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5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
5 Cancer Statistics 2006 Presentation
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5 Cancer Statistics 2006 Presentation

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  • The American Cancer Society presents Cancer Statistics 2006.
  • Cancer accounts for nearly one-quarter of deaths in the United States, exceeded only by heart diseases. In 2003, there were 556,902 cancer deaths in the US.
  • Compared to the rate in 1950, the cancer death rate decreased slightly in 2003, while rates for other major chronic diseases decreased substantially during this period.
  • Lung cancer is, by far, the most common fatal cancer in men (31%), followed by colon & rectum (10%), and prostate (9%). In women, lung (26%), breast (15%), and colon & rectum (10%) are the leading sites of cancer death.
  • From 2002 to 2003, the number of recorded cancer deaths decreased by 778 in men, but increased by 409 in women, resulting in a net decrease of 369 total cancer deaths, the first such decrease since 1930, when nationwide mortality data began to be compiled.The decrease in the number of Americans dying from cancer is a result of declining cancer death rates outpacing the impact of growth and aging of the population.
  • The death rate from all cancers combined has decreased by 1.5% per year since 1993 among men and by 0.8% per year since 1992 among women. Compared to the peak rates in 1990 for men and 1991 for women, the cancer death rate for all sites combined in 2002 was 14.3% lower in men and 7.2% lower in women.
  • Most of the increase in cancer death rates for men prior to 1990 was attributable to lung cancer. However, since 1990, the age-adjusted lung cancer death rate in men has been decreasing. Stomach cancer mortality has decreased considerably since 1930. Death rates from prostate and colorectal cancers have also been declining.
  • Lung cancer is currently the most common cause of cancer death in women, with the death rate more than two times what it was 25 years ago. In comparison, breast cancer death rates were virtually unchanged between 1930 and 1990, and have since decreased on average 2.3% per year. The death rates for stomach and uterine cancers have decreased steadily since 1930; colorectal cancer death rates have been decreasing for over 50 years.
  • Overall, cancer death rates are higher in men than women in every racial and ethnic group. African American men and women have the highest rates of cancer mortality. Asian and Pacific Islander men and women have the lowest cancer death rates, about half the rate of African American men and women, respectively. Note: Rates for populations other than white and African American may be affected by problems in ascertaining race/ethnicity information from medical records. This is likely to result in reported death rates that are lower than true death rates.
  • African Americans have higher cancer death rates than whites for numerous cancer sites. Death rates for myeloma and cancers of the prostate, larynx, stomach, oral cavity, esophagus, liver, small intestine, colon and rectum, lung and bronchus, and pancreas are all higher in African-American men than in white men.
  • Death rates are higher in African American women than white women for many cancer sites, including myeloma and cancers of the stomach, cervix, esophagus, larynx, uterus, small intestine, pancreas, colon & rectum, liver, breast, urinary bladder, gallbladder, and oral cavity.
  • Overall, cancer death rates are higher in African-American men than white men and in African-American women than white women. However, the cancer death rate is declining faster in African-American men than white men.
  • Now we will turn our attention to the number of new cancers anticipated in the US this year. It is estimated that almost 1.4 million new cases of cancer will be diagnosed in 2006. Cancers of the prostate and breast will be the most frequently diagnosed cancers in men and women, respectively, followed by lung and colorectal cancers both in men and in women.
  • This slide shows trends in cancer incidence for all sites combined, for the years 1975-2002. Incidence rates stabilized in men from 1995 to 2002 and increased in women by 0.3% per year from 1987 to 2002.
  • Between 1988 and 1992, prostate cancer incidence rates increased dramatically due to earlier diagnosis with prostate-specific antigen (PSA) blood testing, after increasing steadily from 1975 to 1988. Incidence rates for both lung and colorectal cancers in men have declined in recent years.
  • In women, breast cancer incidence rates increased rapidly in the 1980s due to increased use of mammography and have increased gradually since that time. During the most recent time period (1998-2002), incidence rates of lung cancer have leveled off, while rates of colorectal cancer have decreased.
  • Overall, cancer incidence rates are higher in men than women. Among men, African Americans have the highest incidence followed by white, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan Natives. Racial differences in cancer incidence among women are less pronounced; white women have the highest incidence rates followed by African American, Hispanic, Asian/Pacific Islander, and American Indian/Alaskan Native women. Note: Rates for populations other than white and African American may be affected by problems in ascertaining race/ethnicity information from medical records. This is likely to result in reported incidence rates that are lower than true incidence rates. In addition, populations covered by SEER cancer registries may not be representative of these populations in other parts of the country. For example, American Indians/Alaskan Natives in the Southwestern areas covered by SEER have much lower rates of smoking and lung cancer than American Indians/Alaskan Natives in the Northern plains states.
  • Cancer incidence rates are consistently higher in African-American men than white men. In contrast, cancer incidence rates are generally higher in white women than African-American women, although the difference is not as great.
  • The next four slides look at the lifetime probability of developing cancer and relative survival rates of cancer.Presently, the risk of an American man developing cancer over his lifetime is one in two. The leading cancer sites are prostate, lung, and colon and rectum.
  • Approximately one in three women in the United States will develop cancer over her lifetime. The leading sites are breast, lung, and colon and rectum.
  • The 5-year relative survival rate from cancer is 66% for whites and 56% for African Americans (taking normal life expectancy into consideration). For many sites, survival rates in African Americans are 10% to more than 20% lower than in whites. This is due, in part, to African Americans being less likely to receive a cancer diagnosis at an early, localized stage, when treatment can improve chances of survival. Additional factors that contribute to the survival differential include unequal access to medical care and a higher prevalence of coexisting medical conditions and other risk factors.
  • The survival rates for all cancers combined and for certain site-specific cancers have improved significantly since the 1970s, due, in part, to both earlier detection and advances in treatment. Survival rates markedly increased for cancers of the prostate, breast, colon, rectum, and for leukemia. With new treatment techniques and increased utilization of screening, there is hope for even greater improvements in the not-too-distant future.
  • The next series of slides look at the burden of cancer among our nation's children. Cancer-related mortality has been decreasing in children ages 0-14 steadily for more than 2 decades.
  • Leukemia is the most common cancer among children ages 0-14 years and comprises approximately 30% of all childhood cancers. Acute lymphocytic leukemia is the most common form of leukemia in children. Cancer of the brain/other nervous system is the second most common incident cancer in both boys and girls.
  • Leukemia also accounts for the most cancer deaths in children, and comprises roughly a third of cancer deaths among boys and girls 0-14 years. Cancers of the brain/other nervous system are the second leading cause of cancer death in children 0-14.
  • The 5-year relative survival rate for all three age groups increased significantly between the mid 1970s and late 1990s. For example, the 5-year relative survival rate increased from 55.1% in 1974-76 to 79.2% in 1995-2001 for cases diagnosed among children 10-14 years old.
  • The last set of slides describes at the prevalence of cancer risk factors, such as tobacco use and physical inactivity, and the prevalence of cancer screening, such as use of mammography. Tobacco use is a major preventable cause of death, particularly from lung cancer. The year 2004 marks the anniversary of the release of the first Surgeon General’s report on Tobacco and Health, which initiated a decline of per capita cigarette smoking in the United States. As a result of the cigarette smoking epidemic, lung cancer death rates showed a steady increase through 1990, then began to decline among men. The lung cancer death rate among US women, who began regular cigarette smoking later than men, continues to increase slightly.
  • The reduction in cigarette consumption has been associated with a decrease in adult smoking prevalence in both men and women since 1965. The difference in cigarette smoking across gender narrowed from 1965 to 1985, a result of smoking becoming more popular among women and higher rates of quitting among male smokers following the Surgeon General’s Report.
  • In recent years, there have been increased efforts by states to implement comprehensive tobacco control programs. Between 1990 and 2003, tobacco consumption has declined from 133 to 79 packs per capita in the United States, with even greater declines among states with strong tobacco control programs.
  • Reduction in cigarette smoking among youth is an important factor in reducing prevalence and addiction in adulthood. Smoking among high school students increased from 1991 to 1997 and then began to decline. It is thought that the increase in smoking from 1991 to 1997 was due to aggressive youth targeted marketing and promotions; tobacco companies greatly increased their expenditures and promotions during that period. The subsequent decline is thought to be due to increased price of cigarettes as well as tobacco control efforts. Patterns were similar for Whites, African Americans, and Hispanics and for males and females.
  • The American Cancer Society recommends that individuals eat five or more servings of vegetables and fruits a day for cancer prevention. Fruit and vegetable consumption may protect against cancers of the mouth and pharynx, esophagus, lung, stomach, and colon and rectum. However, there has been little improvement in consumption since the mid-1990s. Less than one in four adults was eating the recommended servings in 2003.
  • The American Cancer Society recommends that adults engage in at least moderate physical activity for 30 or more minutes on 5 or more days of the week. However, similar to trends in nutrition, there has been little change in leisure-time physical activity during the 1990s. Almost one-fourth of adults do not engage in any leisure-time physical activity. Even more striking is that almost half of adults with less than a high school education do not participate in any leisure-time physical activity. It should be noted that leisure-time physical activity, as presented in this graph, does not reflect job-related physical activity for the currently employed population. While there has been little change in leisure-time physical activity since the early 1990s, data from other sources illustrates long-term social changes that have contributed to reduced total physical activity in US adults. For example, the number of trips outside the home made by walking has decreased by 42% between 1975 and 1995.
  • Regular physical activity has many important health benefits, including reducing risk factors for cardiovascular disease, cancer, and other chronic diseases. Today however, the prevalence of students attending physical education (PE) class daily is significantly lower than it was in 1991. Given the dramatic rise in the prevalence of overweight among teens (it has tripled since 1980), schools are increasingly being identified as an opportunity to increase physical activity among students.
  • People who become overweight in childhood and adolescence are more likely to be overweight or obese as adults. With at least half of the overweight children becoming overweight adults, future adult populations are at increased risk for developing cancer and other serious chronic diseases. The prevalence of overweight children and adolescents has increased since the 1970s, with the most dramatic increases occurring in the late 1980s and 1990s. In fact, over the past three decades the proportion of overweight children has doubled among 2-5 year olds and tripled among 6-19 year olds.
  • Obesity has reached epidemic proportions in the United States. The percentage of adults age 20 to 74 who are obese increased from 1960 to 2002 with the largest increases occurring in the 1990s. Similar trends were observed among men and women.
  • This slide highlights the obesity epidemic as mentioned in the previous slide. In 2004, over 50% of the adults in all states, including District of Columbia, were overweight or obese, compared to just 12 states in 1992.
  • The American Cancer Society states that women aged 40 and older should have an annual mammogram and clinical breast exam (CBE) as part of a periodic health exam. Women should know how their breasts normally feel and report any changes to their health care provider. A breast self-examination (BSE) is an option for women starting in their 20s.
  • The prevalence of women reporting a mammogram within the past year increased from 50% in 1991 to 64% in 2000, and has since declined to 58% in 2004. During this time, mammogram utilization varied considerably by educational attainment. The prevalence of women with less than a high school education reporting a recent mammogram was approximately 9 percentage points lower than the prevalence for all women. Even more striking is that the prevalence for women with no health insurance is approximately 25 percentage points lower than the prevalence for all women.
  • The American Cancer Society cervical cancer screening guidelines state that women should begin screening approximately three years after she begins having vaginal intercourse, but no later than 21 years of age. Screening should be done every year with regular Pap tests or every two years using liquid-based tests. At or after age 30, women who have had three normal tests in a row may get screened every 2-3 years. Women 70 and older who have had three or more consecutive normal Pap tests in the last 10 years may choose to stop cervical cancer screening.
  • This graph shows that the prevalence of women who have had a Pap test within the past three years has remained high, and has increased during the late 1990s. Throughout the decade, the prevalence among women with less than a high school education as well as the prevalence among women with no health insurance was approximately 10 percent lower than the percentage for all women.
  • The American Cancer Society recommends that beginning at age 50, men and women should receive a fecal occult blood test (FOBT) every year, or a flexible sigmoidoscopy (FSIG) every five years, or an annual FOBT and FSIG every five years (preferred to either method alone), or a double-contrast barium enema every five years, or a colonoscopy every ten years.
  • In 2004, approximately 19% of US adults 50 and older had a fecal occult blood test (FOBT) in the previous year. Adults with less than a high school education are less likely to report a recent FOBT. The prevalence for adults with no health insurance is approximately 10 percentage points lower than the prevalence for all adults.
  • While there has been a downward trend during recent years in the use of FOBT, the prevalence of flexible sigmoidoscopy (FSIG) or colonoscopy increased from 1999 to 2004. Adults with less than a high school education were less likely to report FSIG or colonoscopy than all adults. Even more striking is that the prevalence for adults with no health insurance is approximately 26 percentage points lower than the prevalence for all adults. Continuing efforts are needed to address health system barriers to colon cancer screening, to encourage health care practitioners to promote screening to their patients, and to raise awareness among eligible adults about the importance of getting screened for CRC.
  • The prostate-specific antigen (PSA) test and the digital rectal exam (DRE) should be offered annually, beginning at age 50, to men who have a life expectancy of at least 10 years.
  • This graph shows that the percentage of men who have had a PSA test within the past year decreased by 6 percentage points from 2001. Men with less than a high school education and men with no health insurance were less likely to report a PSA test than all men 50 and older.
  • This graph shows that the percentage of men who have had a DRE within the past year decreased by approximately seven percentage points from 2001. Men with less than a high school education and men with no health insurance were less likely to report a DRE than all men 50 and older. The American Cancer Society suggests that men speak with their physician to make an informed decision on prostate cancer screening.
  • The vast majority of skin cancers are the result of unprotected and excessive ultraviolet radiation exposure. The American Cancer Society estimates that UV exposure is associated with more than one million cases of basal and squamous cell cancers and 62,190 cases of malignant melanoma in 2006. Sunburns, a short-term consequence of unprotected or excessive UV exposure, were reported more frequently by men than women. Variations by race, ethnicity, and gender were observed with the highest prevalence of sunburns among white non-Hispanic males and females.
  • Adolescence is a period of heightened unprotected sun exposure. Sunburn during childhood and intense intermittent unprotected sun exposure increases the risk of melanoma and other skin cancers. 72% of youth reported getting sunburned during the summer months. Sunburn prevalence varied by race and sun sensitivity.
  • Transcript

    • 1. Cancer Statistics 2006 A Presentation From the American Cancer Society ©2006, American Cancer Society, Inc.
    • 2. US Mortality, 2003 No. of % of all Rank Cause of Death deaths deaths 1. Heart Diseases 685,089 28.0 2. Cancer 556,902 22.7 3. Cerebrovascular diseases 157,689 6.4 4. Chronic lower respiratory diseases 126,382 5.2 5. Accidents (Unintentional injuries) 109,277 4.5 6. Diabetes mellitus 74,219 3.0 7. Influenza and pneumonia 65,163 2.7 8. Alzheimer disease 63,457 2.6 18. Nephritis 42,453 1.7 10. Septicemia 34,069 1.4 Source: US Mortality Public Use Data Tape 2003, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.
    • 3. Change in the US Death Rates* by Cause, 1950 & 2003 Rate Per 100,000 586.8 600 1950 500 2003 400 300 231.6 193.9 190.1 180.7 200 100 53.3 48.1 21.9 0 Heart Cerebrovascular Pneumonia/ Cancer Diseases Diseases Influenza * Age-adjusted to 2000 US standard population. Sources: 1950 Mortality Data - CDC/NCHS, NVSS, Mortality Revised. 2003 Mortality Data: US Mortality Public Use Data Tape, 2003, NCHS, Centers for Disease Control and Prevention, 2006
    • 4. 2006 Estimated US Cancer Deaths* Men Women Lung & bronchus 31% 26% Lung & bronchus 291,270 273,560 Colon & rectum 10% 15% Breast Prostate 9% 10% Colon & rectum Pancreas 6% 6% Pancreas Leukemia 4% 6% Ovary Liver & intrahepatic 4% 4% Leukemia bile duct 3% Non-Hodgkin Esophagus 4% lymphoma Non-Hodgkin 3% 3% Uterine corpus lymphoma 2% Multiple myeloma Urinary bladder 3% 2% Brain/ONS Kidney 3% 23% All other sites All other sites 23% ONS=Other nervous system. Source: American Cancer Society, 2006.
    • 5. Trends in the Number of Cancer Deaths Among Men and Women, US, 1930-2003 300,000 290,000 Men Men 285,000 250,000 280,000 Number of Cancer Deaths Women 275,000 200,000 270,000 Women 265,000 150,000 2000 2001 2002 2003 100,000 50,000 0 1930 1940 1950 1960 1970 1980 1990 2000 Source: US Mortality Public Use Data Tape, 2003, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.
    • 6. Cancer Death Rates*, All Sites Combined, All Races, US, 1975-2002 300 Rate Per 100,000 Men 250 Both Sexes 200 Women 150 100 50 0 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 *Age-adjusted to the 2000 US standard population. Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Mortality - All COD, Public-Use With State, Total U.S. (1969-2002), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2005. Underlying mortality data provided by NCHS (www.cdc.gov/nchs).
    • 7. Cancer Death Rates*, for Men, US,1930-2002 100 Rate Per 100,000 Lung 80 60 Stomach Prostate 40 Colon & rectum 20 Pancreas Leukemia Liver 0 1940 1945 1950 1955 1970 1975 1980 1990 2000 1930 1935 1960 1965 1985 1995 *Age-adjusted to the 2000 US standard population. Source: US Mortality Public Use Data Tapes 1960-2002, US Mortality Volumes 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2005.
    • 8. Cancer Death Rates*, for Women, US,1930-2002 100 Rate Per 100,000 80 60 Lung 40 Uterus Breast Colon & rectum Stomach 20 Ovary Pancreas 0 1940 1945 1950 1955 1970 1975 1980 1990 2000 1930 1935 1960 1965 1985 1995 *Age-adjusted to the 2000 US standard population. Source: US Mortality Public Use Data Tapes 1960-2002, US Mortality Volumes 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2005.
    • 9. Cancer Death Rates*, by Race and Ethnicity, US,1998-2002 400 Men Women 339.4 350 300 242.5 250 194.3 200 171.4 164.5 159.7 148.0 150 113.8 111.0 99.4 100 50 0 White African Asian/Pacific American Hispanic† American Islander Indian/ Alaskan Native *Per 100,000, age-adjusted to the 2000 US standard population. Hispanic is not mutually exclusive from whites, African Americans, Asian/Pacific Islanders, and American Indians/ † Alaska Natives. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 10. Cancer Sites in Which African American Death Rates* Exceed White Death Rates* for Men, US, 1998-2002 Ratio of African Site African American White American/White All sites 339.4 242.5 1.4 Prostate 68.1 27.7 2.5 Larynx 5.2 2.3 2.3 Stomach 12.8 5.6 2.3 Myeloma 8.8 4.4 2.0 Oral cavity and pharynx 7.1 3.9 1.8 Esophagus 11.2 7.5 1.5 Liver and intrahepatic bile duct 9.5 6.2 1.5 Small intestine 0.7 0.5 1.4 Colon and rectum 34.0 24.3 1.4 Lung and bronchus 101.3 75.2 1.3 Pancreas 15.8 12.0 1.3 *Per 100,000, age-adjusted to the 2000 US standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 11. Cancer Sites in Which African American Death Rates* Exceed White Death Rates* for Women, US, 1998-2002 Ratio of African Site African American White American/White All sites 194.3 164.5 1.2 Stomach 6.3 2.8 2.3 Myeloma 6.5 2.9 2.2 Uterine cervix 5.3 2.5 2.1 Esophagus 3.2 1.7 1.9 Larynx 0.9 0.5 1.8 Uterine corpus 7.0 3.9 1.8 Small intestine 0.5 0.3 1.7 Pancreas 12.6 9.0 1.4 Colon and rectum 24.1 16.8 1.4 Liver and intrahepatic bile duct 3.8 2.7 1.4 Breast 34.7 25.9 1.3 Urinary bladder 2.9 2.3 1.3 Gallbladder 1.0 0.8 1.3 Oral cavity and pharynx 1.9 1.6 1.2 *Per 100,000, age-adjusted to the 2000 US standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 12. Cancer Death Rates* by Sex and Race, US, 1975-2002 500 Rate Per 100,000 450 African American men 400 350 300 White men 250 African American women 200 White women 150 100 50 0 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 *Age-adjusted to the 2000 US standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 13. 2006 Estimated US Cancer Cases* Men Women 720,280 679,510 31% Breast Prostate 33% 12% Lung & bronchus Lung & bronchus 13% 11% Colon & rectum Colon & rectum 10% 6% Uterine corpus Urinary bladder 6% 4% Non-Hodgkin Melanoma of skin 5% lymphoma Non-Hodgkin4% 4% Melanoma of skin lymphoma 3% Thyroid Kidney 3% 3% Ovary Oral cavity 3% 2% Urinary bladder Leukemia 3% 2% Pancreas Pancreas 2% 22% All Other Sites All Other Sites 18% *Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. Source: American Cancer Society, 2006.
    • 14. Cancer Incidence Rates*, All Sites Combined, All Races, 1975-2002 Rate Per 100,000 700 600 Men Both Sexes 500 400 Women 300 200 100 0 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 *Age-adjusted to the 2000 US standard population and adjusted for delay in reporting. Source: Surveillance, Epidemiology, and End Results Program, 1973-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 15. Cancer Incidence Rates* for Men, 1975-2002 Rate Per 100,000 250 Prostate 200 150 Lung 100 Colon and rectum 50 Urinary bladder Non-Hodgkin lymphoma Melanoma of the skin 0 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 *Age-adjusted to the 2000 US standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 16. Cancer Incidence Rates* for Women, 1975-2002 Rate Per 100,000 250 200 150 Breast 100 Colon and rectum Lung 50 Uterine Corpus Ovary Non-Hodgkin lymphoma 0 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 *Age-adjusted to the 2000 US standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 17. Cancer Incidence Rates* by Race and Ethnicity, 1998-2002 Rate Per 100,000 800 Men Women 682.6 700 600 556.4 500 429.3 420.7 398.5 383.5 400 310.9 303.6 300 255.4 220.5 200 100 0 White African American Asian/Pacific Islander American Indian/ Hispanic† Alaska Native *Age-adjusted to the 2000 US standard population. Hispanic is not mutually exclusive from whites, African Americans, Asian/Pacific Islanders, and American Indians. † Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 18. Cancer Incidence Rates* by Sex and Race, All Sites, 1975-2002 Rate Per 100,000 900 800 700 African-American men White men 600 500 White women 400 African-American women 300 200 100 0 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 *Age-adjusted to the 2000 US standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and
    • 19. Lifetime Probability of Developing Cancer, by Site, Men, 2000-2002* Site Risk All sites† 1 in 2 Prostate 1 in 6 Lung and bronchus 1 in 13 Colon and rectum 1 in 17 Urinary bladder‡ 1 in 28 Non-Hodgkin lymphoma 1 in 46 Melanoma 1 in 52 Kidney 1 in 64 Leukemia 1 in 67 Oral Cavity 1 in 73 Stomach 1 in 82 * For those free of cancer at beginning of age interval. Based on cancer cases diagnosed during 2000 to 2002. † All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder. ‡ Includes invasive and in situ cancer cases Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.0 Statistical Research and Applications Branch, NCI, 2005. http://srab.cancer.gov/devcan
    • 20. Lifetime Probability of Developing Cancer, by Site, Women, US, 2000-2002* Site Risk All sites† 1 in 3 Breast 1 in 8 Lung & bronchus 1 in 17 Colon & rectum 1 in 18 Uterine corpus 1 in 38 Non-Hodgkin lymphoma 1 in 55 Ovary 1 in 68 Melanoma 1 in 77 Pancreas 1 in 79 Urinary bladder‡ 1 in 88 Uterine cervix 1 in 135 * For those free of cancer at beginning of age interval. Based on cancer cases diagnosed during 2000 to 2002. † All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder. ‡ Includes invasive and in situ cancer cases Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.0 Statistical Research and Applications Branch, NCI, 2005. http://srab.cancer.gov/devcan
    • 21. Cancer Survival*(%) by Site and Race,1995-2001 % African Site White American Difference All Sites 66 56 10 Breast (female) 90 76 14 Colon 65 55 10 Esophagus 16 10 6 Leukemia 49 38 11 Non-Hodgkin lymphoma 61 52 9 Oral cavity 62 40 22 Prostate 100 97 3 Rectum 65 56 9 Urinary bladder 83 64 19 Uterine cervix 75 66 9 Uterine corpus 86 62 24 *5-year relative survival rates based on cancer patients diagnosed from 1995 to 2001 and followed through 2002. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 22. Five-year Relative Survival (%)* during Three Time Periods By Cancer Site 1983-1985 1995-2001 Site 1974-1976 All sites 50 53 65 Breast (female) 75 78 88 Colon 50 58 64 Leukemia 34 41 48 Lung and bronchus 12 14 15 Melanoma 80 85 92 Non-Hodgkin lymphoma 47 54 60 Ovary 37 41 45 † Pancreas 3 3 5 Prostate 67 75 100 Rectum 49 55 65 Urinary bladder 73 78 82 *5-year relative survival rates based on follow up of patients through 2002. †Recent changes in classification of ovarian cancer have affected 1995-2001 survival rates. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 23. Cancer Incidence & Death Rates* in Children 0-14 Years, 1975-2002 Rate Per 100,000 18 16 Incidence 14 12 10 8 6 Mortality 4 2 0 1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 *Age-adjusted to the 2000 Standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 24. Cancer Incidence Rates* in Children 0-14 Years, by Site, 1998-2002 Site Male Female Total All sites 15.6 14.3 15.0 Leukemia 4.9 4.2 4.6 Acute Lymphocytic 3.9 3.4 3.6 Brain/ONS 3.6 3.3 3.5 Soft tissue 1.1 0.9 1.0 Non-Hodgkin lymphoma 1.2 0.6 1.0 Kidney and renal pelvis 0.8 1.0 0.9 Bone and Joint 0.6 0.6 0.6 Hodgkin lymphoma 0.6 0.5 0.5 *Per 100,000, age-adjusted to the 2000 US standard population. ONS = Other nervous system Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 25. Cancer Death Rates* in Children 0-14 Years, by Site, US, 1998-2002 Site Male Female Total All sites 2.7 2.3 2.5 Leukemia 0.8 0.7 0.8 Acute Lymphocytic 0.4 0.3 0.4 Brain/ONS 0.8 0.7 0.7 Non-Hodgkin lymphoma 0.1 0.1 0.1 Soft tissue 0.1 0.1 0.1 Bone and Joint 0.1 0.1 0.1 Kidney and Renal pelvis 0.1 0.1 0.1 *Per 100,000, age-adjusted to the 2000 US standard population. ONS = Other nervous system Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 26. Trends in Survival, Children 0-14 Years, All Sites Combined 1974-2001 Year of Age 5 - Year Relative Survival Rates * Diagnosis 0 - 4 Years 1974 - 1976 19 9 5 - 5 - 9 Years 0 20 1 1974 - 1976 1 0 - 14 1974 - 1976 Years 1995 - 2001 19 9 5 - 2001 *5-year relative survival rates, based on follow up of patients through 2002. Source: Surveillance, Epidemiology, and End Results Program, 1975-2002, Division of Cancer Control and Population Sciences, National Cancer Institute, 2005.
    • 27. Tobacco Use in the US, 1900-2002 5000 100 4500 90 4000 80 Per Capita Cigarette Consumption Age-Adjusted Lung Cancer Death 3500 70 Per capita cigarette 3000 60 consumption Rates* 2500 50 Male lung cancer 2000 40 death rate 1500 30 1000 20 Female lung cancer 500 10 death rate 0 0 1900 1905 1910 1915 1920 1925 1935 1945 1950 1955 1960 1965 1975 1980 1985 1990 1995 2000 1930 1940 1970 Year *Age-adjusted to 2000 US standard population. Source: Death rates: US Mortality Public Use Tapes, 1960-2002, US Mortality Volumes, 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2005. Cigarette consumption: US Department of Agriculture, 1900-2002.
    • 28. Trends in Cigarette Smoking Prevalence* (%), by Gender, Adults 18 and Older, US, 1965-2004 60 50 40 Prevalence (%) 30 Men 20 Women 10 0 1965 1974 1979 1983 1985 1992 1995 1997 1998 1999 2000 2001 2002 2004 1990 1994 2003 Year *Redesign of survey in 1997 may affect trends. Source: National Health Interview Survey, 1965-2004, National Center for Health Statistics, Centers for Disease Control and Prevention, 2005.
    • 29. Trends in per capita cigarette consumption for selected states and the average consumption across all states, 1980-2003 140 120 100 United States Per Capit a Sales (# of Packs) 80 Massachusetts California 60 40 20 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 Year Data from: Orzechowski W, Walker RC. The tax burden on tobacco: historical compilation 2003: Volume 36. Arlington (VA): Orzechowski and Walker; 2003.
    • 30. Current* Cigarette Smoking Prevalence (%), by Gender and Race/Ethnicity, High School Students, US, 1991-2003 50 1991 1995 1997 1999 2001 2003 40 40 40 39 40 38 37 35 36 34 33 33 32 32 32 31 30 Prevalence (%) 30 28 28 28 27 27 26 23 23 22 19 19 18 20 18 17 16 13 14 11 12 11 10 0 White, non- White, non- African African Hispanic Hispanic Male Hispanic Hispanic Male American, non- American, non- Female Female Hispanic Hispanic Male Female *Smoked cigarettes on one or more of the 30 days preceding the survey. Source: Youth Risk Behavior Surveillance System, 1991, 1995, 1997, 1999, 2001, 2003, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2004.
    • 31. Trends in Consumption of Five or More Recommended Vegetable and Fruit Servings for Cancer Prevention, Adults 18 and Older, US, 1994-2003 35 30 24.4 24.4 24.2 24.1 23.6 25 Prevalence (%) 20 15 10 5 0 1994 1996 1998 2000 2003 Year Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape (2000, 2003), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001, 2004.
    • 32. Trends in Prevalence (%) of No Leisure-Time Physical Activity, by Educational Attainment, Adults 18 and Older, US, 1992-2004 60 Adults with less than a high school education 55 50 45 40 Prevalence (%) 35 30 25 All adults 20 15 10 5 0 1992 1994 1996 1998 2000 2002 2003 2004 Year Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Educational attainment is for adults 25 and older. Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape (2000, 2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001, 2003, 2005.
    • 33. Trends in Prevalence (%) of High School Students Attending PE Class Daily, by Grade, US, 1991-2003 70 60 50 Prevalence (%) 40 9th 10th 30 11th 20 12th 10 0 1991 1993 1995 1997 1999 2001 2003 Year Source: Youth Risk Behavior Surveillance System, 1991-2003, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2004. MMWR 2004;53(36):844-847.
    • 34. Trends in Overweight* Prevalence (%), Children and Adolescents, by Age Group, US, 1971-2002 20 16 16 15 Prevalence (%) 11 11 10 10 7 7 6 5 5 5 4 5 0 2 to 5 years 6 to 11 years 12 to 19 years NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94) NHANES 1999-2002 *Overweight is defined as at or above the 95th percentile for body mass index by age and sex based on reference data. Source: National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002, 2004.
    • 35. Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2002† 45 40 34 35 31 28 30 26 Prevalence (%) 23 25 21 20 17 16 17 15 13 15 12 13 15 11 10 5 0 Both sexes Men Women NHES I (1960-62) NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94) NHANES 1999-2002 *Obesity is defined as a body mass index of 30 kg/m2 or greater. † Age adjusted to the 2000 US standard population. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002, 2004.
    • 36. Trends in Overweight* Prevalence (%), Adults 18 and Older, US, 1992-2004 1992 1995 1998 2004 Less than 50% 50 to 55% More than 55% State did not participate in survey *Body mass index of 25.0 kg/m2or greater. Source: Behavioral Risk Factor Surveillance System, CD-ROM (1984-1995, 1998) and Public Use Data Tape (2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 2000, 2005.
    • 37. Screening Guidelines for the Early Detection of Breast Cancer, American Cancer Society  Yearly mammograms are recommended starting at age 40. A clinical breast exam should be part of a periodic health exam, about every three years for women in their 20s and 30s, and every year for women 40 and older. Women should know how their breasts normally feel and report any breast changes promptly to their health care providers. Breast self-exam is an option for women starting in their 20s. Women at increased risk (e.g., family history, genetic tendency, past breast cancer) should talk with their doctors about the benefits and limitations of starting mammography screening earlier, having additional tests (i.e., breast ultrasound and MRI), or having more frequent exams.
    • 38. Mammogram Prevalence (%), by Educational Attainment and Health Insurance Status, Women 40 and Older, US, 1991-2004 70 60 All women 40 and older 50 Prevalence (%) Women with less than a high school education 40 30 Women with no health insurance 20 10 0 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2002 2004 Year *A mammogram within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use Data Tape (2000, 2002, 2004), National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2000, 2001, 2003, 2005.
    • 39. Screening Guidelines for the Early Detection of Cervical Cancer, American Cancer Society Screening should begin approximately three years after a women begins having vaginal intercourse, but no later than 21 years of age. Screening should be done every year with regular Pap tests or every two years using liquid-based tests. At or after age 30, women who have had three normal test results in a row may get screened every 2-3 years. However, doctors may suggest a woman get screened more frequently if she has certain risk factors, such as HIV infection or a weakened immune system. Women 70 and older who have had three or more consecutive Pap tests in the last ten years may choose to stop cervical cancer screening. Screening after a total hysterectomy (with removal of the cervix) is not necessary unless the surgery was done as a treatment for cervical cancer.
    • 40. Trends in Recent* Pap Test Prevalence (%), by Educational Attainment and Health Insurance Status, Women 18 and Older, US, 1992-2004 100 All women 18 and older 80 Women with no health insurance Women with less than a high school education Prevalence (%) 60 40 20 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2002 2004 Year * A Pap test within the past three years. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Educational attainment is for women 25 and older. Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use Data Tape (2000, 2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Center for Disease Control and Prevention, 1997, 1999, 2000, 2000, 2001, 2003, 2005.
    • 41. Screening Guidelines for the Early Detection of Colorectal Cancer, American Cancer Society Beginning at age 50, men and women should follow one of the following examination schedules: A fecal occult blood test (FOBT) every year A flexible sigmoidoscopy (FSIG) every five years Annual fecal occult blood test and flexible sigmoidoscopy every five years* A double-contrast barium enema every five years A colonoscopy every ten years *Combined testing is preferred over either annual FOBT or FSIG every 5 years alone. People who are at moderate or high risk for colorectal cancer should talk with a doctor about a different testing schedule
    • 42. Trends in Recent* Fecal Occult Blood Test Prevalence (%), by Educational Attainment and Health Insurance Status, Adults 50 Years and Older, US, 1997-2004 30 1997 1999 2001 2002 2004 24 25 22 21 20 19 20 18 Prevalence (%) 16 16 16 14 15 12 9 9 9 10 8 5 0 Total Less than a high school No health insurance education *A fecal occult blood test within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System CD-ROM (1996-1997, 1999) and Public Use Data Tape (2001, 2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention and Prevention, 1999, 2000, 2002, 2003, 2005.
    • 43. Trends in Recent* Flexible Sigmoidoscopy or Colonoscopy Prevalence (%), by Educational Attainment and Health Insurance Status, Adults 50 Years and Older, US, 1997-2004 50 45 1997 1999 2001 2002 2004 45 41 39 40 36 34 35 32 33 Prevalence (% ) 31 29 28 30 25 18 19 20 16 16 17 15 10 5 0 Total Less than a high school No health insurance education *A flexible sigmoidoscopy or colonoscopy within the past five years. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System CD-ROM (1996-1997, 1999) and Public Use Data Tape (2001, 2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention and Prevention, 1999, 2000, 2002, 2003, 2005.
    • 44. Screening Guidelines for the Early Detection of Prostate Cancer, American Cancer Society The prostate-specific antigen (PSA) test and the digital rectal examination (DRE) should be offered annually, beginning at age 50, to men who have a life expectancy of at least 10 years. Men at high risk (African-American men and men with a strong family history of one or more first-degree relatives diagnosed with prostate cancer at an early age) should begin testing at age 45. For men at average risk and high risk, information should be provided about what is known and what is uncertain about the benefits and limitations of early detection and treatment of prostate cancer so that they can make an informed decision about testing.
    • 45. Recent* Prostate-Specific Antigen (PSA) Test Prevalence (%), by Educational Attainment and Health Insurance Status, Men 50 Years and Older, US, 2001-2004 70 2001 2002 2004 58 60 55 52 50 46 Prevalence (%) 42 39 40 30 28 30 25 20 10 0 Total Less than a high school No health insurance education *A prostate-specific antigen (PSA) test within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System Public Use Data Tape (2001, 2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2002, 2003, 2005.
    • 46. Recent* Digital Rectal Examination (DRE) Prevalence (%), by Educational Attainment and Health Insurance Status, Men 50 Years and Older, US, 2001-2004 60 57 53 2001 2002 2004 50 50 44 42 37 40 Prevalence (%) 29 30 26 22 20 10 0 Total Less than a high school No health insurance education *A digital rectal examination (DRE) within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System Public Use Data Tape (2001, 2002, 2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2002, 2003, 2005.
    • 47. Sunburn* Prevalence (%) in the Past Year, Adults 18 and Older, US, 1999 50 44.1 45 White non- Hispanic 40 Age-Adjusted Prevalence (%) 35.3 American 35 Indian/Alaskan Native 30 27.4 Other 23.5 25 22.0 18.0 20 Asian/ Pacific 13.3 Islander 15 11.0 10 Black non- 5.3 5.1 Hispanic 5 0 Male Female *Reddening of any part of the skin (regardless of size) for more than 12 hours. Source: Saraiya et al. Am J Prev Med 2002;23(2). Note: The overall prevalence of sunburn among adult males is 39.7% and among females is 28.8%. Behavioral Risk Factor Surveillance System CD-ROM, 1999. National Center for Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2000.
    • 48. Sunburn* Prevalence (%) During the Past Summer, Youth 11-18, US, 1998 90 85.5 77.2 80 74.1 74.1 70.8 70.8 70 64.1 58.4 60 55.2 Prevalence (%) 50 40 36.7 30 20 10 0 r r ity le ity k ity a le ite ia n de he ac Ma itiv itiv itiv Wh Ot Bl la n Ind em s s s Is F en en en an ic ric nS nS nS cif e Su Su Su / Pa Am igh ian ow um di L As H Me *Any reddening of the skin that lasts for at least 12 hours from either exposure to the sun or from a tanning booth or sunlamp. Note: Prevalence estimates for racial/ethnic categories other than white may not be stable due to small sample sizes and have wide confidence intervals. Source: Davis et al. Pediatrics 2002;110(1).
    • 49. Thank you

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