Annual Report to the nation finds cancer death rates continue to drop; Lower cancer rates observed in U.S. Latino populations

A new report from the nation's leading cancer organizations finds that Americans' risk of dying from cancer continues to drop, maintaining a trend that began in the early 1990s. However, the rate of new cancers remains stable. The "Annual Report to the Nation on the Status of Cancer, 1975-2003, Featuring Cancer among U.S. Hispanic/Latino Populations" is published in the October 15, 2006, issue of Cancer*.

The report includes comprehensive data on trends over the past several decades for all major cancers. It shows that the long-term decline in overall cancer death rates continued through 2003 for all races and both sexes combined. The declines were greater among men (1.6 percent per year from 1993 through 2003) than women (0.8 percent per year from 1992 through 2003).

Death rates decreased for 11 of the 15 most common cancers in men and for 10 of the 15 most common cancers in women. The authors attribute the decrease in death rates, in part, to successful efforts to reduce exposure to tobacco, earlier detection through screening, and more effective treatment, saying that continued success will depend on maintaining and enhancing these efforts.

"The greater decline in cancer death rates among men is due in large part to their substantial decrease in tobacco use. We need to enhance efforts to reduce tobacco use in women so that the rate of decline in cancer death rates becomes comparable to that of men," said Betsy A. Kohler, President of the North American Association of Central Cancer Registries, Inc (NAACCR).

Overall cancer incidence rates (the rate at which new cancers are diagnosed) for both sexes and all races combined have been stable from 1992 through 2003. Overall rates for men were stable from 1995 through 2003, while rates for women increased from 1979 through 2003. Notably, incidence rates for female breast cancer stabilized from 2001 through 2003, ending increases that began in the 1980s. Whether this first indication of a changing trend is real or a random fluctuation cannot be determined until data reporting in the next few years is complete. Also, the data suggest a small increase in the female lung cancer incidence rate from 1991 through 2003, which is a much slower rate of increase than in prior years.

Among women, incidence rates decreased for: colon and rectum cancers and cancers of the uterus (1998 to 2003, the most recent time period studied) ovarian cancer (1985 to 2003) oral cancers (1980 to 2003) stomach and cervical cancers (since at least 1975)

Among men, incidence rates have: decreased for colon and rectum cancers (1998 to 2003) ; decreased for stomach and oral cancers (since at least 1975) ; decreased for lung cancer (1982 to 2003) ; increased for prostate cancer (1995 to 2003) ; increased for myeloma, leukemia, cancers of the liver, kidney and esophagus (since at least 1975).

Incidence rates for pancreatic cancer for men and women stabilized from 2000 through 2003, after decreasing for about 16 years. Among women, the rates for non-Hodgkin lymphoma (NHL), melanoma, leukemia and cancers of the lung, bladder, and kidney have been increasing since at least 1975. Thyroid cancer incidence rates among women have increased since 1981. The rate increased 2.2 percent per year from 1981-1993. The rate then increased 4.6 percent per year from 1993 to 2000. From 2000 to 2003, the rate increased 9.1 percent per year. These rising trends are likely explained in part by changes in medical surveillance, but may also be a result of changes in risk factors.

"The findings of the Annual Report this year highlight the importance of our nation's investment in carefully tracking cancer incidence trends," said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society. "When there are changes in trends like those reported for breast cancer and thyroid cancer this year, researchers are alerted to look for the causes, often leading to advances in cancer prevention and early detection."

Cancer Rates for U.S. Latino/Hispanic Populations

The report includes a special section on cancer among U.S. Latino/Hispanic populations. It is the most comprehensive coverage of cancer information for this large and rapidly growing ethnic group and is based on 90 percent of the U.S. Latino population. The report finds that for 1999 to 2003, Latinos had lower incidence rates than non-Hispanic whites (NHW) for most cancers, but were less likely than the NHW population to be diagnosed with localized stage disease for cancers of the lung, colon and rectum, prostate, female breast, and cervix. However, Latino children have higher incidence rates of leukemia, retinoblastoma, osteosarcoma, and germ cell tumors than do non-Latino white children.

Several cancer sites with higher incidence rates in Latinos often have infectious origins: human papilloma virus (HPV) in cervical cancer; Helicobacter pylori (H. pylori) in stomach cancer; and Hepatitis B (HBV) and Hepatitis C (HCV) in liver cancer. Relative to the NHW population, the proportion of cases for specific cancers, in relation to all cancer sites combined, varied among four Latino groups (Mexican, Puerto Rican, Cuban, and South/ or Central American).

The report points to several important considerations in developing health interventions for Latinos, including: higher incidence of some infection-related cancers; elevated exposures to environmental risk factors in Latinos' living and work places; lower education, health literacy, and income; limited English proficiency; reduced use of screening services; limited access to health care, often due to lack of insurance; and less information available regarding possible genetic predisposition to cancer.

"Information in this report about lower Latino cancer rates is very encouraging but also points to the urgent need to educate people about the ways to reduce their cancer risk and keep rates such as these as low as possible," said Acting NCI Director John Niederhuber, M.D.

First issued in 1998, the "Annual Report to the Nation" is a collaboration among the North American Association of Central Cancer Registries (NAACCR), the National Cancer Institute (NCI), which is part of the National Institutes of Health, the American Cancer Society (ACS), and the Centers for Disease Control and Prevention (CDC). It provides updated information on cancer rates and trends in the United States.

"We are continuing to make progress in our fight against cancer," said CDC Director Julie Gerberding, M.D. "However, we can't become complacent. We must continue to fight to ensure that resources are available to address the importance of prevention, screening, and early detection, and promoting healthy behaviors which are proven strategies to reduce the burden of cancer."

Earlier detection of disease through screening, improved prognosis through more effective treatment, reduction of exposure to risk factors, and reduction in inequalities in cancer care through more widespread access to effective diagnostic and treatment regimens by the general population all point to the success of the nation's dedication and focus on reducing the burden of cancer in the United States, note the authors of the report. The authors conclude that continued success will depend on maintaining and enhancing these efforts.

* Annual Report to the Nation on the Status of Cancer, 1975-2003, Featuring Cancer among U.S. Hispanic/Latino Populations. The authors of this year's report are Holly L. Howe, Ph.D. (NAACCR), Xiaocheng Wu, M.D. (NAACCR), Lynn A.G. Ries, M.S. (NCI), Vilma Cokkinides (ACS), Faruque Ahmed, Ph.D. (CDC), Ahmedin Jemal, Ph.D. (ACS), Barry Miller, Ph.D. (NCI), Melanie Williams, Ph.D. (NAACCR), Elizabeth Ward, Ph.D. (ACS), Phyllis A. Wingo, Ph.D. (CDC), Amelie Ramirez, Dr.PH. (Baylor), Brenda K. Edwards, Ph.D. (NCI)

** Howe HL, Wu X, Ries LA, Cokkinides V, Ahmed F, Jemal A, Miller B, Williams M, Ward E, Wingo PA, Ramirez A, Edwards BK. Annual Report to the Nation on the Status of Cancer, 1975-2003, Featuring Cancer among U.S. Hispanic/Latino Populations. Cancer. October 15, 2006. Vol. 107, Issue 7.