The decline in U.S. cancer mortality in people born since 1925.
The conventional practice of analyzing overall age-adjusted cancer mortality rates heavily emphasizes the experience of older, higher mortality age groups. This may conceal shifts in lifetime cancer mortality experience emerging first in younger age groups. We examined age-specific cancer mortality rates and birth cohort-specific cancer mortality rates in U.S. mortality data recorded since 1955 to assess the effects of age, period, and cohort in secular mortality trends. Cancer mortality and population data were obtained from WHO Statistical Information System. Age-specific cancer mortality rates have been steadily declining in the United States since the early 1950s, beginning with children and young adults and now including all age groups. During the second half of the 20th century, each successive decade of births from 1925 to 1995 experienced a lower risk of cancer death than its predecessor at virtually every age for which such a comparison can be made. A major decline in cancer mortality has been occurring in the United States for the past 50 years, affecting birth cohorts born as long as 80 years ago. Excepting lung cancer, much of this decline has occurred despite relatively stable cancer incidence. These findings suggest that improvements in cancer detection, treatment, and/or prevention have reduced the risk of cancer death across the life span for individuals born in the last three quarters of the 20th century.
Kort
Eric J
EJ
Laboratory of Molecular Epidemiology, Van Andel Research Institute, Grand Rapids, Michigan 49503, USA. korter@resident.grmerc.net
Paneth
Nigel
N
Vande Woude
George F
GF
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
JAMA. 1988 Mar 18;259(11):1690-4
3278148
N Engl J Med. 1997 Sep 25;337(13):931-4; discussion 937-8
9302311
Br J Cancer. 2002 Jul 1;87(1):43-8
12085254
J Natl Cancer Inst. 2001 Jun 6;93(11):824-42
11390532
N Engl J Med. 1986 May 8;314(19):1226-32
3702918
Cancer Causes Control. 2005 Aug;16(6):701-12
16049809
J Natl Cancer Inst. 2003 Sep 3;95(17):1276-99
12953083
J Natl Cancer Inst. 2005 Oct 5;97(19):1407-27
16204691
J Natl Cancer Inst. 2001 Feb 21;93(4):277-83
11181774
N Engl J Med. 1993 Dec 30;329(27):1977-81
8247072
Lancet. 1962 Jan 20;1(7221):115-9
13918500
Int J Tuberc Lung Dis. 2002 Jul;6(7):562-8
12102293
Cancer. 1978 Aug;42(2 Suppl):979-90
356960
Lung Cancer. 2008 Mar;59(3):282-90
18037190
Cancer. 2000 May 15;88(10):2398-424
10820364
J Natl Cancer Inst. 2004 Jan 21;96(2):99-106
14734699
CA Cancer J Clin. 1993 Jan-Feb;43(1):42-6
8422604
Acta Unio Int Contra Cancrum. 1953;9(3):552-61
13124112
N Engl J Med. 1997 May 29;336(22):1569-74
9164814
Stat Med. 1994 Apr 30;13(8):823-38
8047738
Lancet Oncol. 2008 May;9(5):445-52
18424233
Ann Epidemiol. 1999 Feb;9(2):91-2
10037551
Blood. 1953 Nov;8(11):965-99
13105700
Newsweek. 2008 Sep 15;152(11):42-4, 46, 57-8 passim
18800570
J Natl Cancer Inst. 1999 Apr 21;91(8):675-90
10218505
N Engl J Med. 1997 Sep 25;337(13):935; author reply 937-8
9304050
Biostatistics. 2001 Mar;2(1):109-29
12933560
Cancer Causes Control. 2001 Nov;12(9):813-20
11714109
Br J Cancer. 1951 Mar;5(1):21-7
14839199
Br J Prev Soc Med. 1956 Oct;10(4):159-71
13396199
J Clin Oncol. 2005 Nov 1;23(31):7836-41
16258086
Cancer. 2003 Jun 15;97(12 Suppl):3133-275
12784323
Cancer. 2002 May 15;94(10):2766-92
12173348
Cancer. 1974 May;33(5):1219-5
4856724
J Natl Cancer Inst. 1983 Sep;71(3):473-9
6577223
Int J Cancer. 2000 Jul 1;87(1):122-8
10861462
Biometrics. 1997 Mar;53(1):161-77
9147590