Journal of the National Cancer Institute Advance Access originally published online on November 25, 2008
JNCI Journal of the National Cancer Institute 2008 100(23):1672-1694; doi:10.1093/jnci/djn389
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Annual Report to the Nation on the Status of Cancer, 1975–2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control
Affiliations of authors: Epidemiology and Surveillance Research Department, American Cancer Society, Atlanta, GA (AJ, MJT, MMC, EW); Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA (HKW, CE, UAA); Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (RA); Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD (LAGR, BKE); North American Association of Central Cancer Registries, Springfield, IL (HLH); Louisiana State University Health Science Center, Louisiana State University, New Orleans, LA, and North American Association of Central Cancer Registries, Springfield, IL (X-CW); Cancer Epidemiology Services, New Jersey Department of Health and Senior Services, Trenton, NJ and North American Association of Central Cancer Registries, Springfield, IL (BK)
Correspondence to: Ahmedin Jemal, DVM, PhD, Epidemiology and Surveillance Research, American Cancer Society, 250 Williams St, NW, 6D 206, Atlanta, GA 30303-1002 (e-mail: ajemal{at}cancer.org).
Background: The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year’s report includes trends in lung cancer incidence and death rates, tobacco use, and tobacco control by state of residence.
Methods: Information on invasive cancers was obtained from the NCI, CDC, and NAACCR and information on mortality from the CDC's National Center for Health Statistics. Annual percentage changes in the age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers were estimated by joinpoint analysis of long-term (1975–2005) trends and by least squares linear regression of short-term (1996–2005) trends. All statistical tests were two-sided.
Results: Both incidence and death rates from all cancers combined decreased statistically significantly (P < .05) in men and women overall and in most racial and ethnic populations. These decreases were driven largely by declines in both incidence and death rates for the three most common cancers in men (lung, colorectum, and prostate) and for two of the three leading cancers in women (breast and colorectum), combined with a leveling off of lung cancer death rates in women. Although the national trend in female lung cancer death rates has stabilized since 2003, after increasing for several decades, there is prominent state and regional variation. Lung cancer incidence and/or death rates among women increased in 18 states, 16 of them in the South or Midwest, where, on average, the prevalence of smoking was higher and the annual percentage decrease in current smoking among adult women was lower than in the West and Northeast. California was the only state with decreasing lung cancer incidence and death rates in women.
Conclusions: Although the decrease in overall cancer incidence and death rates is encouraging, large state and regional differences in lung cancer trends among women underscore the need to maintain and strengthen many state tobacco control programs.
Manuscript received June 27, 2008; revised September 11, 2008; accepted September 30, 2008.
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J Natl Cancer Inst 2008 100: 1657.
J Natl Cancer Inst 2008 100: 1657.
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