Annual report to the nation on the status of cancer, 1975-2005, featuring trends in lung cancer, tobacco use, and tobacco control.
BACKGROUND
The 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's report includes trends in lung cancer incidence and death rates, tobacco use, and tobacco control by state of residence.


METHODS
Information 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 (1975-2005) trends and by least squares linear regression of short-term (1996-2005) trends. All statistical tests were two-sided.


RESULTS
Both 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.


CONCLUSIONS
Although 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.
Jemal
Ahmedin
A
Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA 30303-1002, USA. ajemal@cancer.org
Thun
Michael J
MJ
Ries
Lynn A G
LA
Howe
Holly L
HL
Weir
Hannah K
HK
Center
Melissa M
MM
Ward
Elizabeth
E
Wu
Xiao-Cheng
XC
Eheman
Christie
C
Anderson
Robert
R
Ajani
Umed A
UA
Kohler
Betsy
B
Edwards
Brenda K
BK
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000570:American Cancer Society; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D016018:Least-Squares Analysis; D016014:Linear Models; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D054547:National Cancer Institute (U.S.); D009369:Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality / Q000517:prevention & control; D012107:Research Design; D018426:SEER Program; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000331:legislation & jurisprudence; D016540:Smoking Cessation / Q000706:statistics & numerical data; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D055815:Young Adult