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NCI Report: Cancer Death Rates Continue to Drop in U.S.

But HPV-related cancers are on the rise (Jan. 7)

The Annual Report to the Nation on the Status of Cancer, 1975–2009 — co-authored by researchers at the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) — shows that overall cancer death rates continued to decline in the U.S. among both men and women, among all major racial and ethnic groups, and for all of the most common cancer sites, including lung, colon, rectum, female breast, and prostate. However, the report also shows that death rates continued to increase during the latest period (2000 through 2009) for melanoma of the skin (among men only) and for cancers of the liver, pancreas, and uterus. Moreover, the incidence rates are increasing for human papillomavirus (HPV)-associated oropharyngeal and anal cancers, and vaccination coverage levels in the U.S. during 2008 and 2010 remained low among adolescent girls.

The new report was published online in the Journal of the National Cancer Institute.

The decline in overall cancer death rates continues a trend that began in the early 1990s, the report notes. From 2000 through 2009, cancer death rates decreased by 1.8% per year among men and by 1.4% per year among women. Death rates among children up to 14 years of age also continued to decrease by 1.8% per year. During 2000 through 2009, death rates among men decreased for 10 of the 17 most common cancers (lung, prostate, colon and rectum, leukemia, non-Hodgkin lymphoma, kidney, stomach, myeloma, oral cavity and pharynx, and larynx) and increased for melanoma of the skin and cancers of the pancreas and liver. During the same 10-year period, death rates among women decreased for 15 of the 18 most common cancers (lung, breast, colon and rectum, ovary, leukemia, non-Hodgkin lymphoma, brain and other nervous system, myeloma, kidney, stomach, cervix, bladder, esophagus, oral cavity and pharynx, and gallbladder) and increased for cancers of the pancreas, liver, and uterus.

Between 2000 and 2009, overall cancer incidence rates decreased by 0.6% per year among men, were stable among women, and increased by 0.6% per year among children (aged 0 to 14 years). During that period, incidence rates among men decreased for five of the 17 most common cancers (prostate, lung, colon and rectum, stomach, and larynx) and increased for six others (kidney, pancreas, liver, thyroid, melanoma of the skin, and myeloma). Among women, incidence rates decreased for seven of the 18 most common cancers (lung, colon and rectum, bladder, cervix, oral cavity and pharynx, ovary, and stomach), and increased for seven others (thyroid, melanoma of the skin, kidney, pancreas, leukemia, liver, and uterus). Incidence rates were stable for the other top 17 cancers, including breast cancer in women and non-Hodgkin lymphoma in men and women.

The new report includes an evaluation of the burden and trends in HPV-associated cancers as well as HPV vaccination coverage levels among adolescent girls. The report shows that from 2000 through 2009, incidence rates for HPV-associated oropharyngeal cancer increased among white men and women, as did rates for anal cancer among white and black men and women. Incidence rates for cancer of the vulva increased among white and black women. Rates of cervical cancer declined among all women except American Indian/Alaska Natives. In addition, cervical cancer incidence rates were higher among women living in low versus high socioeconomic areas. Among men, rates for penile cancer were stable.

The report also showed that in 2010 fewer than half (48.7%) of girls aged 13 through 17 years had received at least one dose of the HPV vaccine, and only 32% had received all three recommended doses. Vaccination series completion rates were generally lower among certain subpopulations, including girls living in the South, those living below the poverty level, and Hispanics. The national three-dose coverage estimate among girls aged 13 through17 years in 2010 falls well short of the U.S. Government’s Healthy People 2020 target of 80% for three-dose coverage among girls aged 13 through15 years, and is much lower than vaccination rates reported in Canada (50% to 85%) and in the United Kingdom and Australia combined (greater than 70%). The authors note that low overall vaccine uptake in the U.S. is likely due to a number of issues, including inadequate provider recommendations, provider reimbursement concerns, infrequent use of reminder/recall systems that would foster completion of the three-dose series, and other factors.

Source: National Cancer Institute; January 7, 2013.

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