Long-term trends in cancer mortality in the United States, 1930-1998.
BACKGROUND
Progress against cancer can be examined by analyzing long-term trends in cancer incidence and mortality. The recent directive from the U.S. Department of Health and Human Services to adopt the 2000 U.S. standard population for the age adjustment of death rates prompted the American Cancer Society to update historical cancer mortality statistics using the new standard.


METHODS
Mortality data were abstracted by race, gender, year, and age at death for 1930 through 1959 from annual volumes of Vital Statistics of the United States. For 1960 through 1998, these data were obtained from data tapes provided by the National Center for Health Statistics. Two U.S. standard million populations (1970 and 2000) were used to calculate age-adjusted rates. Average annual percent change was estimated for each decade by site, gender, and age, and the statistical significance of the change was assessed at p < 0.05.


RESULTS
After long-term increases or mostly level trends that date from the 1930s for some sites, death rates for cancers of the lung (in males), prostate, female breast, colon-rectum, pancreas, leukemia, and ovary were decreasing in the 1990s. Liver cancer death rates were increasing in the 1990s. Throughout the study period, death rates for female lung cancer increased, while death rates for stomach and uterine cancers declined.


CONCLUSIONS
The trends of decreasing cancer death rates for the leading cancer sites in the 1990s are encouraging. However, surveillance researchers must continue to monitor these declines to assess whether the progress seen in this decade persists. Efforts also must be made to study the sites with increasing trends and identify potential underlying causes.
Wingo
Phyllis A
PA
Department of Epidemiology and Surveillance Research, American Cancer Society, National Home Office, Atlanta, Georgia, USA. paw1@cdc.gov
Cardinez
Cheryll J
CJ
Landis
Sarah H
SH
Greenlee
Robert T
RT
Ries
Lynn A G
LA
Anderson
Robert N
RN
Thun
Michael J
MJ
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009309:National Center for Health Statistics, U.S.; D009369:Neoplasms / Q000401:mortality*; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology