Annual report to the nation on the status of cancer (1973 through 1998), featuring cancers with recent increasing trends

Background: The American Cancer Society, the National Cancer Institute (NCI ), the North American Association of Central Cancer Registries, and the Cen ters for Disease Control and Prevention, including the National Center for Health Statistics (NCHS), collaborate to provide an annual update on cancer occurrence and trends in the United States. This year's report contains a special feature that focuses on cancers with recent increasing trends. Meth ods: From 1992 through 1998, age-adjusted rates and annual percent changes are calculated for cancer incidence and underlying cause of death with the use of NCI incidence and NCHS mortality data. Joinpoint analysis, a model o f joined line segments, is used to examine long-term trends for the four mo st common cancers and for those cancers with recent increasing trends in in cidence or mortality. Statistically significant findings are based on a P v alue of .05 by use of a two-sided test. State-specific incidence and death rates for 1994 through 1998 are reported for major cancers. Results: From 1 992 through 1998, total cancer death rates declined in males and females, w hile cancer incidence rates declined only in males, Incidence rates in fema les increased slightly, largely because of breast cancer increases that occ urred in some older age groups, possibly as a result of increased early det ection. Female lung cancer mortality, a major cause of death in women, cont inued to increase but more slowly than in earlier years. In addition, the i ncidence or mortality rate increased in 10 other sites, accounting for abou t 13% of total cancer incidence and mortality in the United States. Conclus ions: Overall cancer incidence and death rates continued to decline in the United States, Future progress will require sustained improvements in cance r prevention, screening, and treatment.