The report notes that, although the decreases in overall cancer incidence and death rates are encouraging, large state and regional differences in lung cancer trends among women underscore the need to strengthen many state tobacco control programs.

Although cancer death rates have been dropping since the first Annual Report 10 years ago, the latest edition marks the first time the report has documented a simultaneous decline in cancer incidence for both men and women.

Based on the long-term incidence trend, rates for all cancers combined decreased 0.8% per year from 1999 through 2005 for both sexes combined; rates decreased 1.8% per year from 2001 through 2005 for men and 0.6% per year from 1998 through 2005 for women.

The decline in both incidence and death rates for all cancers combined is due in large part to declines in the 3 most common cancers among men (lung, colon/rectum, and prostate) and the 2 most common cancers among women (breast and colon/rectum), combined with a leveling off of lung cancer death rates among women.

The new report shows that, from 1996 through 2005, death rates for all cancers combined decreased for all racial and ethnic populations and for both men and women, except for American Indian/Alaska Native men and women, for whom rates were stable. The drop in death rates has been steeper for men, who have higher rates, than for women. Death rates declined for 10 of the top 15 causes of cancer death among both men and women.

However, death rates for certain individual cancers are increasing, including esophageal cancer for men, pancreatic cancer for women, and liver cancer for both men and women. Overall cancer death rates were highest for African-Americans and lowest for Asian American/Pacific Islanders.

Among men, incidence rates dropped for cancers of the lung, colon/rectum, oral cavity, and stomach. Prostate cancer incidence rates decreased by 4.4% per year from 2001 through 2005 after increasing by 2.1% per year from 1995 to 2001. In contrast, incidence rates increased for cancers of the liver, kidney, and esophagus, as well as for melanoma (2003-2005), non-Hodgkin lymphoma, and myeloma. Incidence rates were stable for cancers of the bladder, pancreas, and brain/nervous system, and for leukaemia.

For women, incidence rates dropped for cancers of the breast, colon/rectum, uterus, ovary, cervix, and oral cavity but increased for cancers of the lung, thyroid, pancreas, brain/nervous system, bladder, and kidney, as well as for leukaemia, non-Hodgkin lymphoma, and melanoma.

The report finds substantial differences in lung cancer death rate trends by state and geographic region. For example, lung cancer death rates dropped an average of 2.8% per year among men in California from 1996 through 2005, more than twice the drop seen in many states in the Midwest and the South. The geographic variation is even more extreme among women, for whom lung cancer death rates increased from 1996 through 2005 in 13 states and decreased only in 3. The report also notes that, in 5 states (Pennsylvania, Illinois, Minnesota, Nebraska, and Idaho), lung cancer incidence among women showed an increasing trend, whereas the mortality trend was level.

"It's very promising to see the progress we are making in our fight against cancer," said Julie Gerberding, MD, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia. "Unfortunately, tobacco use continues to plague our country…We must recommit ourselves to implementing tobacco control programs that we know work if we are truly going to impact the staggering toll of tobacco on our society."

"The observed decrease in the incidence and death rates from all cancers combined in men and women overall and in nearly all racial and ethnic groups is highly encouraging," concluded the authors. "However, this must be seen as a starting point rather than a destination." They said a dual effort, combining better application of existing knowledge with ongoing research to improve prevention, early detection, and treatment will be needed to sustain and extend this progress into the future.

To view the full report, go to: <http://jnci.oxfordjournals.org>.

SOURCE: National Institutes of Health

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