Yongping Hao

Cancer Statistics, 2008

Each year, the American Cancer Society estimates the number of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. Incidence and death rates are age‐standardized to the 2000 US standard million population. A total of 1,437,180 new cancer cases and 565,650 deaths from cancer are projected to occur in the United States in 2008. Notable trends in cancer incidence and mortality include stabilization of incidence rates for all cancer sites combined in men from 1995 through 2004 and in women from 1999 through 2004 and a continued decrease in the cancer death rate since 1990 in men and since 1991 in women. Overall cancer death rates in 2004 compared with 1990 in men and 1991 in women decreased by 18.4% and 10.5%, respectively, resulting in the avoidance of over a half million deaths from cancer during this time interval. This report also examines cancer incidence, mortality, and survival by site, sex, race/ethnicity, education, geographic area, and calendar year, as well as the proportionate contribution of selected sites to the overall trends. Although much progress has been made in reducing mortality rates, stabilizing incidence rates, and improving survival, cancer still accounts for more deaths than heart disease in persons under age 85 years. Further progress can be accelerated by supporting new discoveries and by applying existing cancer control knowledge across all segments of the population.

CANCER STATISTICS, 2009

Each year, the American Cancer Society estimates the number of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. Incidence and death rates are standardized by age to the 2000 United States standard million population. A total of 1,479,350 new cancer cases and 562,340 deaths from cancer are projected to occur in the United States in 2009. Overall cancer incidence rates decreased in the most recent time period in both men (1.8% per year from 2001 to 2005) and women (0.6% per year from 1998 to 2005), largely because of decreases in the three major cancer sites in men (lung, prostate, and colon and rectum [colorectum]) and in two major cancer sites in women (breast and colorectum). Overall cancer death rates decreased in men by 19.2% between 1990 and 2005, with decreases in lung (37%), prostate (24%), and colorectal (17%) cancer rates accounting for nearly 80% of the total decrease. Among women, overall cancer death rates between 1991 and 2005 decreased by 11.4%, with decreases in breast (37%) and colorectal (24%) cancer rates accounting for 60% of the total decrease. The reduction in the overall cancer death rates has resulted in the avoidance of about 650,000 deaths from cancer over the 15‐year period. This report also examines cancer incidence, mortality, and survival by site, sex, race/ethnicity, education, geographic area, and calendar year. Although progress has been made in reducing incidence and mortality rates and improving survival, cancer still accounts for more deaths than heart disease in persons younger than 85 years of age. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population and by supporting new discoveries in cancer prevention, early detection, and treatment. CA Cancer J Clin 2009;59:225‐249. ? 2009 American Cancer Society, Inc.

Changes in Treatment of Advanced Oropharyngeal Cancer, 1985–2001

Objective: The aim of this study is to describe patterns of care of advanced oropharyngeal cancer during 1985 to 2001.

Changes in treatment of advanced laryngeal cancer 1985-2001.

OBJECTIVE: In 1991, a randomized study was published and demonstrated that use of nonsurgical therapy (chemoradiation) provided similar survival to total laryngectomy (the gold standard) for patients with advanced-stage laryngeal cancer. The purpose of this study was to assess how treatment of advanced laryngeal cancer was influenced by such developments in non-surgical therapy. STUDY DESIGN: Patterns of care study using National Cancer Database (1985–2001). RESULTS: The percentage of advanced-stage patients treated with chemoradiation increased from 8.3% to 20.8% while the proportion treated with radiation alone decreased from 38.9% to 23.0%. Use of chemoradiation increased at a significantly faster rate after the 1991 publication at both community cancer centers and teaching research facilities. The use of total laryngectomy decreased slightly during this period. CONCLUSIONS: The use of chemoradiation increased after the 1991 publication. It was impossible to determine from the NCDB whether additional patients who could benefit from chemo-RT were not offered or did not complete this treatment option. We recommend that treatment recommendations discussed at tumor boards be recorded in cancer registries.

A New Method of Estimating United States and State‐level Cancer Incidence Counts for the Current Calendar Year

The American Cancer Society (ACS) has published the estimated number of new cancer cases and deaths in the current year for the United States that are commonly used by cancer control planners and the media. The methods used to produce these estimates have changed over the years as data (incidence) and statistical models improved. In this paper we present a new method that uses statistical models of cancer incidence that incorporate potential predictors of spatial and temporal variation of cancer occurrence and that account for delay in case reporting and then projects these estimated numbers of cases ahead 4 years using a piecewise linear (joinpoint) regression method. Based on evidence presented here that the new method produces more accurate estimates of the number of new cancer cases for years and areas for which data are available for comparison, the ACS has elected to use it to estimate the number of new cancer cases in Cancer Facts & Figures 2007 and in Cancer Statistics, 2007.

Trends in the Incidence of Colorectal Cancer in Relation to County-Level Poverty among Blacks and Whites

OBJECTIVE The overall incidence of colorectal cancer has been decreasing rapidly in the United States since 1998. The extent to which the recent accelerated decline varies by socioeconomic status has not been examined. We analyzed trends in colorectal cancer incidence rates from 1992-2004 by area socioeconomic status, race, gender and stage at diagnosis. METHODS Incidence data from 13 Surveillance, Epidemiology and End Results reporting areas were used to examine temporal trends in age-standardized colorectal cancer incidence rates from 1992-2004 by race, gender, stage at diagnosis and 3 levels of county poverty (counties with <10%, 10% to <20% and > or =20% of residents living below the poverty level). RESULTS Among whites, colorectal cancer incidence rates decreased in both men and women residing in low- and moderate-poverty areas. The decrease involved both early- and late-stage disease in men and late-stage disease in women. In contrast, among those residing in high-poverty areas incidence rates increased for early-stage disease in men; rates were stable for late-stage disease in men and for both categories of stage in women. Among blacks, incidence rates decreased only in men residing in low-poverty areas. CONCLUSIONS The recent decrease in colorectal cancer incidence has not yet benefited persons residing in high-poverty areas. Additional effort is needed to extend prevention and early detection measures to all segments of the population.

U.S. congressional district cancer death rates

BackgroundGeographic patterns of cancer death rates in the U.S. have customarily been presented by county or aggregated into state economic or health service areas. Herein, we present the geographic patterns of cancer death rates in the U.S. by congressional district. Many congressional districts do not follow state or county boundaries. However, counties are the smallest geographical units for which death rates are available. Thus, a method based on the hierarchical relationship of census geographic units was developed to estimate age-adjusted death rates for congressional districts using data obtained at county level. These rates may be useful in communicating to legislators and policy makers about the cancer burden and potential impact of cancer control in their jurisdictions.ResultsMortality data were obtained from the National Center for Health Statistics (NCHS) for 1990–2001 for 50 states, the District of Columbia, and all counties. We computed annual average age-adjusted death rates for all cancer sites combined, the four major cancers (lung and bronchus, prostate, female breast, and colorectal cancer) and cervical cancer. Cancer death rates varied widely across congressional districts for all cancer sites combined, for the four major cancers, and for cervical cancer. When examined at the national level, broad patterns of mortality by sex, race and region were generally similar with those previously observed based on county and state economic area.ConclusionWe developed a method to generate cancer death rates by congressional district using county-level mortality data. Characterizing the cancer burden by congressional district may be useful in promoting cancer control and prevention programs, and persuading legislators to enact new cancer control programs and/or strengthening existing ones. The method can be applied to state legislative districts and other analyses that involve data aggregation from different geographic units.

Racial disparities in lung cancer mortality in U.S. congressional districts, 1990–2001

The objective of this study was to detect statistically significant racial disparities in lung cancer mortality at the U.S. congressional district level. We applied absolute disparity statistics to mortality data from the National Center for Health Statistics (NCHS) for 1990-2001, mapped significant lung cancer mortality disparities by race and gender within U.S. congressional districts, and uncovered previously unreported disparities. The disparity statistics comparing black and white females revealed higher mortality rates for black females in the Midwestern U.S., and higher mortality rates for white females in the South-eastern U.S. Our methodology provides a spatial tool for guiding public health cancer control practices to monitor, target and reduce disparities.