Cancer incidence among women has increased slightly

Overall rates of cancer death for both men and women have declined in the United States, and cancer incidence has remained stable among men. However, overall cancer incidence among women has increased slightly, according to a special article that appears in the October 5 issue of the Journal of the National Cancer Institute.

This annual report to the nation, which this year includes statistics on the 15 most common cancers in the five major racial and ethnic populations in the United States for 1995 to 2002 and features a section on trends in the delivery and determinants of cancer treatment, is a collaborative effort by the National Cancer Institute (NCI), the Centers for Disease Control and Prevention (CDC), the North American Association of Central Cancer Registries (NAACCR), and the American Cancer Society.

To produce this report, the authors, led by Brenda K. Edwards, Ph.D., of the National Cancer Institute, gathered data on cancer incidence and deaths from the NCI, CDC, and NAACCR. They also derived population-based treatment data from the Surveillance, Epidemiology, and End Results (SEER) program, SEER-Medicare linked databases, and NCI Patterns of Care/Quality of Care studies.

Among men, cancer incidence remained stable from 1995 through 2002, and the overall rate of cancer death decreased by 1.5% per year from 1993 through 2002. Incidence of melanoma and cancers of the esophagus, kidney, and prostate increased, but incidence of cancers of the colon and rectum, larynx, lung, oral cavity, and stomach decreased. Death rates decreased for 12 of the 15 most common cancers.

Among women, cancer incidence increased by 0.3% per year from 1987 through 2002, but the overall rate of cancer death decreased by 0.8% per year from 1992 through 2002. Incidence of leukemia, non-Hodgkin lymphoma, melanoma, and cancers of the bladder, breast, kidney, and thyroid increased, but incidence of cancers of the cervix, colon and rectum, oral cavity, ovary, and stomach decreased. Death rates decreased for 9 of the 15 most common cancers.

One strategy for reducing the number of cancer deaths and improving survival among those diagnosed with cancer is to ensure that evidence-based treatment services are available and accessible, the authors suggest. A review of studies on trends in cancer treatment suggested that because the dissemination of guidelines for cancer treatment is not always rapid and complete, some aspects of recommended treatments--such as the use of radiation therapy after breast-conserving surgery for women with early-stage breast cancer--may not be fully implemented in the community treatment setting. The authors also found some evidence of possible disparities in the patterns of treatment based on patient age at diagnosis, race, and type of health plan as well as geographical variations.

"Placing a high priority on continuing [partnerships within the cancer surveillance community], as well as on developments in medical informatics and the electronic medical record, and the adoption of standardized messaging and vocabularies, may facilitate monitoring of the translation of basic science and clinical advances to cancer prevention and detection and uniformly high-quality care in all areas and populations of the United States," the authors conclude.