Annual report to the nation on the status of cancer, 1973-1996, with a special section on lung cancer and tobacco smoking

Background: The American Cancer Society, the National Cancer Institute (NCI ), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS), provide the second annual rep ort to the nation on progress in cancer prevention and control, with a spec ial section on lung cancer and tobacco smoking. Methods: Age-adjusted rates (using the 1970 U.S. standard population) were based on cancer incidence d ata from NCI and underlying cause of death data compiled by NCHS, The preva lence of tobacco use was derived from CDC surveys, Reported P values are tw o-sided. Results: From 1990 through 1996, cancer incidence (-0.9% per year; P = .16) and cancer death (-0.6% per year; P = .001) rates for all sites c ombined decreased. Among the 10 leading cancer incidence sites, statistical ly significant decreases in incidence rates were seen in males for leukemia and cancers of the lung, colon/rectum, urinary bladder, and oral cavity an d pharynx, Except for lung cancer, incidence rates for these cancers also d eclined in females. Among the 10 leading cancer mortality sites, statistica lly significant decreases in cancer death rates were seen for cancers of th e male lung, female breast, the prostate, male pancreas, and male brain and , for both sexes, cancers of the colon/rectum and stomach. Age-specific ana lyses of lung cancer revealed that rates in males first declined at younger ages and then for each older age group successively over time; rates in fe males appeared to be in the early stages of following the same pattern, wit h rates decreasing for women aged 40-59 years. Conclusions: The declines in cancer incidence and death rates, particularly for lung cancer, are encour aging. However, unless recent upward trends in smoking among adolescents ca n be reversed, the lung cancer rates that are currently declining in the Un ited States may rise again.