title: Annual report to the nation on the status of cancer, 1973-1996, with a special section on lung cancer and tobacco smoking.
abstract: 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.
authors.affiliation: Epidemiology and Surveillance Research Department, American Cancer Society, Atlanta, GA 30329-4251, USA. pwingo@cancer.org
authors.forename: P A
authors.initials: PA
authors.lastname: Wingo
authors.forename: L A
authors.initials: LA
authors.lastname: Ries
authors.forename: G A
authors.initials: GA
authors.lastname: Giovino
authors.forename: D S
authors.initials: DS
authors.lastname: Miller
authors.forename: H M
authors.initials: HM
authors.lastname: Rosenberg
authors.forename: D R
authors.initials: DR
authors.lastname: Shopland
authors.forename: M J
authors.initials: MJ
authors.lastname: Thun
authors.forename: B K
authors.initials: BK
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000570:American Cancer Society; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology; D018288:Carcinoma, Small Cell / Q000453:epidemiology; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D009369:Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality / Q000517:prevention & control; D015995:Prevalence; D012189:Retrospective Studies; D018426:SEER Program; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology