Introduction The number of adults entering the age groups at greatest risk for being diagnosed with cancer is increasing. Projecting cancer incidence can help the cancer control community plan and ...evaluate prevention strategies aimed at reducing the growing number of cancer cases. Methods We used data from the Surveillance, Epidemiology, and End Results Program and the US Census Bureau to estimate average, annual, age-standardized cancer incidence rates and case counts (for all sites combined and top 22 invasive cancers) in the US for 2015 and to project cancer rates and counts to 2050. We used age, period, and cohort models to inform projections. Results Between 2015 and 2050, we predict the overall age-standardized incidence rate (proxy for population risk for being diagnosed with cancer) to stabilize in women (1%) and decrease in men (−9%). Cancers with the largest change in risk include a 34% reduction for lung and bronchus and a 32% increase for corpus uterine (32%). Because of the growth and aging of the US population, we predict that the annual number of cancer cases will increase 49%, from 1,534,500 in 2015 to 2,286,300 in 2050, with the largest percentage increase among adults aged ≥75 years. Cancers with the largest projected absolute increase include female breast, colon and rectum, and prostate. Discussion By 2050, we predict the total number of incident cases to increase by almost 50% as a result of the growth and aging of the US population. A greater emphasis on cancer risk reduction is needed to counter these trends.
Heart disease and cancer are the first and second leading causes of death in the United States. Age-standardized death rates (risk) have declined since the 1960s for heart disease and for cancer ...since the 1990s, whereas the overall number of heart disease deaths declined and cancer deaths increased. We analyzed mortality data to evaluate and project the effect of risk reduction, population growth, and aging on the number of heart disease and cancer deaths to the year 2020.
We used mortality data, population estimates, and population projections to estimate and predict heart disease and cancer deaths from 1969 through 2020 and to apportion changes in deaths resulting from population risk, growth, and aging.
We predicted that from 1969 through 2020, the number of heart disease deaths would decrease 21.3% among men (-73.9% risk, 17.9% growth, 34.7% aging) and 13.4% among women (-73.3% risk, 17.1% growth, 42.8% aging) while the number of cancer deaths would increase 91.1% among men (-33.5% risk, 45.6% growth, 79.0% aging) and 101.1% among women (-23.8% risk, 48.8% growth, 76.0% aging). We predicted that cancer would become the leading cause of death around 2016, although sex-specific crossover years varied.
Risk of death declined more steeply for heart disease than cancer, offset the increase in heart disease deaths, and partially offset the increase in cancer deaths resulting from demographic changes over the past 4 decades. If current trends continue, cancer will become the leading cause of death by 2020.
During 2000–2014, age-standardized five-year net survival for cervical cancer was 63–64% in the United States. Using data from CONCORD-3, we analyzed cervical cancer survival trends by race, stage ...and period of diagnosis.
Data from 41 state-wide population-based cancer registries on 138,883 women diagnosed with cervical cancer during 2001–2014 were available. Vital status was followed up until December 31, 2014. We estimated age-standardized five-year net survival, by race (Black or White), stage and calendar period of diagnosis (2001–2003, 2004–2008, 2009–2014) in each state, and for all participating states combined.
White women were most commonly diagnosed with localized tumors (45–50%). However, for Black women, localized tumors were the most common stage (43.0%) only during 2001–2003. A smaller proportion of Black women received cancer-directed surgery than White women.
For all stages combined, five-year survival decreased between 2001-2003 and 2009–2014 for both White (64.7% to 63.0%) and Black (56.7% to 55.8%) women. For localized and regional tumors, survival increased over the same period for both White (by 2–3%) and Black women (by 5%). Survival did not change for Black women diagnosed with distant tumors but increased by around 2% for White women.
Despite similar screening coverage for both Black and White women and improvements in stage-specific survival, Black women still have poorer survival than White women. This may be partially explained by inequities in access to optimal treatment. The results from this study highlight the continuing need to address the disparity in cervical cancer survival between White and Black women in the United States.
•Slight decline in cervical cancer survival for both Black and White women.•Black women have poorer survival from cervical cancer than White women.•Black women have lower stage-specific survival than White women.
Summary Background Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1·9 million adults (aged 15–99 years) diagnosed with a first, primary, invasive ...cancer of the breast (women), colon, rectum, or prostate during 1990–94 and followed up to 1999, by use of individual tumour records from 101 population-based cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2–4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate race-specific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control. Funding Centers for Disease Control and Prevention (Atlanta, GA, USA), Department of Health (London, UK), Cancer Research UK (London, UK).
Because cancer registry data provide a census of cancer cases, registry data can be used to: 1) define and monitor cancer incidence at the local, state, and national levels; 2) investigate patterns ...of cancer treatment; and 3) evaluate the effectiveness of public health efforts to prevent cancer cases and improve cancer survival. The purpose of this article is to provide a broad overview of the history of cancer surveillance programs in the United States, and illustrate the expanding ways in which cancer surveillance data are being made available and contributing to cancer control programs. The article describes the building of the cancer registry infrastructure and the successful coordination of efforts among the 2 federal agencies that support cancer registry programs, the Centers for Disease Control and Prevention and the National Cancer Institute, and the North American Association of Central Cancer Registries. The major US cancer control programs also are described, including the National Comprehensive Cancer Control Program, the National Breast and Cervical Cancer Early Detection Program, and the Colorectal Cancer Control Program. This overview illustrates how cancer registry data can inform public health actions to reduce disparities in cancer outcomes and may be instructional for a variety of cancer control professionals in the United States and in other countries. Cancer 2017;123:4969‐76. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
This article provides a broad overview of the history of cancer surveillance programs in the United States and the use of cancer registry data for cancer control programs at the Centers for Disease Control and Prevention. The information in this overview illustrates the ways in which cancer surveillance data can be used to define and monitor burden at the local, state, and national levels and evaluate the effectiveness of public health efforts for cancer control and improved cancer survival.
Background
Although pediatric cancer mortality and survival have improved in the United States over the past 40 years, differences exist by age, race/ethnicity, cancer site, and economic status. To ...assess progress, this study examined recent mortality and survival data for individuals younger than 20 years.
Methods
Age‐adjusted death rates were calculated with the National Vital Statistics System for 2002‐2016. Annual percent changes (APCs) and average annual percent changes (AAPCs) were calculated with joinpoint regression. Five‐year relative survival was calculated on the basis of National Program of Cancer Registries data for 2001‐2015. Death rates and survival were estimated overall and by sex, 5‐year age group, race/ethnicity, cancer type, and county‐based economic markers.
Results
Death rates decreased during 2002‐2016 (AAPC, –1.5), with steeper declines during 2002‐2009 (APC, –2.6), and then plateaued (APC, –0.4). Leukemia and brain cancer were the most common causes of death from pediatric cancer, and brain cancer surpassed leukemia in 2011. Death rates decreased for leukemia and lymphoma but were unchanged for brain, bone, and soft‐tissue cancers. From 2001‐2007 to 2008‐2015, survival improved from 82.0% to 85.1%. Survival was highest in both periods among females, those aged 15 to 19 years, non‐Hispanic Whites, and those in counties in the top 25% by economic status. Survival improved for leukemias, lymphomas, and brain cancers but plateaued for bone and soft‐tissue cancers.
Conclusions
Although overall death rates have decreased and survival has increased, differences persist by sex, age, race/ethnicity, cancer type, and economic status. Improvements in pediatric cancer outcomes may depend on improving therapies, access to care, and supportive and long‐term care.
Death rates of pediatric cancer decreased during 2002‐2016, with steeper declines during 2002‐2009, and then rates plateaued. Leukemia and brain cancer were the most common causes of death from pediatric cancer, and brain cancer surpassed leukemia in 2011.
BACKGROUND
Overall, cervical cancer survival in the United States has been reported to be among the highest in the world, despite slight decreases over the last decade. Objective of the current study ...was to describe cervical cancer survival trends among US women and examine differences by race and stage.
METHODS
This study used data from the CONCORD‐2 study to compare survival among women (aged 15‐99 years) diagnosed in 37 states covering 80% of the US population. Survival was adjusted for background mortality (net survival) with state‐ and race‐specific life tables and was age‐standardized with the International Cancer Survival Standard weights. Five‐year survival was compared by race (all races, blacks, and whites). Two time periods, 2001‐2003 and 2004‐2009, were considered because of changes in how the staging variable was collected.
RESULTS
From 2001 to 2009, 90,620 women were diagnosed with invasive cervical cancer. The proportion of cancers diagnosed at a regional or distant stage increased over time in most states. Overall, the 5‐year survival was 63.5% in 2001‐2003 and 62.8% in 2004‐2009. The survival was lower for black women versus white women in both calendar periods and in most states; black women had a higher proportion of distant‐stage cancers.
CONCLUSIONS
The stability of the overall survival over time and the persistent differences in survival between white and black women in all US states suggest that there is a need for targeted interventions and improved access to screening, timely treatment, and follow‐up care, especially among black women. Cancer 2017;123:5119‐37. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
The 5‐year survival for women with cervical cancer in the United States was 63.5% between 2001‐2003 and remained constant between 2004‐2009. However, the survival for black women was lower than survival for white women, in both time periods.
BACKGROUND
The lifetime risk of developing leukemia in the United States is 1.5%. There are challenges in the estimation of population‐based survival using registry data because treatments and ...prognosis vary greatly by subtype. The objective of the current study was to determine leukemia survival estimates in the United States from 1995 to 2009 according to subtype, sex, geographical area, and race.
METHODS
Five‐year net survival was estimated using data for 370,994 patients from 43 registries in 37 states and in 6 metropolitan areas, covering approximately 81% of the adult (15‐99 years) US population. Leukemia was categorized according to principal subtype (chronic lymphocytic leukemia, acute myeloid leukemia, and acute lymphocytic leukemia), and subcategorized in accordance with the HAEMACARE protocol. We analyzed age‐standardized 5‐year net survival by calendar period (1995‐1999, 2000‐2004, and 2005‐2009), leukemia subtype, sex, race, and US state.
RESULTS
The age‐standardized 5‐year net survival estimates increased from 45.0% for patients diagnosed during 1995‐1999 to 49.0% for those diagnosed during 2000‐2004 and 52.0% for those diagnosed during 2005‐2009. For patients diagnosed during 2005‐2009, 5‐year survival was 18.2% (95% confidence interval 95% CI, 17.8%‐18.6%) for acute myeloid leukemia, 44.0% (95% CI, 43.2%‐44.8%) for acute lymphocytic leukemia, and 77.3% (95% CI, 76.9%‐77.7%) for chronic lymphocytic leukemia. For nearly all leukemia subtypes, survival declined in successive age groups above 45 to 54 years. Men were found to have slightly lower survival than women; however, this discrepancy was noted to have fallen in successive calendar periods. Net survival was substantially higher in white than black patients in all calendar periods. There were large differences in survival noted between states and metropolitan areas.
CONCLUSIONS
Survival from leukemia in US adults improved during 1995‐2009. Some geographical differences in survival may be related to access to care. We found disparities in survival by sex and between black and white patients.
While survival from leukemia in adults in the United States has improved during 1995‐2009, disparities are found in survival by sex and between black and white patients.
Gallbladder cancer is a rare cancer with unusual distribution, and few population-based estimates for the United States have been published.
Using population-based cancer incidence and mortality ...data, we examined U.S. gallbladder cancer incidence and death rates for 2007-2011 and trends for 1999-2011.
During 2007 to 2011, approximately 3,700 persons were diagnosed with primary gallbladder cancer (rate = 1.13 cases per 100,000) and 2,000 died from the disease (rate = 0.62 deaths per 100,000) each year in the United States. Two thirds of gallbladder cancer cases and deaths occurred among women. Gallbladder cancer incidence and death rates were three times higher among American Indian and Alaska Native persons than non-Hispanic white persons. By state, gallbladder cancer incidence and death rates ranged by about 2-fold. During 1999 to 2011, gallbladder cancer incidence rates decreased among women but remained level among men; death rates declined among women but stabilized among men after declining from 1999 to 2006. Gallbladder cancer incidence rates increased in some subgroups, notably among black persons, those aged <45 years, and for endocrine tumors.
Data from U.S. population-based cancer registries confirm that gallbladder cancer incidence and death rates are higher among women than men, highest among American Indian and Alaska Native persons, and differ by region. While overall incidence and death rates decreased during 1999 to 2011, incidence rates increased among some small subgroups.
Surveillance of gallbladder cancer incidence and mortality, particularly to monitor increases in subgroups, may provide clues to etiology and stimulate further research.
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