The annual report to the nation on the status of cancer, 1973-1997, with aspecial section on colorectal cancer

BACKGROUND. This annual report to the nation addresses progress in cancer p revention and control in the U.S. with a special section on colorectal canc er. This report is the joint effort of the American Cancer Society, the Nat ional Cancer Institute (NCI), the North American Association of Central Can cer Registries (NAACCR), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS). METHODS. Age-adjusted rates were based on cancer incidence data from the NC I and NAACCR and underlying cause of death as compiled by NCHS. Joinpoint a nalysis was based on NCI Surveillance, Epidemiology, and End Results (SEER) program incidence rates and NCHS death rates for 1973-1997. The prevalence of screening examinations for colorectal cancer was obtained from the CDC' s Behavioral Risk Factor Surveillance System and the NCHS's National Health Interview Survey. RESULTS. Between 1990-1997, overall cancer incidence and death rates declin ed. Joinpoint analyses of cancer incidence and death rates confirmed the de clines described in earlier reports. The incidence trends for colorectal ca ncer have shown recent steep declines for whites in contrast to a leveling off of the rates for blacks. State-to-state variations occurred in colorect al cancer screening prevalence as well as incidence and death rates. CONCLUSIONS. The continuing declines in overall cancer incidence and death rates are encouraging. However, a few of the top ten incidence or mortality cancer sites continued to increase or remained level. For many cancer site s, whites had lower incidence and mortality rates than blacks but higher ra tes than Hispanics, Asian and Pacific Islanders, and American Indians/Alask a Natives. The variations in colorectal cancer incidence and death rates by race/ethnicity, gender, age, and geographic area may be related to differe nces in risk factors, demographic characteristics, screening, and medical p ractice. New efforts currently are underway to increase awareness of screen ing benefits and treatment for colorectal cancer. Cancer 2000;88:2398-424. (C) 2000 American Cancer Society.