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Annual report
to the nation finds cancer death rate
decline doubling...Special feature examines
cancer in American Indians and Alaska
natives
A new report from the
nation’s leading cancer organizations shows
cancer death rates decreased on average 2.1
percent per year from 2002 through 2004,
nearly twice the annual decrease of 1.1
percent per year from 1993 through 2002. The
findings are in the “Annual Report to the
Nation on the Status of Cancer, 1975-2004,
Featuring Cancer in American Indians and
Alaska Natives” published online October 15,
2007 (www.interscience.wiley.com/cancer/report2007
)
and appearing in the November 15, 2007,
issue of Cancer.
A featured special
section provides the most comprehensive
cancer data to date for American Indians and
Alaska Natives (AI/AN) across the United
States. Cancer incidence rates among AI/AN
men and women varied two-fold among six
geographic regions of the country. From 1999
through 2004, AI/AN men from the Northern
Plains region and AI/AN women from Alaska
and the Northern and Southern Plains regions
had higher cancer incidence rates than
non-Hispanic white (NHW) men and women in
the same areas.
Among the general
population, the report shows that long-term
declines in cancer death rates continued
through 2004 for both sexes and, despite
overall higher death rates for men, the
declines from 2002 through 2004 were 2.6
percent per year among men and 1.8 percent
per year among women. Death rates decreased
for the majority of the top 15 cancers in
men and women. Important declines were noted
for the three leading causes of cancer
deaths in men: lung, prostate and colorectal
cancers. In women, deaths rates from
colorectal cancer and breast cancer
decreased, while the rate of increase for
lung cancer deaths slowed substantially.
“The significant
decline in cancer death rates demonstrates
important progress in the fight against
cancer that has been achieved through
effective tobacco control, screening, early
detection, and appropriate treatment," said
Centers for Disease Control and Prevention
(CDC) Director, Julie L. Gerberding, M.D.
“As a nation, we must commit to continuing
and enhancing these important public health
efforts.”
“The evidence is
unmistakable: we are truly turning the tide
in the cancer battle,” said John R. Seffrin,
Ph.D., chief executive officer of the
American Cancer Society (ACS). “The gains
could be even greater if everyone in the
U.S. had access to essential healthcare,
including primary care and prevention
services.”
Overall cancer
incidence rates (the rates at which new
cancers are diagnosed) for both sexes and
all races combined declined slightly from
1992 through 2004. Incidence rates for
female breast cancer dropped substantially
from 2001 through 2004. This drop is
possibly related to declining use of hormone
replacement therapy as well as the recently
reported decline in use of screening
mammography. Also, lung cancer incidence
rates in women stabilized from 1998 through
2004 after long term increases, and in men
the rate declined 1.8 percent per year from
the period 1991 through 2004. Colorectal
cancer incidence rates decreased by more
than 2.0 percent per year for men and women,
likely due to prevention through the removal
of precancerous polyps.
In the Special Feature
section of the Report, the authors found
that while the top three cancers for men and
for women are the same for AI/AN and NHW
populations, there are important differences
by region and type of cancer, including:
-
For all cancers
combined, AI/AN incidence rates were
lower in the Southwest and higher in the
Plains and Alaska
-
Lung and colorectal
cancer incidence rates were highest in
the Northern Plains and Alaska and were
significantly elevated in comparison
with NHW rates
-
The incidence rates
for cancers of the kidney, stomach,
liver, cervix and gallbladder were
higher in AI/AN than in NHW populations
in all regions combined
-
With the exception of
Alaska, AI/AN persons were less likely
than NHW persons to be diagnosed with
early stages of colorectal cancer, with
the difference being larger in the
Southwest, Northern Plains, and Southern
Plains than other regions
-
AI/AN women in all
regions of the U.S. were less likely
than NHW women to be diagnosed with
localized breast cancer.
“We are firmly
committed to addressing cancer health
disparities so that the benefits of decades
of research can reach all Americans,” said
National Cancer Institute (NCI) Director
John E. Niederhuber, M.D. “The fact that
lung and colorectal cancers rates were
higher in some American Indian and Alaska
Native populations points to the work we
still have to do.”
AI/AN populations were
more likely to live in poverty and less
likely to have a high school education and
health coverage when compared to NHW
persons, all indicators of less access to
cancer prevention and control services.
Also, current smoking rates were high among
AI/AN overall, with the highest prevalence
among AI/AN in Alaska and in the Northern
Plains; in all regions, more AI/AN than NHW
persons reported being obese; and screening
rates for breast, colorectal, prostate and
cervical cancers were lower among AI/AN than
NHW persons.
“We now have an
infrastructure in this country for obtaining
high-quality information about new cases of
cancer and we can now describe the successes
in cancer interventions and treatment as
well as uncover populations with varying
risks and outcomes,” said Holly L. Howe,
Ph.D., executive director of North American
Association of Central Cancer Registries (NAACCR).
“Without this surveillance, we would be
ill-equipped to address the challenges we
face in further reducing the cancer burden.”
The authors report that
earlier detection of disease through
screening, improved prognosis through more
effective treatment, tobacco control, and
reduction in inequalities in cancer care all
point to the success of the nation’s
dedication and focus on reducing the burden
of cancer in the U.S. The study was
conducted by scientists at the CDC, ACS,
NCI, which is part of the National
Institutes of Health, and NAACCR, in
collaboration with scientists from the
Indian Health Service and Mayo Clinic
College of Medicine.
###
Espey DK, Wu X, Swan J,
Wiggins C, Jim M, Ward E, Wingo PA, Howe HL,
Ries LAG, Miller BA, Jemal A, Ahmed F, Cobb
N, Kaur JS, Edwards BK. Annual Report to the
Nation on the Status of Cancer, 1975-2004,
Featuring Cancer in American Indians and
Alaska Natives. Cancer; Published online,
October 15, 2007 (DOI: 10.1002/cncr. 23044);
Print issue date, November 15, 2007
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