Cancer Incidence and Mortality Cancer Incidence and Mortality in Massachusetts,in Massachusetts,

1995-19991995-1999

Bureau of Health Statistics, Research and Evaluation

Massachusetts Department of Public Health

Massachusetts Cancer RegistryMassachusetts Cancer Registry

Statewide ReportStatewide Report

Cancer Incidence and Mortality (1995-1999)

Cancer Incidence Trends in Massachusetts Over Time

New Features

• Race/Ethnicity Data

• 2000 US Population Standard

• No comparison with SEER/NCHS

Example of 1970 vs 2000 Standards1995 Cancer Incidence Data*

1970 Standard 2000 Standard

Lung (Males) 76.4 91.0

Lung (Females) 48.5 54.8

* * age-adjusted rates per 100,000

Massachusetts Cancer IncidenceMassachusetts Cancer IncidenceNewly Diagnosed CasesNewly Diagnosed Cases

1995-19991995-1999

156,735 diagnosed cases

- 77,922 in males

- 78,787 in females

Distribution of Cancer Incidence Distribution of Cancer Incidence Massachusetts, 1995-1999Massachusetts, 1995-1999

Males Males Females Females

Colon/Rectum12.3%

Bronchus &Lung15.6%

UrinaryBladder

4.9%

Prostate30.4%Other

36.8%

Other36.6%

Uterine6.1%

Colon/Rectum12.6%

Bronchus & Lung13.1%

Breast31.6%

n = 77,922 n = 78,787

Distribution of Cancer Deaths Distribution of Cancer Deaths Massachusetts, 1995-1999Massachusetts, 1995-1999

Males Males Females Females

Colon/Rectum10.8%

Prostate11.5%

Pancreas4.7%

Bronchus & Lung28.8%Other

44.2%Other42.9%

Pancreas5.6% Colon/Rectum

12.1%

Breast16.3%

Bronchus & Lung23.1%

n = 34,822 n = 34,843

Massachusetts Incidence Rates*1995 vs. 1999

* * rates per 100,000; age-adjusted to 2000 standard million

1995 1999 %Diff.

Males 577.6 583.0 +0.9

Females 432.8 447.4 +3.4

TOTAL 486.8 498.3 +2.4

Massachusetts Mortality Rates*1995 vs. 1999

* * rates per 100,000; age-adjusted to 2000 standard million

1995 1999 %Diff.

Males 287.7 268.4 -6.7

Females 190.9 174.0 -8.9

TOTAL 226.9 209.2 -7.8

Leading Cancers by Race/Ethnicity Males, 1995-1999

White, NH Black, NH Asian, NH Hispanic

Prostate172.6

Prostate293.6

Prostate95.3

Prostate141.7

Lung92.4

Lung109.6

Lung73.1

Lung58.0

C/R74.5

C/R76.9

C/R43.0

C/R40.8

Bladder31.0

Stomach24.1

Liver24.0

Oral19.6

* incidence rates per 100,000; age-adjusted to the 2000 standard million

Leading Cancers by Race/Ethnicity Females, 1995-1999

White, NH Black, NH Asian, NH Hispanic

Breast145.4

Breast113.7

Breast81.6

Breast82.3

Lung58.1

Lung48.9

C/R46.4

C/R27.4

C/R50.9

C/R47.8

Lung35.6

Lung21.9

Uterus28.2

Uterus20.4

Uterus15.2

Uterus17.9

* incidence rates per 100,000; age-adjusted to the 2000 standard million

Leading Cancer Deaths by Race/Ethnicity, Males, 1995-1999

White, NH Black, NH Asian, NH Hispanic

Lung78.5

Lung98.8

Lung50.2

Lung29.1

Prostate33.9

Prostate69.6

Liver18.9

Prostate20.2

C/R30.5

C/R43.3

Prostate18.4

C/R13.6

Pancreas12.9

Pancreas19.1

Stomach15.6

Esophagus7.7

* mortality rates per 100,000; age-adjusted to the 2000 standard million

Leading Cancer Deaths by Race/Ethnicity, Females, 1995-1999

White, NH Black, NH Asian, NH Hispanic

Lung44.8

Lung45.6

Lung25.5

Breast12.6

Breast31.1

Breast38.2

Breast16.8

C/R10.9

C/R20.6

C/R28.3

C/R16.7

Lung9.2

Pancreas10.1

Pancreas15.3

Stomach10.3

NHL5.2

* mortality rates per 100,000; age-adjusted to the 2000 standard million

1995 vs. 1999 Incidence Rates*, MA Males1995 vs. 1999 Incidence Rates*, MA Males

* * rates per 100,000; age-adjusted to 2000 standard million

Annual Age-Adjusted Cancer Incidence Rates*Annual Age-Adjusted Cancer Incidence Rates*Massachusetts Males, 1995-1999Massachusetts Males, 1995-1999

* * age-adjusted to 2000 standard million

per

100

,000

m

ales

Annual Age-Adjusted Cancer Mortality Rates*Annual Age-Adjusted Cancer Mortality Rates*Massachusetts Males, 1995-1999Massachusetts Males, 1995-1999

* * age-adjusted to 2000 standard million

per

100

,000

mal

es

1995 vs. 1999 Incidence Rates*, MA Females1995 vs. 1999 Incidence Rates*, MA Females

* * rates per 100,000; age-adjusted to 2000 standard million

Annual Age-Adjusted Cancer Incidence Rates*Annual Age-Adjusted Cancer Incidence Rates*Massachusetts Females, 1995-1999Massachusetts Females, 1995-1999

* * age-adjusted to 2000 standard million

per

100

,000

fem

ales

Annual Age-Adjusted Cancer Mortality Rates*Annual Age-Adjusted Cancer Mortality Rates*Massachusetts Females, 1995-1999Massachusetts Females, 1995-1999

* * age-adjusted to 2000 standard million

per

100

,000

fe

mal

es

Lung Cancer Incidence Rates* Lung Cancer Incidence Rates* MA, 1995-1999MA, 1995-1999

* * age-adjusted to 2000 standard million

per

100

,000

pe

rson

s

Prostate and Breast Cancer Incidence Rates* Prostate and Breast Cancer Incidence Rates* MA, 1995-1999MA, 1995-1999

* * age-adjusted to 2000 standard million

per

100

,000

pe

rson

s

Prostate CancerProstate Cancer

Fall toward an equilibrium reflecting truly incident cases

Outpatient diagnoses

Decreased utilization of PSA screening tests

Colo-Rectal Cancer Incidence Rates* Colo-Rectal Cancer Incidence Rates* MA, 1995-1999 MA, 1995-1999

* * age-adjusted to 2000 standard million

per

100

,000

pe

rson

s

Colo-Rectal CancerColo-Rectal Cancer

Diet (increased intake of vegetables and other sources of fiber)

Use of nonsteroidal anti-inflammatory drugs such as aspirin

Earlier detection/screening

Removal of polyps

ConclusionsConclusions

• Prostate cancer rates have increased 5.7% between 1995 and 1999, but there still has been an overall decrease from its peak incidence in 1992.

• Breast cancer, the leading cancer in females, increased 1.7% between 1995 and 1999.

• Lung cancer in females has increased 7.7% between 1995 and 1999.

Conclusions (cont.)Conclusions (cont.)• Melanoma increased in both males and females; 17.4%

in males and 31.4% in females.• Leading cancers with increased incidence of at least

5% from 1995 through 1999 include: prostate and melanoma in males; lung and melanoma in females.

• Leading cancers with decreased incidence of at least 5% from 1995 through 1999 include: oral cavity and pharynx and bladder cancer in males; ovarian and cervical in females.

Estimated % of Total Cancer Deaths Estimated % of Total Cancer Deaths Attributable to Established Risk Factors (U.S.)Attributable to Established Risk Factors (U.S.)

Tobacco..................... 30%

Adult Diet / Obesity... 30%

All Other Factors....... 40%

Risk factor

source: “Harvard Report on Cancer Prevention” in Cancer Causes & Control, International Association of Cancer Registries, 1996

MDPH Cancer Prevention and MDPH Cancer Prevention and Early Detection ProgramsEarly Detection Programs

• Mass. Tobacco Control Program

• Women’s Health Network

• Chronic Disease Prevention Programs

• Men’s Health Partnership

• Skin Cancer Prevention Program

• MA Skin Cancer Prevention Collaborative

• Colorectal Cancer Awareness Program

• Oral Cancer Partnership