US Cancer Incidence and Mortality Continue to Decline

BETHESDA, Md—The overall incidence of cancer in the United States dropped an average of 1.1% per year, and the mortality rate also declined an average of 1.1% per year during the period 1992 to 1998, according to an annual report on the status of cancer prepared by four cancer organizations.

Most of the lower cancer incidence rate was attributed to a 2.9% annual drop among white males and a 3.1% decline among black males. The death rate during the period decreased an average of 1.6% for men and 0.8% for women. The incidence of lung cancer fell 1.6% per year from 1992 to 1998, which the report attributed mostly to a 2.7% fall in men and a leveling off in the rate for women.

The overall breast cancer mortality rate continues its decline, but the disease’s incidence, conversely, continues its documented quarter-century rise. It increased by more than 40% between 1973 and 1998. According to NCI, recent analyses indicate that physicians are diagnosing more early-stage breast cancer and that the increased incidence may result from the use of aggressive screening and early detection, primarily with mammography. Recently, an increase in the rate of stage II node-positive breast cancer in white women age 50 to 64 has been noted.

Colorectal incidence rates rose until 1985, decreased until 1995, and then stabilized. The rates, however, vary significantly across ethnic and racial groups, ranging in 1998 from 10.2 per 100,000 among Hispanics to 22.8 per 100,000 in blacks.

The incidence rate of prostate cancer spiked in the late 1980s after the introduction of the prostate-specific antigen (PSA) screening test, the report noted. Since that time, incidence rates for the disease have diminished, as have prostate cancer death rates in more recent years. However, wide variations in incidence exist among different parts of the United States, which the report attributes to differing rates of PSA testing. Geographic areas where PSA screening is high report high incidence rates, which often signify the discovery of clinically insignificant prostate cancers.

The American Cancer Society, NCI, Centers for Disease Control and Prevention, and North American Association of Central Cancer Registries prepared the report, which appears in the June 6, 2001 issue of the Journal of the National Cancer Institute (pp 824-842).