The latest annual report by leading cancer organizations in the US found that overall rates of new cancer cases and deaths have fallen for the first time since the report was first compiled ten years ago, but within those figures there are disturbingly large state and regional differences in lung cancer rates among women, highlighting the need to tighten tobacco control in many states.

The annual report, as usual, was compiled by researchers from the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) and was published on 25 November in an online advance access issue of the Journal of the National Cancer Institute.

This year the report includes figures on lung cancer incidence and deaths, together with use and control of tobacco by state of residence.

For the report the researchers used information on invasive cancers from the NCI, CDC, and NAACCR, combined with figures on death rates taken from the CDC’s National Center for Health Statistics. After standardizing for age, they worked out the overall annual percentage change in incidence and death rates for all cancers, and for the top 15 individual cancer types.

The results showed that:

  • There was a statistically significant drop in incidence and death rates from all cancers combined in men and women overall (0.8 percent per year from 1999 through 2005, P < 0.05), and in most racial and ethnic groups.
  • This drop was driven largely by falls in incidence and deaths from lung, colorectal and prostate cancer in men, and breast and colorectal cancer in women, together with a levelling off of lung cancer deaths in women.
  • Although the national rate of deaths due to lung cancer in women has levelled off since 2003, after going up for several decades before that, there remain significant state and regional variations.
  • Rates of lung cancer incidence and/or deaths among women went up in 18 states.
  • 16 of the 18 states are in the South or Midwest, which on average also have the highest rate of women smokers and lower rates of decline in smoking among adult women compared to states in the West and Northeast.
  • The only state to show decreasing rates of lung cancer incidence and deaths among women was California.

The researchers concluded that:

“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.”

Chief Medical officer of the ACS, Dr Otis W Brawley, who was not one of the authors, said:

“The drop in incidence seen in this year’s Annual Report is something we’ve been waiting to see for a long time.”

“However, we have to be somewhat cautious about how we interpret it, because changes in incidence can be caused not only by reductions in risk factors for cancer, but also by changes in screening practices,” he added.

“Regardless, the continuing drop in mortality is evidence once again of real progress made against cancer, reflecting real gains in prevention, early detection, and treatment,” said Brawley.

“Annual Report to the Nation on the Status of Cancer, 1975 – 2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control.”
Ahmedin Jemal, Michael J. Thun, Lynn A. G. Ries, Holly L. Howe, Hannah K. Weir, Melissa M. Center, Elizabeth Ward, Xiao-Cheng Wu, Christie Eheman, Robert Anderson, Umed A. Ajani, Betsy Kohler, and Brenda K. Edwards.
Journal of the National Cancer Institute, Advance Access published on November 25, 2008.
DOI 10.1093/jnci/djn389.

Click here for Abstract.

Click here for the full press release from the NCI.

Sources: Journal abstract, National Cancer Institute.

Written by: Catharine Paddock, PhD