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Health & Medicine for Senior Citizens

Cancer Rates Continue to Decline Despite Booming Senior Citizen Population

First ever decrease in death from lung cancer for women; men see small increase in prostate cancer rate

Cancer Primarily

A Disease of Aging

"The actual number of people dying from cancer (sometimes called the count) can be influenced by several factors, including the growth in the number of older people in the United States (cancer is primarily a disease of aging) and the increase in size of the population.'" - Annual Cancer Report, NAACCR, NCI, CDC, ACS

April 1, 2011 – Senior citizens, the favorite targets for a variety of cancers, should be pleased with news released yesterday that rates of death from all cancers continued to decline for men and women in the latest report on the period between 2003 and 2007. And, despite the growth in the elderly population, the overall rate of new cancers diagnosed decreased almost one percent a year during this period.

Rates of death in the United States from all cancers for men and women continued to decline between 2003 and 2007, the most recent reporting period available, according to the latest Annual Report to the Nation on the Status of Cancer. The report also finds that the overall rate of new cancer diagnoses for men and women combined decreased an average of slightly less than 1 percent per year for the same period.

The drop in cancer death rates continues a trend that began in the early 1990s, according to the latest Annual Report to the Nation on the Status of Cancer.

 

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On of the most encouraging findings in the report is that for the first time lung cancer death rates decreased in women, more than a decade after rates began dropping in men.

One finding, however, was not the best of news for senior men - there was a very small uptick in prostate cancer rates, and if these rates were excluded from the analysis, there would be a continued decline in overall male incidence rates. Overall cancer incidence rates in men were essentially unchanged.

The report is co-authored by researchers from the North American Association of Central Cancer Registries (NAACCR), the National Cancer Institute (NCI), part of the National Institutes of Health, the Centers for Disease Control and Prevention, and the American Cancer Society. It appeared online March 31, 2011, in the Journal of the National Cancer Institute, and in print on May 4, 2011.

Of special note, childhood cancer incidence rates (rates of new diagnoses) continued to increase while death rates in this age group decreased. Childhood cancer is classified as cancers occurring in those 19 years of age or younger.

In the Special Feature section of the report, the authors explore the diversity of brain tumors and other nervous system cancers beyond those that are identified as malignant, including those that are borderline and benign. The researchers analyzed data between 2004 and 2007 and found that in adults, non-malignant tumors were about twice as common as malignant tumors.

“Our new data show that non-malignant brain tumors are far more common than malignant brain tumors, and affect different population groups. Brain tumors have a far-reaching effect on our families and friends, yet they are difficult to study due to their diversity,” said Betsy Kohler, executive director, NAACCR. “We hope that the collection of both malignant and non-malignant brain tumors by central cancer registries will continue to provide a significant source of information and insight to researchers.”

Other highlights from the report show that, in men, incidence rates have declined for cancers of the lung, colon and rectum, oral cavity and pharynx, stomach, and brain (malignant only) while rates have risen for kidney, pancreas and liver cancers, as well as melanoma of the skin.

In women, incidence rates decreased for breast, lung, colorectal, uterine, cervical, bladder, and oral cavity cancers, but increased for kidney, pancreas, and thyroid cancers as well as for leukemia and melanomas of the skin.

"It is gratifying to see the continued steady decline in overall cancer incidence and death rates in the United States — the result of improved methods for preventing, detecting, and treating several types of cancer," said Harold Varmus, M.D., NCI director.

"But the full repertoire of numbers reported today also reflects the enormous complexity of cancer, with different trends for different kinds of cancers, important differences among our diverse people, and different capabilities to prevent, detect, and treat various cancers. Moreover, as our population continues to age, we have an obligation to discover and deliver better ways to control all types of cancers."

Among racial/ethnic groups, cancer death rates were highest among black men and black women, but this group also showed the largest decline for the period between 1998 and 2007 compared with other racial groups. For new cancers, black men had the highest incidence rates in the 2003 to 2007 period studied. Among women, white women had the highest overall incidence rates.

Breast cancer was the most commonly diagnosed cancer among women regardless of race or ethnicity. The differences and fluctuations in death rates by racial/ethnic group, sex, and cancer site may reflect differences in risk behaviors, socioeconomic status, and access to and use of screening and treatment.

“As we work towards reducing the cancer burden in the population as a whole, it is important that we apply what we know about prevention, detection and treatment of cancer to populations at highest risk,” said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society.

“While it's promising that mortality gaps are closing for some racial/ethnic groups, continued efforts are needed to prevent the avoidable deaths that these gaps represent.”

Despite the drop in lung cancer deaths among women nationwide, lung cancer still kills more people than any other type of cancer.

“Lung cancer can become a rare disease if states support well-funded tobacco control programs,” said CDC Director Thomas Frieden, M.D. “Aggressive ad campaigns that show the impact of smoking, combined with higher cigarette prices and strong state laws that protect nonsmokers from secondhand smoke, will decrease the number of adult smokers and save lives."

In the Special Feature section, the authors note that non-malignant tumors make up two-thirds of all adult brain tumors and one-third of childhood brain tumors, with meningiomas being the most common type of brain and other nervous system tumor in the U.S. Changes in diagnostic techniques, including the introduction of computed tomography, or CT, scans in the 1970s and magnetic resonance imaging, or MRI, in the 1980s, have led to less invasive methods for diagnosing brain tumors, but also have had a strong influence on incidence rates over the past decades. Newer molecular studies have improved classification of brain tumors for treatment and prognostic purposes.

Of note in the discussion of trends in malignant brain tumor incidence is the relative stability of long-term trends for tumors of neuroepithelial tissue, which arise from glial (support) cells in the brain and other tissues. Incidence rates for glioblastoma, the most common, as well as highly fatal, form of these malignant tumors, increased from 1980 through 1991, likely due to increasing use of aggressive diagnostic procedures in elderly patients, but since 1991 the rates have been stable.

The report notes that the relatively low variation in incidence and mortality rates over the past several decades for brain cancers suggest that external risk factors in the environment do not play a major roles in this disease.

Key Questions and Answers About Cancer Report

What is happening with long-term incidence trends for the top 15 cancers?

Among men, incidence rates of melanoma, and cancers of the liver, kidney, and pancreas increased in the five-year period from 2003 through 2007.  Incidence rates decreased for lung, oral cavity, brain, stomach, and colorectal cancers. Rates were stable for cancers of the bladder, and esophagus, as well as for non-Hodgkin lymphoma, myeloma, and leukemia. Prostate cancer incidence rates were stable with a non-statistically significant increase of 3.0 percent per year during the period from 2005 through 2007.

Among women, incidence rates of melanoma, and cancers of the kidney, thyroid, leukemia, and pancreas increased during the period from 2003 through 2007. Incidence rates decreased for cancers of the breast, lung, colorectum, uterus, cervix, bladder and oral cavity. Rates were stable for ovary and brain/nervous system cancers.

What is happening with incidence trends for breast cancer?

Breast cancer incidence rates, which increased 1.1 percent per year from 1992 through 1999, declined an average of 1.8 percent per year from 1999 through 2007.  When examining incidence data for each year, the authors note that the decline in incidence does not continue after 2003.

The factors that influence breast cancer incidence are complex, including changes in reproductive risk, obesity, the prevalence of mammography screening, and others. Recent reports suggest that the decrease in breast cancer incidence may be related to the rapid discontinuation of hormone replacement therapy, a known risk factor for breast cancer, as well as to a decline in mammography screening prevalence.  

A paper published Feb. 28, 2011, in Cancer Epidemiology, Biomarkers and Prevention (CEBP), examined trends in breast cancer incidence from 2000 through 2007. The research showed a decrease in breast cancer incidence rates from 2002 through 2003, but that this decline abated after 2003.

What is happening with cancer mortality trends overall?  

Based on long-term mortality trends, overall cancer death rates have continued to decrease since the early 1990s among both men and women and decreased an average 1.6 percent per year between 2003 and 2007.  For 2003 through2007, this decline was slightly more pronounced among men (1.9 percent per year) than women (1.5 percent per year). For children up to age 20, cancer death rates have declined since the 1970s. Death rates are the best indicator of progress against cancer.

What is happening with death rates for the top 15 cancers among men and women?

Among men, death rates decreased for 10 of the top 15 sites for both a five-year and 10-year period, including lung, prostate, colorectal, kidney, stomach, brain (malignant), and oral cavity cancers, as well as non-Hodgkin lymphoma, myeloma, and leukemia. Although colorectal cancer death rates declined for more than two decades, the most recent decline, from 2005 through 2007, was not statistically significant. Death rates for cancer of the liver and melanoma have increased, and an upturn in deaths due to cancer of the pancreas was reported during the most recent five-year time period.

Among women, death rates decreased for 11 of the top 15 cancers, including breast, ovary, and bladder, colorectal, brain (malignant), stomach, and kidney, as well as non-Hodgkin lymphoma, leukemia, and myeloma. Lung cancer death rates decreased in the recent five-year period, from 2003 through 2007, following long-term increases during the period from 1975 through 2003.

In contrast, after decreasing from 1975 through 1997, the death rates for uterine cancer increased from 1997 through 2007. The pattern for ovarian cancer mortality has been inconsistent over time; however, rates decreased between 2003 and 2007. After many years of decreasing, cervical cancer death rates for the most recent five-year period do not show a statistically significant decrease. Death rates for pancreatic and liver cancer have increased since at least the late 1970s in women.

If cancer death rates continue to fall, does that mean the number of people dying from cancer will also continue to fall?

Not necessarily. The data described in the report are rates (number of deaths per 100,000 persons in the United States) and are adjusted for age, so they are comparable across various factors, such as race, time, and region. The actual number of people dying from cancer (sometimes called the count) can be influenced by several factors, including the growth in the number of older people in the United States (cancer is primarily a disease of aging) and the increase in size of the population.

Therefore, while the cancer death rate may go down in a given year, if there is an increase in the size and the overall age of the U.S. population that same year, the actual count of the number of cancer deaths could go up.


 Information Sources:

The North American Association of Central Cancer Registries, Inc. (NAACCR, Inc.), is a professional organization that develops and promotes uniform data standards for cancer registration; provides education and training; certifies population-based registries; aggregates and publishes data from central cancer registries; and promotes the use of cancer surveillance data and systems for cancer control and epidemiologic research, public health programs, and patient care to reduce the burden of cancer in North America.

The National Cancer Institute (NCI) leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, visit the NCI Web site at http://www.cancer.gov or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

CDC's Division of Cancer Prevention and Control is a leader in nationwide efforts to ease the burden of cancer. CDC works with national cancer organizations, state health agencies, and other key groups to develop, implement, and promote effective strategies for preventing and controlling cancer.

The American Cancer Society saves lives and creates a world with less cancer and more birthdays by helping you stay well, helping you get well, by finding cures and fighting back. As the nation's largest non-governmental investor in cancer research, contributing about $3.4 billion, we turn what we know about cancer into what we do. To learn more or to get help, call 1-800-227-2345 or visit www.cancer.org

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

National Cancer Institute: http://www.cancer.gov

CDC’s Division of Cancer Prevention and Control:http://www.cdc.gov/cancer

American Cancer Society: http://www.cancer.org

 

 

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