT colonography: technical feasibility and first experiences in patients with colorectal cancer Gut, January 1, 2006; 55(1): 68 - 73. [Abstract] [Full Text] [PDF] |
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J. A. Magee, L.-w. Chang, G. D. Stormo, and J. Milbrandt Direct, Androgen Receptor-Mediated Regulation of the FKBP5 Gene via a Distal Enhancer Element Endocrinology, January 1, 2006; 147(1): 590 - 598. [Abstract] [Full Text] [PDF] |
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D. Wei, M. Kanai, S. Huang, and K. Xie Emerging role of KLF4 in human gastrointestinal cancer Carcinogenesis, January 1, 2006; 27(1): 23 - 31. [Abstract] [Full Text] [PDF] |
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S. Tauro, C. Craddock, K. Peggs, G. Begum, P. Mahendra, G. Cook, J. Marsh, D. Milligan, A. Goldstone, A. Hunter, et al. Allogeneic Stem-Cell Transplantation Using a Reduced-Intensity Conditioning Regimen Has the Capacity to Produce Durable Remissions and Long-Term Disease-Free Survival in Patients With High-Risk Acute Myeloid Leukemia and Myelodysplasia J. Clin. Oncol., December 20, 2005; 23(36): 9387 - 9393. [Abstract] [Full Text] [PDF] |
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T. Zhang, H.-C. Sun, Y. Xu, K.-Z. Zhang, L. Wang, L.-X. Qin, W.-Z. Wu, Y.-K. Liu, S.-L. Ye, and Z.-Y. Tang Overexpression of Platelet-Derived Growth Factor Receptor {alpha} in Endothelial Cells of Hepatocellular Carcinoma Associated with High Metastatic Potential Clin. Cancer Res., December 15, 2005; 11(24): 8557 - 8563. [Abstract] [Full Text] [PDF] |
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C. L. Nguyen, W. J. Scott, N. A. Young, T. Rader, L. R. Giles, and M. Goldberg Radiofrequency Ablation of Primary Lung Cancer: Results From an Ablate and Resect Pilot Study Chest, November 1, 2005; 128(5): 3507 - 3511. [Abstract] [Full Text] [PDF] |
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H. Takeuchi, J. Kim, A. Fujimoto, N. Umetani, T. Mori, A. Bilchik, R. Turner, A. Tran, C. Kuo, and D. S.B. Hoon X-Linked Inhibitor of Apoptosis Protein Expression Level in Colorectal Cancer Is Regulated by Hepatocyte Growth Factor/C-Met Pathway via Akt Signaling Clin. Cancer Res., November 1, 2005; 11(21): 7621 - 7628. [Abstract] [Full Text] [PDF] |
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M. T. Hueman, Z. A. Dehqanzada, T. E. Novak, J. M. Gurney, M. M. Woll, G. B. Ryan, C. E. Storrer, C. Fisher, D. G. McLeod, C. G. Ioannides, et al. Phase I Clinical Trial of a HER-2/neu Peptide (E75) Vaccine for the Prevention of Prostate-Specific Antigen Recurrence in High-Risk Prostate Cancer Patients Clin. Cancer Res., October 15, 2005; 11(20): 7470 - 7479. [Abstract] [Full Text] [PDF] |
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S. Banerjee, Y. Zhang, S. Ali, M. Bhuiyan, Z. Wang, P. J. Chiao, P. A. Philip, J. Abbruzzese, and F. H. Sarkar Molecular Evidence for Increased Antitumor Activity of Gemcitabine by Genistein In vitro and In vivo Using an Orthotopic Model of Pancreatic Cancer Cancer Res., October 1, 2005; 65(19): 9064 - 9072. [Abstract] [Full Text] [PDF] |
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S. A. Belinsky, D. M. Klinge, J. D. Dekker, M. W. Smith, T. J. Bocklage, F. D. Gilliland, R. E. Crowell, D. D. Karp, C. A. Stidley, and M. A. Picchi Gene Promoter Methylation in Plasma and Sputum Increases with Lung Cancer Risk Clin. Cancer Res., September 15, 2005; 11(18): 6505 - 6511. [Abstract] [Full Text] [PDF] |
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H. Choy, A. Nabid, B. Stea, C. Scott, W. Roa, L. Kleinberg, J. Ayoub, C. Smith, L. Souhami, S. Hamburg, et al. Phase II Multicenter Study of Induction Chemotherapy Followed by Concurrent Efaproxiral (RSR13) and Thoracic Radiotherapy for Patients With Locally Advanced Non-Small-Cell Lung Cancer J. Clin. Oncol., September 1, 2005; 23(25): 5918 - 5928. [Abstract] [Full Text] [PDF] |
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F. Wu, Z.-B. Wang, H. Zhu, W.-Z. Chen, J.-Z. Zou, J. Bai, K.-Q. Li, C.-B. Jin, F.-L. Xie, and H.-B. Su Feasibility of US-guided High-Intensity Focused Ultrasound Treatment in Patients with Advanced Pancreatic Cancer: Initial Experience Radiology, September 1, 2005; 236(3): 1034 - 1040. [Abstract] [Full Text] [PDF] |
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A. Herman-Antosiewicz and S. V. Singh Checkpoint Kinase 1 Regulates Diallyl Trisulfide-induced Mitotic Arrest in Human Prostate Cancer Cells J. Biol. Chem., August 5, 2005; 280(31): 28519 - 28528. [Abstract] [Full Text] [PDF] |
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T. Arumugam, D. M. Simeone, K. Van Golen, and C. D. Logsdon S100P Promotes Pancreatic Cancer Growth, Survival, and Invasion Clin. Cancer Res., August 1, 2005; 11(15): 5356 - 5364. [Abstract] [Full Text] [PDF] |
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U. K. Misra, R. Deedwania, and S. V. Pizzo Binding of Activated {alpha}2-Macroglobulin to Its Cell Surface Receptor GRP78 in 1-LN Prostate Cancer Cells Regulates PAK-2-dependent Activation of LIMK J. Biol. Chem., July 15, 2005; 280(28): 26278 - 26286. [Abstract] [Full Text] [PDF] |
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T. Friess, W. Scheuer, and M. Hasmann Combination Treatment with Erlotinib and Pertuzumab against Human Tumor Xenografts Is Superior to Monotherapy Clin. Cancer Res., July 15, 2005; 11(14): 5300 - 5309. [Abstract] [Full Text] [PDF] |
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J. E. Ippolito, J. Xu, S. Jain, K. Moulder, S. Mennerick, J. R. Crowley, R. R. Townsend, and J. I. Gordon An integrated functional genomics and metabolomics approach for defining poor prognosis in human neuroendocrine cancers PNAS, July 12, 2005; 102(28): 9901 - 9906. [Abstract] [Full Text] [PDF] |
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C. M. Mery, A. N. Pappas, R. Bueno, Y. L. Colson, P. Linden, D. J. Sugarbaker, and M. T. Jaklitsch Similar Long-term Survival of Elderly Patients With Non-small Cell Lung Cancer Treated With Lobectomy or Wedge Resection Within the Surveillance, Epidemiology, and End Results Database Chest, July 1, 2005; 128(1): 237 - 245. [Abstract] [Full Text] [PDF] |
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D. J. Waters, S. Shen, L. T. Glickman, D. M. Cooley, D. G. Bostwick, J. Qian, G. F. Combs Jr, and J. S. Morris Prostate cancer risk and DNA damage: translational significance of selenium supplementation in a canine model Carcinogenesis, July 1, 2005; 26(7): 1256 - 1262. [Abstract] [Full Text] [PDF] |
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H. Kohno, R. Suzuki, S. Sugie, H. Tsuda, and T. Tanaka Dietary Supplementation with Silymarin Inhibits 3,2'-Dimethyl-4-Aminobiphenyl-Induced Prostate Carcinogenesis in Male F344 Rats Clin. Cancer Res., July 1, 2005; 11(13): 4962 - 4967. [Abstract] [Full Text] [PDF] |
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A. Raval, D. M. Lucas, J. J. Matkovic, K. L. Bennett, S. Liyanarachchi, D. C. Young, L. Rassenti, T. J. Kipps, M. R. Grever, J. C. Byrd, et al. TWIST2 Demonstrates Differential Methylation in Immunoglobulin Variable Heavy Chain Mutated and Unmutated Chronic Lymphocytic Leukemia J. Clin. Oncol., June 10, 2005; 23(17): 3877 - 3885. [Abstract] [Full Text] [PDF] |
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T R Levin, F A Farraye, R E Schoen, G Hoff, W Atkin, J H Bond, S Winawer, R W Burt, D A Johnson, L M Kirk, et al. Quality in the technical performance of screening flexible sigmoidoscopy: recommendations of an international multi-society task group Gut, June 1, 2005; 54(6): 807 - 813. [Abstract] [Full Text] [PDF] |
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R. Barrera, W. Shi, D. Amar, H. T. Thaler, N. Gabovich, M. S. Bains, and D. A. White Smoking and Timing of Cessation: Impact on Pulmonary Complications After Thoracotomy Chest, June 1, 2005; 127(6): 1977 - 1983. [Abstract] [Full Text] [PDF] |
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M. Bonham, J. Posakony, I. Coleman, B. Montgomery, J. Simon, and P. S. Nelson Characterization of Chemical Constituents in Scutellaria baicalensis with Antiandrogenic and Growth-Inhibitory Activities toward Prostate Carcinoma Clin. Cancer Res., May 15, 2005; 11(10): 3905 - 3914. [Abstract] [Full Text] [PDF] |
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A. Stone, L. D. Ratnasinghe, G. L. Emerson, R. Modali, T. Lehman, G. Runnells, A. Carroll, W. Carter, S. Barnhart, A. A. Rasheed, et al. CYP3A43 Pro340Ala Polymorphism and Prostate Cancer Risk in African Americans and Caucasians Cancer Epidemiol. Biomarkers Prev., May 1, 2005; 14(5): 1257 - 1261. [Abstract] [Full Text] [PDF] |
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G. D. CRUZ, J. S. OSTROFF, J. V. KUMAR, and S. GAJENDRA Preventing and detecting oral cancer: Oral health care providers' readiness to provide health behavior counseling and oral cancer examinations J Am Dent Assoc, May 1, 2005; 136(5): 594 - 601. [Abstract] [Full Text] [PDF] |
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Y. Zhang, S. Banerjee, Z.-w. Wang, D. J. Marciniak, A. P.N. Majumdar, and F. H. Sarkar Epidermal Growth Factor Receptor-Related Protein Inhibits Cell Growth and Induces Apoptosis of BxPC3 Pancreatic Cancer Cells Cancer Res., May 1, 2005; 65(9): 3877 - 3882. [Abstract] [Full Text] [PDF] |
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S. N. Zenk, A. J. Schulz, B. A. Israel, S. A. James, S. Bao, and M. L. Wilson Neighborhood Racial Composition, Neighborhood Poverty, and the Spatial Accessibility of Supermarkets in Metropolitan Detroit Am J Public Health, April 1, 2005; 95(4): 660 - 667. [Abstract] [Full Text] [PDF] |
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A. W. Suttie, G. E. Dinse, A. Nyska, G. J. Moser, T. L. Goldsworthy, and R. R. Maronpot An Investigation of the Effects of Late-Onset Dietary Restriction on Prostate Cancer Development in the TRAMP Mouse Toxicol Pathol, April 1, 2005; 33(3): 386 - 397. [Abstract] [Full Text] [PDF] |
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R. Chen, S. Pan, T. A. Brentnall, and R. Aebersold Proteomic Profiling of Pancreatic Cancer for Biomarker Discovery Mol. Cell. Proteomics, April 1, 2005; 4(4): 523 - 533. [Abstract] [Full Text] [PDF] |
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