Cancer statistics, 2000: a benchmark for the new century
Authors: G. L. Woolam
Journal: CA A Cancer Journal for Clinicians (2000)

The American Cancer Society's Epidemiology and Surveillance Research Department provides a valuable service by annually compiling available cancer incidence and mortality statistics and deriving estimates of the expected numbers of new cases and deaths for the current year. Because of the delays inherent in the release of incidence and mortality data, and because the United States does not yet have a comprehensive national cancer registry, these estimates provide a useful way to evaluate the current burden of cancer on the US and individual state populations. As we look at cancer incidence and mortality rates in the US, we see some interesting trends, as well as a number of areas where organizations, such as the ACS, can work to make a difference. The good news is that age-adjusted incidence rates for all cancer sites combined continue to decrease. This downward trend began after the peak year of 1992. Additionally, incidence rates for the leading cancers diagnosed in men and women (prostate, breast, lung and bronchus, and colon and rectum) are either declining or have begun to slow. Unfortunately, cancer incidence remains unequally distributed among specific groups. In fact, African Americans, the population with the highest cancer incidence rates, are about 60% more likely to develop cancer than are Hispanics and Asian/Pacific Islanders, and nearly three times more likely to develop cancer than American Indians. Breast cancer death rates are decreasing primarily for white women and younger women, underscoring a need to get lifesaving messages to minorities, various ethnic groups, and older women. Indeed, even though white women develop breast cancer more frequently than women of other racial or ethnic groups, black women are most likely to die of the disease. The lung and bronchus cancer death rate among US women remains among the highest in the world. Overall, African Americans are about 33% more likely to die of cancer than are whites. This year's statistical summary includes something new: Information on trends in the recorded number of deaths from cancer. While age-adjusted death rates allow for comparisons over time that adjust for the changing size and age structure of the population, trends in the recorded number of deaths can be used to monitor changes in the overall mortality burden on the population. Examining these absolute numbers since 1997—the most recent year for which data are available—we see there has been a decrease in the total number of male deaths from cancer for the first time since complete records have been kept. Among women, the recorded number of total cancer deaths continues to increase, but at a slower rate. These documented numbers of deaths represent a lessening of the cancer burden on the health care system and serve as a marker that positive, exciting changes are occurring. This year's statistics take on heightened meaning, as they have been calculated for the year 2000, a natural benchmark leading us to pause, consider our successes, and ponder what we can do better. Continued declines in overall age-adjusted incidence and mortality rates and the first-ever decline in the number of male deaths from cancer represent an excellent starting point for the challenges ahead.