© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 8, 675-690,
April 21, 1999
© 1999 Oxford University Press
SPECIAL ARTICLE |
Annual Report to the Nation on the Status of Cancer, 1973-1996, With a Special Section on Lung Cancer and Tobacco Smoking
Affiliations of authors: P. A. Wingo, M. J. Thun, Epidemiology and Surveillance Research Department, American Cancer Society, Atlanta, GA; L. A. G. Ries, D. R. Shopland, B. K. Edwards, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD; G. A. Giovino (Office on Smoking and Health), D. S. Miller (Division of Cancer Prevention and Control), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta; H. M. Rosenberg, Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.
Correspondence to: Phyllis A. Wingo, Ph.D., American Cancer Society, 1599 Clifton Rd., NE, Atlanta, GA 30329-4251 (e-mail: pwingo{at}cancer.org).
BACKGROUND: The American Cancer Society, the National Cancer Institute (NCI), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS), provide the second annual report to the nation on progress in cancer prevention and control, with a special section on lung cancer and tobacco smoking. METHODS: Age-adjusted rates (using the 1970 U.S. standard population) were based on cancer incidence data from NCI and underlying cause of death data compiled by NCHS. The prevalence of tobacco use was derived from CDC surveys. Reported P values are two-sided. RESULTS: From 1990 through 1996, cancer incidence (-0.9% per year; P = .16) and cancer death (-0.6% per year; P = .001) rates for all sites combined decreased. Among the 10 leading cancer incidence sites, statistically significant decreases in incidence rates were seen in males for leukemia and cancers of the lung, colon/rectum, urinary bladder, and oral cavity and pharynx. Except for lung cancer, incidence rates for these cancers also declined in females. Among the 10 leading cancer mortality sites, statistically significant decreases in cancer death rates were seen for cancers of the male lung, female breast, the prostate, male pancreas, and male brain and, for both sexes, cancers of the colon/rectum and stomach. Age-specific analyses of lung cancer revealed that rates in males first declined at younger ages and then for each older age group successively over time; rates in females appeared to be in the early stages of following the same pattern, with rates decreasing for women aged 40-59 years. CONCLUSIONS: The declines in cancer incidence and death rates, particularly for lung cancer, are encouraging. However, unless recent upward trends in smoking among adolescents can be reversed, the lung cancer rates that are currently declining in the United States may rise again.
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