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Cancer Trends Progress Report – 2011/2012 Update

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In the Report
Introduction
Trends-at-a-Glance
Summary Tables
Prevention
Early Detection
Diagnosis
> Incidence
Stage at Diagnosis
Treatment
Life After Cancer
End of Life



Incidence
(Through 2008)
Diagnosis

After several decades of significant increase, delay adjusted rates have stabilized since 1999.

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Measuring New Cancer Cases

In 2010, more than one-half of all new cancers were cancers of the prostate, female breast, lung, and colon/rectum. According to American Cancer Society projections, there were 1,529,560 new cases of cancer in 2010, including 217,730 cases of prostate cancer; 209,060 cases of female breast cancer; 222,520 cases of lung cancer; and 142,570 cases of colon/rectum cancer.

Cancer incidence is usually measured as the number of new cases each year for every 100,000 people (for gender-specific cancers, people of the same gender serve as the denominator) and age-adjusted (to a standard population) to allow comparisons over time.

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Measure

Incidence rate: The observed number of new cancer cases per 100,000 people per year is adjusted for cancer case reporting delays, based on data from approximately 10 percent of the U.S. population.

Delay Adjustment: Delay adjustment is a method of estimating delayed reporting of incident cases and then adjusting rates to account for this delay.

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Period – 1975–2008

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Trends

All sites combined: All sites combined: Overall incidence was on the rise from 1975 to 1989, with non-significant changes in rates from 1989 to 1998. From 1998 to 2008, incidence has significantly declined. Among men, incidence rates rose from 1975 to 1992. From 1992 to 1995, cancer incidence among men significantly declined, with no significant change between 1995 and 2000. From 2000 to 2007, incidence trends among men resumed a decline. Among women, from 1975 to 1979 incidence rates were stable before rising between 1979 and 1987 and then stabilizing through 1998. From 1998 to 2005, cancer incidence among women significantly declined, and was stable from 2005 to 2008.

Prostate cancer: Incidence rose between 1975 and 1992 and then fell until around 1995. After a period of non-significant change from 1995 to 2000, rates declined again from 2000 to 2008.

Female breast cancer: After an initial period of no significant change, incidence rates rose between 1980 and 1987, before stabilizing from 1987 to 1998. Incidence rates fell from 1998 to 2008.

Colorectal cancer: Among males and females, incidence rose between 1975 and 1985. Among both men and women, incidence rates have fallen steadily since 1985, except for a period of non-significant change in rates among both men and women from 1995 to 1998.

Lung cancer: Incidence of lung cancer was consistently higher among males than females between 1975 and 2008. Incidence rates increased among men from 1975 until 1982 and fell from 1982 to 2008. Lung cancer incidence rates steadily increased among women from 1975 to 2008.

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Most Recent Estimates (Delay-adjusted)

In 2008, new cases of cancer occurred at the following rates:

All sites combined: 473.95 cases per 100,000 people per year

Prostate: 157.04 per 100,000 men per year

Female breast: 128.84 per 100,000 women per year

Colorectal: 50.98 per 100,000 men per year and 39.64 per 100,000 women per year

Lung: 71.85 per 100,000 men per year and 53.59 per 100,000 women per year

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Healthy People 2020 Targets

Reduce new cases of invasive colorectal cancer to 38.6 per 100,000 people.

Reduce new cases of invasive uterine cervical cancer to 7.1 per 100,000 females.

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Groups at High Risk for Getting New Cancers

Among major racial/ethnic groups, blacks have the highest rate of new cancers, followed by whites. Comparatively, rates are lower among American Indians/Alaska Natives, Hispanics, and Asians and Pacific Islanders.

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Cancer Sites with Increasing Incidence Trends

The small subset of cancer sites with the fastest increasing incidence rates (annual percent changes of 1 percent or more per year) include melanoma of the skin, cancer of the kidney and renal pelvis, thyroid, pancreas, and liver and intrahepatic bile duct cancers. The incidence rates of some other cancer sites are also rising; however, they are rising at rates of less than 1 percent per year. These cancers include non-Hodgkin lymphoma, childhood cancer, leukemia, testis, myeloma, and esophageal cancer. Rising cancer incidence trends must be interpreted with caution, because they can reflect a “real” increase in cases, a temporary increase in cases associated with early detection, or a permanent increase in cases associated with finding cases that are histologically malignant but biologically indolent.

Cancer Sites with Decreasing Incidence Trends

Incidence rates are decreasing for all cancer sites combined and for the four leading cancers (prostate, breast, lung, and colorectal cancer). In addition incidence rates of several other cancer sites are also decreasing including cancers of the ovary, stomach, uterine cervix, brain and other nervous system, and larynx.

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Key Issues

Although the rate of increase in lung cancer incidence among women has slowed recently, the increasing trend remains statistically significant, and lung cancer is by far the leading cause of cancer deaths among women. This highlights the need to reduce smoking prevalence and environmental tobacco smoke (ETS) exposure among all women, focusing especially on those populations whose tobacco use and ETS exposure remains high, such as women with lower levels of education.

Although most major cancers are occurring less frequently, cancers of some sites are on the rise and require greater efforts at control. For instance, incidence rates of some cancers, including melanoma of the skin, cancer of the kidney, and renal pelvis, thyroid, pancreas, and liver and intrahepatic bile duct cancers are rising with annual percent changes of greater than 1 percent. Incidence rates of some other cancers are also rising; however, they are rising at a rate of less than 1 percent per year. These cancer sites include non-Hodgkin lymphoma, childhood cancer, leukemia, myeloma, testicular cancer, and esophageal cancer.

Rising incidence rates must be interpreted with caution, because trends can reflect “real” increases in cases, temporary increase in cases with earlier detection, or additional finding of cases that are histologically malignant but biologically indolent.

Incidence rates of most leading cancers are decreasing, including all cancer combined, prostrate, female breast, lung, and colorectal cancers. Incidence rates are also decreasing for other sites, including cancers of the ovary, stomach, uterine cervix, brain and other nervous system, and larynx.

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Additional Information on Incidence

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Back: Diagnosis

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