Temporal and Spatial Analysis of Cancer Rates in the United States

Introduction: Spatial, temporal and racial patterns of cancer remain largely unexplained in the United States. Time trends of cancer incidence and mortality can be used to estimate the current cancer burden, anticipate clinical care needs, and suggest hypotheses regarding possible etiologic explanations for underlying trends. Methods: Using U.S. 1979-2003 cancer incidence and 1969-2003 cancer mortality data, age-period-cohort and Joinpoint regression models were fit to summarize gender- and race-specific temporal trends for three broad cancer categories that include tobacco-related cancer, screen-detectable cancer, and cancer unrelated to tobacco and screening. Demographic patterns and time trends of non-Hodgkin's lymphoma (NHL) incidence between Pennsylvania and the U.S. from 1985 to 2004 were compared. Using Idaho cancer incidence, 1990-2005, and arsenic levels in ground water, 1990-2005, spatial analysis was conducted to identify geographic patterns of cancer incidence and to evaluate the relationship between arsenic exposure in ground water and cancer incidence in Idaho. Results: Over the last three decades, tobacco-related cancer incidence declined among men and increased among women. Screen-detectable cancer incidence increased, more rapidly among men than women. For cancer unrelated to tobacco and screening, incidence increased in every gender-and-race group. Though not identical, NHL incidence patterns, with substantial increases, were similar in the U.S. and Pennsylvania. NHL incidence was higher in Pennsylvania counties with a greater percentage of urban residents. Although spatial clustering was demonstrated in Idaho cancer incidence, no relationship was found between arsenic exposure in ground water and Idaho cancer incidence. Conclusion: NHL and other cancers unrelated to smoking or screening have increased in the U.S. in the past two decades in white and black men and women. Etiologic research should attempt to identify modifiable risk factors, including environmental exposures, responsible for the increasing incidence of NHL and cancer unrelated to tobacco and screening. The ecologic association observed in Pennsylvania between NHL incidence and urban residence may be relevant to NHL risk in the entire United States. Additional environmental and demographic information should be evaluated in order to clarify the arsenic-related cancer risk in Idaho counties where ground water has been found to contain higher levels of arsenic. Public Health Significance: Age, period and cohort modeling of cancer incidence and mortality provides important indications of current and future health care needs and also suggests hypotheses for future research. The results of this analysis provide health professionals, researchers, and policy-makers with detailed information and an understandable overview of cancer patterns in the United States. Hypotheses should be generated about these unexplained patterns of cancer so that avoidable cancer risks can be identified that will decrease the cancer burden and associated requirements for health care

Cancer Causes Control

PurposeAn examination of multiple primary cancers can provide insight into the etiologic role of genes, the environment, and prior cancer treatment on a cancer patient\u2019s risk of developing a subsequent cancer. Different rules for registering multiple primary cancers (MP) are used by cancer registries throughout the world making data comparisons difficult.MethodsWe evaluated the effect of SEER and IARC/IACR rules on cancer incidence rates and trends using data from the SEER Program. We estimated age-standardized incidence rate (ASIR) and trends (1975\u20132011) for the top 26 cancer categories using joinpoint regression analysis.ResultsASIRs were higher using SEER compared to IARC/IACR rules for all cancers combined (3 %) and, in rank order, melanoma (9 %), female breast (7 %), urinary bladder (6 %), colon (4 %), kidney and renal pelvis (4 %), oral cavity and pharynx (3 %), lung and bronchus (2 %), and non-Hodgkin lymphoma (2 %). ASIR differences were largest for patients aged 65+ years. Trends were similar using both MP rules with the exception of cancers of the urinary bladder, and kidney and renal pelvis.ConclusionsThe choice of multiple primary coding rules effects incidence rates and trends. Compared to SEER MP coding rules, IARC/IACR rules are less complex, have not changed over time, and report fewer multiple primary cancers, particularly cancers that occur in paired organs, at the same anatomic site and with the same or related histologic type. Cancer registries collecting incidence data using SEER rules may want to consider including incidence rates and trends using IARC/IACR rules to facilitate international data comparisons.11700/Cancer Research UK/United KingdomCC999999/Intramural CDC HHS/United States2018-03-14T00:00:00Z26809509PMC5851446vault:2756

J Natl Cancer Inst

BackgroundThe 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\u2019s report includes trends in lung cancer incidence and death rates, tobacco use, and tobacco control by state of residence.MethodsInformation 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\u20132005) trends and by least squares linear regression of short-term (1996\u20132005) trends. All statistical tests were two-sided.ResultsBoth 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.ConclusionsAlthough 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.2008758

Cancer

BACKGROUNDThe American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States.METHODSIncidence data were obtained from the CDC\u2010funded and NCI\u2010funded population\u2010based cancer registry programs and compiled by NAACCR. Data on cancer deaths were obtained from the National Center for Health Statistics National Vital Statistics System. Trends in age\u2010standardized incidence and death rates for all cancers combined and for the leading cancer types by sex, race, and ethnicity were estimated by joinpoint analysis and expressed as the annual percent change. Stage distribution and 5\u2010year survival by stage at diagnosis were calculated for breast cancer, colon and rectum (colorectal) cancer, lung and bronchus cancer, and melanoma of the skin.RESULTSOverall cancer incidence rates from 2008 to 2014 decreased by 2.2% per year among men but were stable among women. Overall cancer death rates from 1999 to 2015 decreased by 1.8% per year among men and by 1.4% per year among women. Among men, incidence rates during the most recent 5\u2010year period (2010\u20102014) decreased for 7 of the 17 most common cancer types, and death rates (2011\u20102015) decreased for 11 of the 18 most common types. Among women, incidence rates declined for 7 of the 18 most common cancers, and death rates declined for 14 of the 20 most common cancers. Death rates decreased for cancer sites, including lung and bronchus (men and women), colorectal (men and women), female breast, and prostate. Death rates increased for cancers of the liver (men and women); pancreas (men and women); brain and other nervous system (men and women); oral cavity and pharynx (men only); soft tissue, including heart (men only); nonmelanoma skin (men only); and uterus. Incidence and death rates were higher among men than among women for all racial and ethnic groups. For all cancer sites combined, black men and white women had the highest incidence rates compared with other racial groups, and black men and black women had the highest death rates compared with other racial groups. Non\u2010Hispanic men and women had higher incidence and mortality rates than those of Hispanic ethnicity. Five\u2010year survival for cases diagnosed from 2007 through 2013 ranged from 100% (stage I) to 26.5% (stage IV) for female breast cancer, from 88.1% (stage I) to 12.6% (stage IV) for colorectal cancer, from 55.1% (stage I) to 4.2% (stage IV) for lung and bronchus cancer, and from 99.5% (stage I) to 16% (stage IV) for melanoma of the skin. Among children, overall cancer incidence rates increased by 0.8% per year from 2010 to 2014, and overall cancer death rates decreased by 1.5% per year from 2011 to 2015.CONCLUSIONSFor all cancer sites combined, cancer incidence rates decreased among men but were stable among women. Overall, there continue to be significant declines in cancer death rates among both men and women. Differences in rates and trends by race and ethnic group remain. Progress in reducing cancer mortality has not occurred for all sites. Examining stage distribution and 5\u2010year survival by stage highlights the potential benefits associated with early detection and treatment. Cancer 2018;124:2785\u20102800. \ua9 2018 American Cancer Society201829786848PMC6033186674

Comparing Trends in Cancer Rates Across Overlapping Regions

Monitoring and comparing trends in cancer rates across geographic regions or over different time periods has been one main task of the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program as it profiles health care quality as well as decides health care resource allocations within a spatial-temporal framework. A fundamental difficulty, however, arises when such comparisons have to be made for regions or time intervals that overlap, e.g. comparing the change in trends of mortality rates in a local area (e.g. the mortality rate of Breast Cancer in California) with a more global level (i.e. the national mortality rate of Breast Cancer). In view of sparsity of available methodologies, this paper develops a simple corrected Z-test that accounts for such overlapping. The performance of the proposed test over the two-sample “pooled” t-test that assumes independence across comparison groups is assessed via the Pitman asymptotic relative efficiency as well as Monte Carlo simulations and applications to the SEER cancer data. The proposed test will be important for the SEER*STAT software, maintained by the NCI, for the analysis of the SEER data

Declining Death Rates Reflect Progress against Cancer

BACKGROUND: The success of the "war on cancer" initiated in 1971 continues to be debated, with trends in cancer mortality variably presented as evidence of progress or failure. We examined temporal trends in death rates from all-cancer and the 19 most common cancers in the United States from 1970-2006. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed trends in age-standardized death rates (per 100,000) for all cancers combined, the four most common cancers, and 15 other sites from 1970-2006 in the United States using joinpoint regression model. The age-standardized death rate for all-cancers combined in men increased from 249.3 in 1970 to 279.8 in 1990, and then decreased to 221.1 in 2006, yielding a net decline of 21% and 11% from the 1990 and 1970 rates, respectively. Similarly, the all-cancer death rate in women increased from 163.0 in 1970 to 175.3 in 1991 and then decreased to 153.7 in 2006, a net decline of 12% and 6% from the 1991 and 1970 rates, respectively. These decreases since 1990/91 translate to preventing of 561,400 cancer deaths in men and 205,700 deaths in women. The decrease in death rates from all-cancers involved all ages and racial/ethnic groups. Death rates decreased for 15 of the 19 cancer sites, including the four major cancers, with lung, colorectum and prostate cancers in men and breast and colorectum cancers in women. CONCLUSIONS/SIGNIFICANCE: Progress in reducing cancer death rates is evident whether measured against baseline rates in 1970 or in 1990. The downturn in cancer death rates since 1990 result mostly from reductions in tobacco use, increased screening allowing early detection of several cancers, and modest to large improvements in treatment for specific cancers. Continued and increased investment in cancer prevention and control, access to high quality health care, and research could accelerate this progress

Cancer

Background:The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States.Methods:Data on new cancer diagnoses during 2001 to 2016 were obtained from the CDC-funded and NCI-funded population-based cancer registry programs and compiled by NAACCR. Data on cancer deaths during 2001 to 2017 were obtained from the National Center for Health Statistics\u2019 National Vital Statistics System. Trends in incidence and death rates for all cancers combined and for the leading cancer types by sex, racial/ethnic group, and age were estimated by joinpoint analysis and characterized by average annual percent change during the most recent 5 years (2012\u20132016 for incidence and 2013\u20132017 for mortality).Results:Overall, cancer incidence rates decreased 0.6% on average per year during 2012\u20132016, but trends differed by sex, racial/ethnic group, and cancer type. Among males, cancer incidence rates were stable overall and among non-Hispanic white males but decreased in other racial/ethnic groups; rates increased for 5 of the 17 most common cancers, were stable for 7 cancers (including prostate), and decreased for 5 cancers (including lung and bronchus [lung] and colorectal). Among females, cancer incidence rates increased during 2012\u20132016 in all racial/ethnic groups, increasing on average 0.2% per year; rates increased for 8 of the 18 most common cancers (including breast), were stable for 6 cancers (including colorectal), and decreased for 4 cancers (including lung). Overall, cancer death rates decreased 1.5% on average per year during 2013\u20132017, decreasing 1.8% per year among males and 1.4% per year among females. During 2013\u20132017, cancer death rates decreased for all cancers combined among both males and females in each racial/ethnic group, for 11 of the 19 most common cancers among males (including lung and colorectal), and for 14 of the 20 most common cancers among females (including lung, colorectal, and breast). The largest declines in death rates were observed for melanoma of the skin (decreasing 6.1% per year among males and 6.3% among females) and lung (decreasing 4.8% per year among males and 3.7% among females). Among children younger than age 15 years, cancer incidence rates increased an average of 0.8% per year during 2012\u20132016, and cancer death rates decreased an average of 1.4% per year during 2013\u20132017. Among adolescents and young adults aged 15\u201339 years, cancer incidence rates increased an average of 0.9% per year during 2012\u20132016, and cancer death rates decreased an average of 1.0% per year during 2013\u20132017.Conclusions:While overall cancer death rates continue to decline, incidence rates are leveling off among males and increasing slightly among females. These trends reflect population changes in cancer risk factors, screening test use, diagnostic practices, and treatment advances. Many cancers can be prevented or treated effectively if found early. Population-based cancer incidence and mortality data can be used to inform efforts to decrease the cancer burden in the United States and regularly monitor progress towards goals.North American Association of Central Cancer Registries/CC999999/ImCDC/Intramural CDC HHS/United StatesCA/NCI NIH HHS/United StatesDP/NCCDPHP CDC HHS/United StatesAmerican Cancer Society/CC/CDC HHS/United States2021-05-15T00:00:00Z32162336PMC72991517844vault:3562

Cancer Incidence Among US Medicare ESRD Patients Receiving Hemodialysis, 1996-2009

Patients with end-stage renal disease (ESRD) receiving dialysis have been reported to have increased risk of cancer. However, contemporary cancer burden estimates in this population are sparse and do not account for the high competing risk of death characteristic of dialysis patients