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Esser MB, Sherk A, Liu Y, Henley SJ, Naimi TS. Reducing Alcohol Use to Prevent Cancer Deaths: Estimated Effects Among U.S. Adults. Am J Prev Med 2024; 66:725-729. [PMID: 38514233 PMCID: PMC10963036 DOI: 10.1016/j.amepre.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/03/2023] [Accepted: 12/03/2023] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The Dietary Guidelines for Americans, 2020-2025 recommends non-drinking or no more than 2 drinks for men or 1 drink for women in a day. However, even at lower levels, alcohol use increases the risk for certain cancers. This study estimated mean annual alcohol-attributable cancer deaths and the number of cancer deaths that could potentially be prevented if all U.S. adults who drank in excess of the Dietary Guidelines had instead consumed alcohol to correspond with typical consumption of those who drink within the recommended limits. METHODS Among U.S. residents aged ≥20 years, mean annual alcohol-attributable cancer deaths during 2020-2021 that could have been prevented with hypothetical reductions in alcohol use were estimated. Mean daily alcohol consumption prevalence estimates from the 2020-2021 Behavioral Risk Factor Surveillance System, adjusted to per capita alcohol sales to address underreporting of drinking, were applied to relative risks to calculate population-attributable fractions for cancers that can occur from drinking alcohol. Analyses were conducted during February-April 2023. RESULTS In the U.S., an estimated 20,216 cancer deaths were alcohol-attributable/year during 2020-2021 (men: 14,562 [72.0%]; women: 5,654 [28.0%]). Approximately 16,800 deaths (83% of alcohol-attributable cancer deaths, 2.8% of all cancer deaths) could have been prevented/year if adults who drank alcohol in excess of the Dietary Guidelines had instead reduced their consumption to ≤2 drinks/day for men or ≤1 drink/day for women. Approximately 650 additional deaths could have been prevented annually if men consumed 1 drink/day, instead of 2. CONCLUSIONS Implementing evidence-based alcohol policies (e.g., increasing alcohol taxes, regulating alcohol outlet density) to decrease drinking could reduce alcohol-attributable cancers, complementing clinical interventions.
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Affiliation(s)
- Marissa B Esser
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Yong Liu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Timothy S Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
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Wei SC, Freeman D, Himschoot A, Clarke KEN, Van Dyke ME, Adjemian J, Ahmad FB, Benoit TJ, Berney K, Gundlapalli AV, Hall AJ, Havers F, Henley SJ, Hilton C, Johns D, Opsomer JD, Pham HT, Stuckey MJ, Taylor CA, Jones JM. Who Gets Sick From COVID-19? Sociodemographic Correlates of Severe Adult Health Outcomes During Alpha- and Delta-Variant Predominant Periods: September 2020-November 2021. J Infect Dis 2024; 229:122-132. [PMID: 37615368 DOI: 10.1093/infdis/jiad357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Because COVID-19 case data do not capture most SARS-CoV-2 infections, the actual risk of severe disease and death per infection is unknown. Integrating sociodemographic data into analysis can show consequential health disparities. METHODS Data were merged from September 2020 to November 2021 from 6 national surveillance systems in matched geographic areas and analyzed to estimate numbers of COVID-19-associated cases, emergency department visits, and deaths per 100 000 infections. Relative risks of outcomes per infection were compared by sociodemographic factors in a data set including 1490 counties from 50 states and the District of Columbia, covering 71% of the US population. RESULTS Per infection with SARS-CoV-2, COVID-19-related morbidity and mortality were higher among non-Hispanic American Indian and Alaska Native persons, non-Hispanic Black persons, and Hispanic or Latino persons vs non-Hispanic White persons; males vs females; older people vs younger; residents in more socially vulnerable counties vs less; those in large central metro areas vs rural; and people in the South vs the Northeast. DISCUSSION Meaningful disparities in COVID-19 morbidity and mortality per infection were associated with sociodemography and geography. Addressing these disparities could have helped prevent the loss of tens of thousands of lives.
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Affiliation(s)
- Stanley C Wei
- COVID-19 Response Team, Centers for Disease Control and Prevention
| | - Dane Freeman
- Information and Communications Laboratory, Georgia Tech Research Institute
| | - Austin Himschoot
- Information and Communications Laboratory, Georgia Tech Research Institute
| | | | | | | | - Farida B Ahmad
- COVID-19 Response Team, Centers for Disease Control and Prevention
| | - Tina J Benoit
- COVID-19 Response Team, Centers for Disease Control and Prevention
| | - Kevin Berney
- Geospatial Research, Analysis, and Services Program, Agency for Toxic Substances and Disease Registry
| | | | - Aron J Hall
- COVID-19 Response Team, Centers for Disease Control and Prevention
| | - Fiona Havers
- COVID-19 Response Team, Centers for Disease Control and Prevention
| | - S Jane Henley
- COVID-19 Response Team, Centers for Disease Control and Prevention
| | - Charity Hilton
- Information and Communications Laboratory, Georgia Tech Research Institute
| | - Dylan Johns
- COVID-19 Response Team, Centers for Disease Control and Prevention
- Health, Environment, Economics, and Development, ICF International, Reston, Virginia
| | - Jean D Opsomer
- Center of Statistics and Data Science, WESTAT Inc, Rockville, Maryland, USA
| | - Huong T Pham
- COVID-19 Response Team, Centers for Disease Control and Prevention
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Negoita S, Chen HS, Sanchez PV, Sherman RL, Henley SJ, Siegel R, Sung H, Scott S, Benard VB, Kohler BA, Jemal A, Cronin K. Annual Report to the Nation on the Status of Cancer, part 2: Early assessment of the COVID-19 pandemic's impact on cancer diagnosis. Cancer 2024; 130:117-127. [PMID: 37755665 PMCID: PMC10841454 DOI: 10.1002/cncr.35026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/14/2023] [Accepted: 08/11/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND With access to cancer care services limited because of coronavirus disease 2019 control measures, cancer diagnosis and treatment have been delayed. The authors explored changes in the counts of US incident cases by cancer type, age, sex, race, and disease stage in 2020. METHODS Data were extracted from selected US population-based cancer registries for diagnosis years 2015-2020 using first-submission data from the North American Association of Central Cancer Registries. After a quality assessment, the monthly numbers of newly diagnosed cancer cases were extracted for six cancer types: colorectal, female breast, lung, pancreas, prostate, and thyroid. The observed numbers of incident cancer cases in 2020 were compared with the estimated numbers by calculating observed-to-expected (O/E) ratios. The expected numbers of incident cases were extrapolated using Joinpoint trend models. RESULTS The authors report an O/E ratio <1.0 for major screening-eligible cancer sites, indicating fewer newly diagnosed cases than expected in 2020. The O/E ratios were lowest in April 2020. For every cancer site except pancreas, Asians/Pacific Islanders had the lowest O/E ratio of any race group. O/E ratios were lower for cases diagnosed at localized stages than for cases diagnosed at advanced stages. CONCLUSIONS The current analysis provides strong evidence for declines in cancer diagnoses, relative to the expected numbers, between March and May of 2020. The declines correlate with reductions in pathology reports and are greater for cases diagnosed at in situ and localized stage, triggering concerns about potential poor cancer outcomes in the coming years, especially in Asians/Pacific Islanders. PLAIN LANGUAGE SUMMARY To help control the spread of coronavirus disease 2019 (COVID-19), health care organizations suspended nonessential medical procedures, including preventive cancer screening, during early 2020. Many individuals canceled or postponed cancer screening, potentially delaying cancer diagnosis. This study examines the impact of the COVID-19 pandemic on the number of newly diagnosed cancer cases in 2020 using first-submission, population-based cancer registry database. The monthly numbers of newly diagnosed cancer cases in 2020 were compared with the expected numbers based on past trends for six cancer sites. April 2020 had the sharpest decrease in cases compared with previous years, most likely because of the COVID-19 pandemic.
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Affiliation(s)
- Serban Negoita
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Huann-Sheng Chen
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Pamela V. Sanchez
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Recinda L. Sherman
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rebecca Siegel
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Hyuna Sung
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Susan Scott
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Vicki B. Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Betsy A. Kohler
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Kathleen Cronin
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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4
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Siegel DA, King JB, Lupo PJ, Durbin EB, Tai E, Mills K, Van Dyne E, Lunsford NB, Henley SJ, Wilson RJ. Counts, incidence rates, and trends of pediatric cancer in the United States, 2003-2019. J Natl Cancer Inst 2023; 115:1337-1354. [PMID: 37433078 PMCID: PMC11018256 DOI: 10.1093/jnci/djad115] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Cancer is a leading cause of death by disease among children and adolescents in the United States. This study updates cancer incidence rates and trends using the most recent and comprehensive US cancer registry data available. METHODS We used data from US Cancer Statistics to evaluate counts, age-adjusted incidence rates, and trends among children and adolescents younger than 20 years of age diagnosed with malignant tumors between 2003 and 2019. We calculated the average annual percent change (APC) and APC using joinpoint regression. Rates and trends were stratified by demographic and geographic characteristics and by cancer type. RESULTS With 248 749 cases reported between 2003 and 2019, the overall cancer incidence rate was 178.3 per 1 million; incidence rates were highest for leukemia (46.6), central nervous system neoplasms (30.8), and lymphoma (27.3). Rates were highest for males, children 0 to 4 years of age, Non-Hispanic White children and adolescents, those in the Northeast census region, the top 25% of counties by economic status, and metropolitan counties with a population of 1 million people or more. Although the overall incidence rate of pediatric cancer increased 0.5% per year on average between 2003 and 2019, the rate increased between 2003 and 2016 (APC = 1.1%), and then decreased between 2016 and 2019 (APC = -2.1%). Between 2003 and 2019, rates of leukemia, lymphoma, hepatic tumors, bone tumors, and thyroid carcinomas increased, while melanoma rates decreased. Rates of central nervous system neoplasms increased until 2017, and then decreased. Rates of other cancer types remained stable. CONCLUSIONS Incidence of pediatric cancer increased overall, although increases were limited to certain cancer types. These findings may guide future public health and research priorities.
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Affiliation(s)
- David A. Siegel
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica B. King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Philip J. Lupo
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Eric B. Durbin
- Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Eric Tai
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathi Mills
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth Van Dyne
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natasha Buchanan Lunsford
- Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Reda J. Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Stanfill SB, Hecht SS, Joerger AC, González PJ, Maia LB, Rivas MG, Moura JJG, Gupta AK, Le Brun NE, Crack JC, Hainaut P, Sparacino-Watkins C, Tyx RE, Pillai SD, Zaatari GS, Henley SJ, Blount BC, Watson CH, Kaina B, Mehrotra R. From cultivation to cancer: formation of N-nitrosamines and other carcinogens in smokeless tobacco and their mutagenic implications. Crit Rev Toxicol 2023; 53:658-701. [PMID: 38050998 DOI: 10.1080/10408444.2023.2264327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/20/2023] [Indexed: 12/07/2023]
Abstract
Tobacco use is a major cause of preventable morbidity and mortality globally. Tobacco products, including smokeless tobacco (ST), generally contain tobacco-specific N-nitrosamines (TSNAs), such as N'-nitrosonornicotine (NNN) and 4-(methylnitrosamino)-1-(3-pyridyl)-butanone (NNK), which are potent carcinogens that cause mutations in critical genes in human DNA. This review covers the series of biochemical and chemical transformations, related to TSNAs, leading from tobacco cultivation to cancer initiation. A key aim of this review is to provide a greater understanding of TSNAs: their precursors, the microbial and chemical mechanisms that contribute to their formation in ST, their mutagenicity leading to cancer due to ST use, and potential means of lowering TSNA levels in tobacco products. TSNAs are not present in harvested tobacco but can form due to nitrosating agents reacting with tobacco alkaloids present in tobacco during certain types of curing. TSNAs can also form during or following ST production when certain microorganisms perform nitrate metabolism, with dissimilatory nitrate reductases converting nitrate to nitrite that is then released into tobacco and reacts chemically with tobacco alkaloids. When ST usage occurs, TSNAs are absorbed and metabolized to reactive compounds that form DNA adducts leading to mutations in critical target genes, including the RAS oncogenes and the p53 tumor suppressor gene. DNA repair mechanisms remove most adducts induced by carcinogens, thus preventing many but not all mutations. Lastly, because TSNAs and other agents cause cancer, previously documented strategies for lowering their levels in ST products are discussed, including using tobacco with lower nornicotine levels, pasteurization and other means of eliminating microorganisms, omitting fermentation and fire-curing, refrigerating ST products, and including nitrite scavenging chemicals as ST ingredients.
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Affiliation(s)
- Stephen B Stanfill
- Tobacco and Volatiles Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephen S Hecht
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Andreas C Joerger
- Structural Genomics Consortium (SGC), Institute of Pharmaceutical Chemistry, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Pablo J González
- Department of Physics, Universidad Nacional Litoral, and CONICET, Santa Fe, Argentina
| | - Luisa B Maia
- Department of Chemistry, LAQV, REQUIMTE, NOVA School of Science and Technology (FCT NOVA), Caparica, Portugal
| | - Maria G Rivas
- Department of Physics, Universidad Nacional Litoral, and CONICET, Santa Fe, Argentina
| | - José J G Moura
- Department of Chemistry, LAQV, REQUIMTE, NOVA School of Science and Technology (FCT NOVA), Caparica, Portugal
| | | | - Nick E Le Brun
- School of Chemistry, Centre for Molecular and Structural Biochemistry, University of East Anglia, Norwich, UK
| | - Jason C Crack
- School of Chemistry, Centre for Molecular and Structural Biochemistry, University of East Anglia, Norwich, UK
| | - Pierre Hainaut
- Institute for Advanced Biosciences, Grenoble Alpes University, Grenoble, France
| | - Courtney Sparacino-Watkins
- University of Pittsburgh, School of Medicine, Division of Pulmonary Allergy and Critical Care Medicine, Vascular Medicine Institute, PA, USA
| | - Robert E Tyx
- Tobacco and Volatiles Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suresh D Pillai
- Department of Food Science & Technology, National Center for Electron Beam Research, Texas A&M University, College Station, TX, USA
| | - Ghazi S Zaatari
- Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon
| | - S Jane Henley
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benjamin C Blount
- Tobacco and Volatiles Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clifford H Watson
- Tobacco and Volatiles Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Bernd Kaina
- Institute of Toxicology, University Medical Center, Mainz, Germany
| | - Ravi Mehrotra
- Centre for Health, Innovation and Policy Foundation, Noida, India
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Bock S, Henley SJ, O'Neil ME, Singh SD, Thompson TD, Wu M. Cancer Distribution Among Asian, Native Hawaiian, and Pacific Islander Subgroups - United States, 2015-2019. MMWR Morb Mortal Wkly Rep 2023; 72:421-425. [PMID: 37079478 PMCID: PMC10121267 DOI: 10.15585/mmwr.mm7216a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Non-Hispanic Asian (Asian) and non-Hispanic Native Hawaiian and Pacific Islander (NHPI) persons represent growing segments of the U.S. population (1). Epidemiologic cancer studies often aggregate Asian and NHPI persons (2,3); however, because Asian and NHPI persons are culturally, geographically, and linguistically diverse (2,4), subgroup analyses might provide insights into the distribution of health outcomes. To examine the frequency and percentage of new cancer cases among 25 Asian and NHPI subgroups, CDC analyzed the most current 2015-2019 U.S. Cancer Statistics data.* The distribution of new cancer cases among Asian and NHPI subgroups differed by sex, age, cancer type, and stage at diagnosis (for screening-detected cancers). The percentage of cases diagnosed among females ranged from 47.1% to 68.2% and among persons aged <40 years, ranged from 3.1% to 20.2%. Among the 25 subgroups, the most common cancer type varied. For example, although breast cancer was the most common in 18 subgroups, lung cancer was the most common cancer among Chamoru, Micronesian race not otherwise specified (NOS), and Vietnamese persons; colorectal cancer was the most common cancer among Cambodian, Hmong, Laotian, and Papua New Guinean persons. The frequency of late-stage cancer diagnoses among all subgroups ranged from 25.7% to 40.3% (breast), 38.1% to 61.1% (cervical), 52.4% to 64.7% (colorectal), and 70.0% to 78.5% (lung). Subgroup data illustrate health disparities among Asian and NHPI persons, which might be reduced through the design and implementation of culturally and linguistically responsive cancer prevention and control programs, including programs that address social determinants of health.
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Affiliation(s)
- Suzanne Bock
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Mary Elizabeth O'Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Trevor D Thompson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Ellington TD, Henley SJ, Wilson RJ, Miller JW, Wu M, Richardson LC. Trends in breast cancer mortality by race/ethnicity, age, and US census region, United States─1999-2020. Cancer 2023; 129:32-38. [PMID: 36309838 PMCID: PMC10128100 DOI: 10.1002/cncr.34503] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Breast cancer remains a leading cause of morbidity and mortality among women in the United States. Previous analyses show that breast cancer incidence increased from 1999 to 2018. The purpose of this article is to examine trends in breast cancer mortality. METHODS Analysis of 1999 to 2020 mortality data from the Centers for Disease Control and Prevention, National Center for Health Statistics, among women by race/ethnicity, age, and US Census region. RESULTS It was found that overall breast cancer mortality is decreasing but varies by race/ethnicity, age group, and US Census region. The largest decrease in mortality was observed among non-Hispanic White women, women aged 45 to 64 years of age, and women living in the Northeast; whereas the smallest decrease in mortality was observed among non-Hispanic Asian or Pacific Islander women, women aged 65 years or older, and women living in the South. CONCLUSION This report provides national estimates of breast cancer mortality from 1999 to 2020 by race/ethnicity, age group, and US Census region. The decline in breast cancer mortality varies by demographic group. Disparities in breast cancer mortality have remained consistent over the past two decades. Using high-quality cancer surveillance data to estimate trends in breast cancer mortality may help health care professionals and public health prevention programs tailor screening and diagnostic interventions to address these disparities.
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Affiliation(s)
- Taylor D. Ellington
- National Center for Chronic Disease Prevention Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - S. Jane Henley
- National Center for Chronic Disease Prevention Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Reda J. Wilson
- National Center for Chronic Disease Prevention Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jacqueline W. Miller
- National Center for Chronic Disease Prevention Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Manxia Wu
- National Center for Chronic Disease Prevention Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lisa C. Richardson
- National Center for Chronic Disease Prevention Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States
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8
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Ellington TD, Werner AK, Henley SJ, Paddock LE, Agovino PK. Feasibility of Visualizing Cancer Incidence Data at Sub-County Level: Findings from 21 National Program of Cancer Registries. Spat Spatiotemporal Epidemiol 2023. [DOI: 10.1016/j.sste.2023.100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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9
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Ellington TD, Henley SJ, Wilson RJ, Senkomago V, Wu M, Benard V, Richardson LC. Cancer survival in the United States 2007-2016: Results from the National Program of Cancer Registries. PLoS One 2023; 18:e0284051. [PMID: 37167241 PMCID: PMC10174513 DOI: 10.1371/journal.pone.0284051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/22/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Cancer survival has improved for the most common cancers. However, less improvement and lower survival has been observed in some groups perhaps due to differential access to cancer care including prevention, screening, diagnosis, and treatment. METHODS To further understand contemporary relative cancer survival (one- and five- year), we used survival data from CDC's National Program of Cancer Registries (NPCR) for cancers diagnosed during 2007-2016. We examined overall relative cancer survival by sex, race and ethnicity, age, and county-level metropolitan and non-metropolitan status. Relative cancer survival by metropolitan and non-metropolitan status was further examined by sex, race and ethnicity, age, and cancer type. RESULTS Among persons with cancer diagnosed during 2007-2016 the overall one-year and five-year relative survival was 80.6% and 67.4%, respectively. One-year relative survival for persons living in metropolitan counties was 81.1% and 77.8% among persons living in non-metropolitan counties. We found that persons who lived in non-metropolitan counties had lower survival than those who lived in metropolitan counties, and this difference persisted across sex, race and ethnicity, age, and most cancer types. CONCLUSION Further examination of the differences in cancer survival by cancer type or other characteristics might be helpful for identifying potential interventions, such as programs that target screening and early detection or strategies to improve access to high quality cancer treatment and follow-up care, that could improve long-term outcomes. IMPACT This analysis provided a high-level overview of contemporary cancer survival in the United States.
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Affiliation(s)
- Taylor D Ellington
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, United States of America
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Virginia Senkomago
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vicki Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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10
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Henley SJ, Dowling NF, Ahmad FB, Ellington TD, Wu M, Richardson LC. COVID-19 and Other Underlying Causes of Cancer Deaths - United States, January 2018-July 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1583-1588. [PMID: 36520660 PMCID: PMC9762902 DOI: 10.15585/mmwr.mm7150a3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cancer survivors (persons who have received a diagnosis of cancer, from the time of diagnosis throughout their lifespan)* have increased risk for severe COVID-19 illness and mortality (1). This report describes characteristics of deaths reported to CDC's National Vital Statistics System (NVSS), for which cancer was listed as the underlying or a contributing cause (cancer deaths) during January 1, 2018-July 2, 2022. The underlying causes of death, including cancer and COVID-19, were examined by week, age, sex, race and ethnicity, and cancer type. Among an average of approximately 13,000 weekly cancer deaths, the percentage with cancer as the underlying cause was 90% in 2018 and 2019, 88% in 2020, and 87% in 2021. The percentage of cancer deaths with COVID-19 as the underlying cause differed by time (2.0% overall in 2020 and 2.4% in 2021, ranging from 0.2% to 7.2% by week), with higher percentages during peaks in the COVID-19 pandemic. The percentage of cancer deaths with COVID-19 as the underlying cause also differed by the characteristics examined, with higher percentages observed in 2021 among persons aged ≥65 years (2.4% among persons aged 65-74 years, 2.6% among persons aged 75-84 years, and 2.4% among persons aged ≥85 years); males (2.6%); persons categorized as non-Hispanic American Indian or Alaska Native (AI/AN) (3.4%), Hispanic or Latino (Hispanic) (3.2%), or non-Hispanic Black or African American (Black) (2.5%); and persons with hematologic cancers, including leukemia (7.4%), lymphoma (7.3%), and myeloma (5.8%). This report found differences by age, sex, race and ethnicity, and cancer type in the percentage of cancer deaths with COVID-19 as the underlying cause. These results might guide multicomponent COVID-19 prevention interventions and ongoing, cross-cutting efforts to reduce health disparities and address structural and social determinants of health among cancer survivors, which might help protect those at disproportionate and increased risk for death from COVID-19.
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Cronin KA, Scott S, Firth AU, Sung H, Henley SJ, Sherman RL, Siegel RL, Anderson RN, Kohler BA, Benard VB, Negoita S, Wiggins C, Cance WG, Jemal A. Annual report to the nation on the status of cancer, part 1: National cancer statistics. Cancer 2022; 128:4251-4284. [PMID: 36301149 PMCID: PMC10092838 DOI: 10.1002/cncr.34479] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/11/2022] [Accepted: 07/26/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND The American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate to provide annual updates on cancer occurrence and trends in the United States. METHODS Data on new cancer diagnoses during 2001-2018 were obtained from the North American Association of Central Cancer Registries' Cancer in North America Incidence file, which is comprised of data from Centers for Disease Control and Prevention-funded and National Cancer Institute-funded, population-based cancer registry programs. Data on cancer deaths during 2001-2019 were obtained from the National Center for Health Statistics' National Vital Statistics System. Five-year average incidence and death rates along with trends for all cancers combined and for the leading cancer types are reported by sex, racial/ethnic group, and age. RESULTS Overall cancer incidence rates were 497 per 100,000 among males (ranging from 306 among Asian/Pacific Islander males to 544 among Black males) and 431 per 100,000 among females (ranging from 309 among Asian/Pacific Islander females to 473 among American Indian/Alaska Native females) during 2014-2018. The trend during the corresponding period was stable among males and increased 0.2% on average per year among females, with differing trends by sex, racial/ethnic group, and cancer type. Among males, incidence rates increased for three cancers (including pancreas and kidney), were stable for seven cancers (including prostate), and decreased for eight (including lung and larynx) of the 18 most common cancers considered in this analysis. Among females, incidence rates increased for seven cancers (including melanoma, liver, and breast), were stable for four cancers (including uterus), and decreased for seven (including thyroid and ovary) of the 18 most common cancers. Overall cancer death rates decreased by 2.3% per year among males and by 1.9% per year among females during 2015-2019, with the sex-specific declining trend reflected in every major racial/ethnic group. During 2015-2019, death rates decreased for 11 of the 19 most common cancers among males and for 14 of the 20 most common cancers among females, with the steepest declines (>4% per year) reported for lung cancer and melanoma. Five-year survival for adenocarcinoma and neuroendocrine pancreatic cancer improved between 2001 and 2018; however, overall incidence (2001-2018) and mortality (2001-2019) continued to increase for this site. Among children (younger than 15 years), recent trends were stable for incidence and decreased for mortality; and among, adolescents and young adults (aged 15-39 years), recent trends increased for incidence and declined for mortality. CONCLUSIONS Cancer death rates continued to decline overall, for children, and for adolescents and young adults, and treatment advances have led to accelerated declines in death rates for several sites, such as lung and melanoma. The increases in incidence rates for several common cancers in part reflect changes in risk factors, screening test use, and diagnostic practice. Racial/ethnic differences exist in cancer incidence and mortality, highlighting the need to understand and address inequities. Population-based incidence and mortality data inform prevention, early detection, and treatment efforts to help reduce the cancer burden in the United States.
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Affiliation(s)
- Kathleen A Cronin
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Susan Scott
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Albert U Firth
- Information Management Services, Inc, Rockville, Maryland, USA
| | - Hyuna Sung
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Recinda L Sherman
- North American Association of Central Cancer Registries, Springfield, Illinois, USA
| | - Rebecca L Siegel
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Robert N Anderson
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
| | - Betsy A Kohler
- North American Association of Central Cancer Registries, Springfield, Illinois, USA
| | - Vicki B Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Serban Negoita
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Charles Wiggins
- New Mexico Tumor Registry, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA
| | | | - Ahmedin Jemal
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Rohan E, Kuiper N, Bowen SA, Mast DK, House M, French C, Tharpe FS, Henley SJ, Wanliss E, Puckett M. Pairing Project ECHO and patient navigation as an innovative approach to improving the health and wellness of cancer survivors in rural settings. J Rural Health 2022; 38:855-864. [PMID: 35611881 PMCID: PMC10961889 DOI: 10.1111/jrh.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE We conducted a 12-month pilot study of 2 complementary strategies for improving rural cancer survivorship outcomes: (1) Project ECHO, a telementoring model to increase knowledge and skills about cancer survivorship among multidisciplinary health care provider teams in rural areas and (2) patient navigation (PN) services to connect rural cancer survivors with resources for enhancing health and wellness. METHODS We recruited 4 CDC-funded National Comprehensive Cancer Control Program sites to implement Project ECHO and PN interventions for a defined rural population in each of their jurisdictions. Sites received ongoing technical assistance and a stipend to support implementation. We conducted a mixed-methods evaluation consisting of quantitative performance monitoring data and qualitative interviews with site staff to assess implementation. FINDINGS Site teams delivered 21 cancer survivorship ECHO sessions to rural providers resulting in 329 participant encounters. Almost all (93%) ECHO participants reported enhanced knowledge of cancer survivorship issues, and 80% reported intent to apply learnings to their practices. Site teams engaged 16 patient navigators who navigated 164 cancer survivors during the study period. Successful implementation required strong partnerships, clear avenues for recruitment of rural providers and cancer survivors, and activities tailored to local needs. Fostering ongoing relationships among sites through community of practice calls also enhanced implementation. CONCLUSIONS Sites successfully implemented a novel approach for enhancing care for cancer survivors in rural communities. Pairing Project ECHO to address structural barriers and PN to address individual factors affecting survivorship may help bridge the health equity gap experienced by cancer survivors in rural communities.
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Affiliation(s)
- Elizabeth Rohan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | | | | | - Cynthia French
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Felicia Solomon Tharpe
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ena Wanliss
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary Puckett
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Ellington TD, Miller JW, Henley SJ, Wilson RJ, Wu M, Richardson LC. Trends in Breast Cancer Incidence, by Race, Ethnicity, and Age Among Women Aged ≥20 Years - United States, 1999-2018. MMWR Morb Mortal Wkly Rep 2022; 71:43-47. [PMID: 35025856 PMCID: PMC8757618 DOI: 10.15585/mmwr.mm7102a2] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Islami F, Ward EM, Sung H, Cronin KA, Tangka FKL, Sherman RL, Zhao J, Anderson RN, Henley SJ, Yabroff KR, Jemal A, Benard VB. Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics. J Natl Cancer Inst 2021; 113:1648-1669. [PMID: 34240195 PMCID: PMC8634503 DOI: 10.1093/jnci/djab131] [Citation(s) in RCA: 245] [Impact Index Per Article: 81.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/12/2021] [Accepted: 06/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries collaborate to provide annual updates on cancer incidence and mortality and trends by cancer type, sex, age group, and racial/ethnic group in the United States. In this report, we also examine trends in stage-specific survival for melanoma of the skin (melanoma). METHODS Incidence data for all cancers from 2001 through 2017 and survival data for melanoma cases diagnosed during 2001-2014 and followed-up through 2016 were obtained from the Centers for Disease Control and Prevention- and National Cancer Institute-funded population-based cancer registry programs compiled by the North American Association of Central Cancer Registries. Data on cancer deaths from 2001 to 2018 were obtained from the National Center for Health Statistics' National Vital Statistics System. Trends in age-standardized incidence and death rates and 2-year relative survival were estimated by joinpoint analysis, and trends in incidence and mortality were expressed as average annual percent change (AAPC) during the most recent 5 years (2013-2017 for incidence and 2014-2018 for mortality). RESULTS Overall cancer incidence rates (per 100 000 population) for all ages during 2013-2017 were 487.4 among males and 422.4 among females. During this period, incidence rates remained stable among males but slightly increased in females (AAPC = 0.2%, 95% confidence interval [CI] = 0.1% to 0.2%). Overall cancer death rates (per 100 000 population) during 2014-2018 were 185.5 among males and 133.5 among females. During this period, overall death rates decreased in both males (AAPC = -2.2%, 95% CI = -2.5% to -1.9%) and females (AAPC = -1.7%, 95% CI = -2.1% to -1.4%); death rates decreased for 11 of the 19 most common cancers among males and for 14 of the 20 most common cancers among females, but increased for 5 cancers in each sex. During 2014-2018, the declines in death rates accelerated for lung cancer and melanoma, slowed down for colorectal and female breast cancers, and leveled off for prostate cancer. Among children younger than age 15 years and adolescents and young adults aged 15-39 years, cancer death rates continued to decrease in contrast to the increasing incidence rates. Two-year relative survival for distant-stage skin melanoma was stable for those diagnosed during 2001-2009 but increased by 3.1% (95% CI = 2.8% to 3.5%) per year for those diagnosed during 2009-2014, with comparable trends among males and females. CONCLUSIONS Cancer death rates in the United States continue to decline overall and for many cancer types, with the decline accelerated for lung cancer and melanoma. For several other major cancers, however, death rates continue to increase or previous declines in rates have slowed or ceased. Moreover, overall incidence rates continue to increase among females, children, and adolescents and young adults. These findings inform efforts related to prevention, early detection, and treatment and for broad and equitable implementation of effective interventions, especially among under resourced populations.
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Affiliation(s)
- Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Elizabeth M Ward
- North American Association of Central Cancer Registries, Springfield, IL, USA
| | - Hyuna Sung
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Kathleen A Cronin
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Florence K L Tangka
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Recinda L Sherman
- North American Association of Central Cancer Registries, Springfield, IL, USA
| | - Jingxuan Zhao
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Robert N Anderson
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - K Robin Yabroff
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Ahmedin Jemal
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Vicki B Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Yabroff KR, Mariotto A, Tangka F, Zhao J, Islami F, Sung H, Sherman RL, Henley SJ, Jemal A, Ward EM. Annual Report to the Nation on the Status of Cancer, Part 2: Patient Economic Burden Associated With Cancer Care. J Natl Cancer Inst 2021; 113:1670-1682. [PMID: 34698839 PMCID: PMC9891103 DOI: 10.1093/jnci/djab192] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/05/2021] [Accepted: 09/20/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The American Cancer Society, National Cancer Institute, Centers for Disease Control and Prevention, and North American Association of Central Cancer Registries provide annual information about cancer occurrence and trends in the United States. Part 1 of this annual report focuses on national cancer statistics. This study is part 2, which quantifies patient economic burden associated with cancer care. METHODS We used complementary data sources, linked Surveillance, Epidemiology, and End Results-Medicare, and the Medical Expenditure Panel Survey to develop comprehensive estimates of patient economic burden, including out-of-pocket and patient time costs, associated with cancer care. The 2000-2013 Surveillance, Epidemiology, and End Results-Medicare data were used to estimate net patient out-of-pocket costs among adults aged 65 years and older for the initial, continuing, and end-of-life phases of care for all cancer sites combined and separately for the 21 most common cancer sites. The 2008-2017 Medical Expenditure Panel Survey data were used to calculate out-of-pocket costs and time costs associated with cancer among adults aged 18-64 years and 65 years and older. RESULTS Across all cancer sites, annualized net out-of-pocket costs for medical services and prescriptions drugs covered through a pharmacy benefit among adults aged 65 years and older were highest in the initial ($2200 and $243, respectively) and end-of-life phases ($3823 and $448, respectively) and lowest in the continuing phase ($466 and $127, respectively), with substantial variation by cancer site. Out-of-pocket costs were generally higher for patients diagnosed with later-stage disease. Net annual time costs associated with cancer were $304.3 (95% confidence interval = $257.9 to $350.9) and $279.1 (95% confidence interval = $215.1 to $343.3) for adults aged 18-64 years and ≥65 years, respectively, with higher time costs among more recently diagnosed survivors. National patient economic burden, including out-of-pocket and time costs, associated with cancer care was projected to be $21.1 billion in 2019. CONCLUSIONS This comprehensive study found that the patient economic burden associated with cancer care is substantial in the United States at the national and patient levels.
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Affiliation(s)
- K Robin Yabroff
- Correspondence to: K. Robin Yabroff, PhD, Department of Surveillance and Health Equity Science, American Cancer Society, 3380 Chastain Meadows Pkwy NW, Suite 200, Kennesaw, GA 30144, USA (e-mail: )
| | - Angela Mariotto
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Florence Tangka
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jingxuan Zhao
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Farhad Islami
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Hyuna Sung
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Recinda L Sherman
- North American Association of Central Cancer Registries, Springfield, IL, USA
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Elizabeth M Ward
- North American Association of Central Cancer Registries, Springfield, IL, USA
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Siegel DA, Reses HE, Cool AJ, Shapiro CN, Hsu J, Boehmer TK, Cornwell CR, Gray EB, Henley SJ, Lochner K, Suthar AB, Lyons BC, Mattocks L, Hartnett K, Adjemian J, van Santen KL, Sheppard M, Soetebier KA, Logan P, Martin M, Idubor O, Natarajan P, Sircar K, Oyegun E, Dalton J, Perrine CG, Peacock G, Schweitzer B, Morris SB, Raizes E. Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0-17 Years - United States, August 2020-August 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1249-1254. [PMID: 34499628 PMCID: PMC8437056 DOI: 10.15585/mmwr.mm7036e1] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Although COVID-19 generally results in milder disease in children and adolescents than in adults, severe illness from COVID-19 can occur in children and adolescents and might require hospitalization and intensive care unit (ICU) support (1-3). It is not known whether the B.1.617.2 (Delta) variant,* which has been the predominant variant of SARS-CoV-2 (the virus that causes COVID-19) in the United States since late June 2021,† causes different clinical outcomes in children and adolescents compared with variants that circulated earlier. To assess trends among children and adolescents, CDC analyzed new COVID-19 cases, emergency department (ED) visits with a COVID-19 diagnosis code, and hospital admissions of patients with confirmed COVID-19 among persons aged 0-17 years during August 1, 2020-August 27, 2021. Since July 2021, after Delta had become the predominant circulating variant, the rate of new COVID-19 cases and COVID-19-related ED visits increased for persons aged 0-4, 5-11, and 12-17 years, and hospital admissions of patients with confirmed COVID-19 increased for persons aged 0-17 years. Among persons aged 0-17 years during the most recent 2-week period (August 14-27, 2021), COVID-19-related ED visits and hospital admissions in the states with the lowest vaccination coverage were 3.4 and 3.7 times that in the states with the highest vaccination coverage, respectively. At selected hospitals, the proportion of COVID-19 patients aged 0-17 years who were admitted to an ICU ranged from 10% to 25% during August 2020-June 2021 and was 20% and 18% during July and August 2021, respectively. Broad, community-wide vaccination of all eligible persons is a critical component of mitigation strategies to protect pediatric populations from SARS-CoV-2 infection and severe COVID-19 illness.
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Ellington TD, Momin B, Wilson RJ, Henley SJ, Wu M, Ryerson AB. Incidence and Mortality of Cancers of the Biliary Tract, Gallbladder, and Liver by Sex, Age, Race/Ethnicity, and Stage at Diagnosis: United States, 2013 to 2017. Cancer Epidemiol Biomarkers Prev 2021; 30:1607-1614. [PMID: 34244156 DOI: 10.1158/1055-9965.epi-21-0265] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/09/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Few population-based studies have examined incidence and mortality of cancers of the biliary tract, including intrahepatic bile duct, extrahepatic bile duct, ampulla of Vater, and overlapping or other lesions of the biliary tract in one study. METHODS To further the understanding of recent rates of biliary tract cancers, we used population-based data, to examine incidence and mortality during 2013 to 2017. We examined how rates varied by sex, age, race/ethnicity, U.S. census region, and stage at diagnosis. RESULTS Intrahepatic bile duct was the most common biliary tract cancer, with an incidence rate of 1.49 per 100,000 persons. Cancer incidence rates per 100,000 persons were 0.96 for extrahepatic bile duct, 0.45 for ampulla of Vater, and 0.24 for overlapping or other lesions of the biliary tract. Cancer death rates per 100,000 persons were 1.66 for intrahepatic bile duct and 0.45 for other biliary tract. Intrahepatic bile duct incidence and death rates were higher among males than females, higher among Hispanic and Asian and Pacific Islander persons compared with non-Hispanic Whites, and higher in the Northeast and in urban counties. CONCLUSIONS This report provides national estimates of these rare biliary tract cancers. IMPACT Key interventions targeted to high-risk populations may help reduce incidence and mortality of cancers of the biliary tract by improving primary prevention through strategies to reduce tobacco and alcohol use, control overweight and obesity, and promote hepatitis B vaccination and use of syringe service programs meant to curb the transmission of infectious diseases such as viral hepatitis.
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Affiliation(s)
- Taylor D Ellington
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee. .,Division of Cancer Prevention and Control, NCCDPHP, CDC
| | | | - Reda J Wilson
- Division of Cancer Prevention and Control, NCCDPHP, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, NCCDPHP, CDC
| | - Manxia Wu
- Division of Cancer Prevention and Control, NCCDPHP, CDC
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Christie A, Henley SJ, Mattocks L, Fernando R, Lansky A, Ahmad FB, Adjemian J, Anderson RN, Binder AM, Carey K, Dee DL, Dias T, Duck WM, Gaughan DM, Lyons BC, McNaghten AD, Park MM, Reses H, Rodgers L, Van Santen K, Walker D, Beach MJ. Decreases in COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths Among Older Adults Following the Introduction of COVID-19 Vaccine - United States, September 6, 2020-May 1, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:858-864. [PMID: 34111059 PMCID: PMC8191865 DOI: 10.15585/mmwr.mm7023e2] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lee FC, Adams L, Graves SJ, Massetti GM, Calanan RM, Penman-Aguilar A, Henley SJ, Annor FB, Van Handel M, Aleshire N, Durant T, Fuld J, Griffing S, Mattocks L, Liburd L. Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations - United States, April 1-December 22, 2020. MMWR Morb Mortal Wkly Rep 2021; 70:483-489. [PMID: 33793463 PMCID: PMC8022874 DOI: 10.15585/mmwr.mm7013e1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Affiliation(s)
- David A Siegel
- Division of Cancer Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stacey A Fedewa
- Office of Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lori A Pollack
- Division of Cancer Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ahmedin Jemal
- Office of Chief Medical and Scientific Officer, American Cancer Society, Atlanta, Georgia
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Ellington TD, Henley SJ, Wilson RJ, Wu M, Richardson LC. Trends in solitary plasmacytoma, extramedullary plasmacytoma, and plasma cell myeloma incidence and myeloma mortality by racial-ethnic group, United States 2003-2016. Cancer Med 2021; 10:386-395. [PMID: 33270992 PMCID: PMC7826456 DOI: 10.1002/cam4.3444] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 11/30/2022] Open
Abstract
Plasma cell myeloma (also called multiple myeloma), solitary plasmacytoma, and extramedullary plasmacytoma are primarily diseases of the elderly. Evidence suggests an association between excess body weight and multiple myeloma. Few population-based studies have examined incidence and mortality of each site in one study. We analyzed incidence and death rates by site (solitary plasmacytoma, extramedullary plasmacytoma, and multiple myeloma) by gender, age, race/ethnicity, and rural-urban status among adult males and females (aged 20 years or older) in the United States during 2003-2016. Trends were characterized as average annual percentage change (AAPC) in rates. During 2003-2016, overall incidence rates among adults were 0.45 for solitary plasmacytoma, 0.09 for extramedullary plasmacytoma, and 8.47 for multiple myeloma per 100,000 persons. Incidence rates for multiple myeloma increased during 2003-2016 among non-Hispanic whites (AAPC = 1.78%) and non-Hispanic blacks (2.98%) 20-49 years of age; non-Hispanic whites (1.17%) and non-Hispanic blacks (1.24%) 50-59 years of age; and whites non-Hispanic (0.91%), and non-Hispanic blacks (0.96%). During 2003-2016 overall myeloma (extramedullary plasmacytoma and multiple myeloma) death rates among adults was 4.77 per 100,00 persons. Myeloma death rates decreased during 2003-2016 among non-Hispanic white (AAPC = -1.23%) and Hispanic (-1.34%) women; and non-Hispanic white (-0.74%), non-Hispanic American Indian/Alaska Native (-3.05%) men. The US population is projected to become older and will have a larger proportion of persons who have had an earlier and longer exposure to excess body weight. The potential impact of these population changes on myeloma incidence and mortality can be monitored with high-quality cancer surveillance data.
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Affiliation(s)
- Taylor D. Ellington
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - Reda J. Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - Lisa C. Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
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Gold JAW, Rossen LM, Ahmad FB, Sutton P, Li Z, Salvatore PP, Coyle JP, DeCuir J, Baack BN, Durant TM, Dominguez KL, Henley SJ, Annor FB, Fuld J, Dee DL, Bhattarai A, Jackson BR. Race, Ethnicity, and Age Trends in Persons Who Died from COVID-19 - United States, May-August 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1517-1521. [PMID: 33090984 PMCID: PMC7583501 DOI: 10.15585/mmwr.mm6942e1] [Citation(s) in RCA: 220] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ellington TD, Henley SJ, Wilson RJ, Miller JW. Breast Cancer Survival Among Males by Race, Ethnicity, Age, Geographic Region, and Stage - United States, 2007-2016. MMWR Morb Mortal Wkly Rep 2020; 69:1481-1484. [PMID: 33056954 PMCID: PMC7561088 DOI: 10.15585/mmwr.mm6941a2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Breast cancer among males in the United States is rare; approximately 2,300 new cases and 500 associated deaths were reported in 2017, accounting for approximately 1% of all breast cancers.* Risk for male breast cancer increases with increasing age (1), and compared with women, men receive diagnoses later in life and often at a later stage of disease (1). Gradual improvement in breast cancer survival from 1976-1985 to 1996-2005 has been more evident for women than for men (1). Studies examining survival differences among female breast cancer patients observed that non-Hispanic White (White) females had a higher survival than non-Hispanic Black (Black) females (2), but because of the rarity of breast cancer among males, few studies have examined survival differences by race or other factors such as age, stage, and geographic region. CDC's National Program of Cancer Registries (NPCR)† data were used to examine relative survival of males with breast cancer diagnosed during 2007-2016 by race/ethnicity, age group, stage at diagnosis, and U.S. Census region. Among males who received a diagnosis of breast cancer during 2007-2016, 1-year relative survival was 96.1%, and 5-year relative survival was 84.7%. Among characteristics examined, relative survival varied most by stage at diagnosis: the 5-year relative survival for males was higher for cancers diagnosed at localized stage (98.7%) than for those diagnosed at distant stage (25.9%). Evaluation of 1-year and 5-year relative survival among males with breast cancer might help guide health care decisions regarding early detection of male breast cancer and establishing programs to support men at high risk for breast cancer and male breast cancer survivors.
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Affiliation(s)
- Taylor D Ellington
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jacqueline W Miller
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Melkonian SC, Henley SJ, Senkomago V, Thomas CC, Jim MA, Apostolou A, Saraiya M. Cancers Associated with Human Papillomavirus in American Indian and Alaska Native Populations - United States, 2013-2017. MMWR Morb Mortal Wkly Rep 2020; 69:1283-1287. [PMID: 32941412 PMCID: PMC7498173 DOI: 10.15585/mmwr.mm6937a2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Human papillomavirus (HPV) causes most cervical cancers and some cancers of the penis, vulva, vagina, oropharynx, and anus. Cervical precancers can be detected through screening. HPV vaccination with the 9-valent HPV vaccine (9vHPV) can prevent approximately 92% of HPV-attributable cancers (1).* Previous studies have shown lower incidence of HPV-associated cancers in non-Hispanic American Indian and Alaska Native (AI/AN) populations compared with other racial subgroups (2); however, these rates might have been underestimated as a result of racial misclassification. Previous studies have shown that cancer registry data corrected for racial misclassification resulted in more accurate cancer incidence estimates for AI/AN populations (3,4). In addition, regional variations in cancer incidence among AI/AN populations suggest that nationally aggregated data might not adequately describe cancer outcomes within these populations (5). These variations might, in part, result from geographic disparities in the use of health services, such as cancer screening or vaccination (6). CDC analyzed data for 2013-2017 from central cancer registries linked with the Indian Health Service (IHS) patient registration database to assess the incidence of HPV-associated cancers and to estimate the number of cancers caused by HPV among AI/AN populations overall and by region. During 2013-2017, an estimated 1,030 HPV-associated cancers were reported in AI/AN populations. Of these cancers, 740 (72%) were determined to be attributable to HPV types targeted by 9vHPV; the majority were cervical cancers in females and oropharyngeal cancers in males. These data can help identify regions where AI/AN populations have disproportionately high rates of HPV-associated cancers and inform targeted regional vaccination and screening programs in AI/AN communities.
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Siegel DA, Richardson LC, Henley SJ, Wilson RJ, Dowling NF, Weir HK, Tai EW, Buchanan Lunsford N. Pediatric cancer mortality and survival in the United States, 2001-2016. Cancer 2020; 126:4379-4389. [PMID: 32725630 DOI: 10.1002/cncr.33080] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 04/24/2020] [Accepted: 05/02/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although pediatric cancer mortality and survival have improved in the United States over the past 40 years, differences exist by age, race/ethnicity, cancer site, and economic status. To assess progress, this study examined recent mortality and survival data for individuals younger than 20 years. METHODS Age-adjusted death rates were calculated with the National Vital Statistics System for 2002-2016. Annual percent changes (APCs) and average annual percent changes (AAPCs) were calculated with joinpoint regression. Five-year relative survival was calculated on the basis of National Program of Cancer Registries data for 2001-2015. Death rates and survival were estimated overall and by sex, 5-year age group, race/ethnicity, cancer type, and county-based economic markers. RESULTS Death rates decreased during 2002-2016 (AAPC, -1.5), with steeper declines during 2002-2009 (APC, -2.6), and then plateaued (APC, -0.4). Leukemia and brain cancer were the most common causes of death from pediatric cancer, and brain cancer surpassed leukemia in 2011. Death rates decreased for leukemia and lymphoma but were unchanged for brain, bone, and soft-tissue cancers. From 2001-2007 to 2008-2015, survival improved from 82.0% to 85.1%. Survival was highest in both periods among females, those aged 15 to 19 years, non-Hispanic Whites, and those in counties in the top 25% by economic status. Survival improved for leukemias, lymphomas, and brain cancers but plateaued for bone and soft-tissue cancers. CONCLUSIONS Although overall death rates have decreased and survival has increased, differences persist by sex, age, race/ethnicity, cancer type, and economic status. Improvements in pediatric cancer outcomes may depend on improving therapies, access to care, and supportive and long-term care.
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Affiliation(s)
- David A Siegel
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicole F Dowling
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah K Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric W Tai
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ward EM, Sherman RL, Henley SJ, Jemal A, Siegel DA, Feuer EJ, Firth AU, Kohler BA, Scott S, Ma J, Anderson RN, Benard V, Cronin KA. Annual Report to the Nation on the Status of Cancer, Featuring Cancer in Men and Women Age 20-49 Years. J Natl Cancer Inst 2020; 111:1279-1297. [PMID: 31145458 PMCID: PMC6910179 DOI: 10.1093/jnci/djz106] [Citation(s) in RCA: 187] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/09/2019] [Accepted: 05/20/2019] [Indexed: 02/07/2023] Open
Abstract
Background The American Cancer Society, Centers for Disease Control and Prevention, National Cancer Institute, and North American Association of Central Cancer Registries provide annual updates on cancer occurrence and trends by cancer type, sex, race, ethnicity, and age in the United States. This year’s report highlights the cancer burden among men and women age 20–49 years. Methods Incidence data for the years 1999 to 2015 from the Centers for Disease Control and Prevention- and National Cancer Institute–funded population-based cancer registry programs compiled by the North American Association of Central Cancer Registries and death data for the years 1999 to 2016 from the National Vital Statistics System were used. Trends in age-standardized incidence and death rates, estimated by joinpoint, were expressed as average annual percent change. Results Overall cancer incidence rates (per 100 000) for all ages during 2011–2015 were 494.3 among male patients and 420.5 among female patients; during the same time period, incidence rates decreased 2.1% (95% confidence interval [CI] = −2.6% to −1.6%) per year in men and were stable in females. Overall cancer death rates (per 100 000) for all ages during 2012–2016 were 193.1 among male patients and 137.7 among female patients. During 2012–2016, overall cancer death rates for all ages decreased 1.8% (95% CI = −1.8% to −1.8%) per year in male patients and 1.4% (95% CI = −1.4% to −1.4%) per year in females. Important changes in trends were stabilization of thyroid cancer incidence rates in women and rapid declines in death rates for melanoma of the skin (both sexes). Among adults age 20–49 years, overall cancer incidence rates were substantially lower among men (115.3 per 100 000) than among women (203.3 per 100 000); cancers with the highest incidence rates (per 100 000) among men were colon and rectum (13.1), testis (10.7), and melanoma of the skin (9.8), and among women were breast (73.2), thyroid (28.4), and melanoma of the skin (14.1). During 2011 to 2015, the incidence of all invasive cancers combined among adults age 20–49 years decreased −0.7% (95% CI = −1.0% to −0.4%) among men and increased among women (1.3%, 95% CI = 0.7% to 1.9%). The death rate for (per 100 000) adults age 20–49 years for all cancer sites combined during 2012 to 2016 was 22.8 among men and 27.1 among women; during the same time period, death rates decreased 2.3% (95% CI = −2.4% to −2.2%) per year among men and 1.7% (95% CI = −1.8% to −1.6%) per year among women. Conclusions Among people of all ages and ages 20–49 years, favorable as well as unfavorable trends in site-specific cancer incidence were observed, whereas trends in death rates were generally favorable. Characterizing the cancer burden may inform research and cancer-control efforts.
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Affiliation(s)
| | - Recinda L Sherman
- Correspondence to: Recinda L. Sherman, PhD, MPH, CTR, North American Association of Central Cancer Registries, Inc, 2050 W. Iles, Ste A, Springfield, IL 62704-4191 (e-mail: )
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Henley SJ, Ward E, Scott S, Ma J, Anderson RN, Firth AU, Thomas CC, Islami F, Weir HK, Lewis DR, Sherman RL, Wu M, Benard VB, Richardson LC, Jemal A, Cronin K, Kohler BA. Annual report to the nation on the status of cancer, part I: National cancer statistics. Cancer 2020; 126:2225-2249. [PMID: 32162336 PMCID: PMC7299151 DOI: 10.1002/cncr.32802] [Citation(s) in RCA: 452] [Impact Index Per Article: 113.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/17/2020] [Accepted: 01/31/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate to provide annual updates on cancer occurrence and trends in the United States. METHODS Data on new cancer diagnoses during 2001 through 2016 were obtained from the Centers for Disease Control and Prevention-funded and National Cancer Institute-funded population-based cancer registry programs and compiled by the North American Association of Central Cancer Registries. Data on cancer deaths during 2001 through 2017 were obtained from the National Center for Health Statistics' National Vital Statistics System. Trends in incidence and death rates for all cancers combined and for the leading cancer types by sex, racial/ethnic group, and age were estimated by joinpoint analysis and characterized by the average annual percent change during the most recent 5 years (2012-2016 for incidence and 2013-2017 for mortality). RESULTS Overall, cancer incidence rates decreased 0.6% on average per year during 2012 through 2016, but trends differed by sex, racial/ethnic group, and cancer type. Among males, cancer incidence rates were stable overall and among non-Hispanic white males but decreased in other racial/ethnic groups; rates increased for 5 of the 17 most common cancers, were stable for 7 cancers (including prostate), and decreased for 5 cancers (including lung and bronchus [lung] and colorectal). Among females, cancer incidence rates increased during 2012 to 2016 in all racial/ethnic groups, increasing on average 0.2% per year; rates increased for 8 of the 18 most common cancers (including breast), were stable for 6 cancers (including colorectal), and decreased for 4 cancers (including lung). Overall, cancer death rates decreased 1.5% on average per year during 2013 to 2017, decreasing 1.8% per year among males and 1.4% per year among females. During 2013 to 2017, cancer death rates decreased for all cancers combined among both males and females in each racial/ethnic group, for 11 of the 19 most common cancers among males (including lung and colorectal), and for 14 of the 20 most common cancers among females (including lung, colorectal, and breast). The largest declines in death rates were observed for melanoma of the skin (decreasing 6.1% per year among males and 6.3% among females) and lung (decreasing 4.8% per year among males and 3.7% among females). Among children younger than 15 years, cancer incidence rates increased an average of 0.8% per year during 2012 to 2016, and cancer death rates decreased an average of 1.4% per year during 2013 to 2017. Among adolescents and young adults aged 15 to 39 years, cancer incidence rates increased an average of 0.9% per year during 2012 to 2016, and cancer death rates decreased an average of 1.0% per year during 2013 to 2017. CONCLUSIONS Although overall cancer death rates continue to decline, incidence rates are leveling off among males and are increasing slightly among females. These trends reflect population changes in cancer risk factors, screening test use, diagnostic practices, and treatment advances. Many cancers can be prevented or treated effectively if they are found early. Population-based cancer incidence and mortality data can be used to inform efforts to decrease the cancer burden in the United States and regularly monitor progress toward goals.
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Affiliation(s)
- S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth Ward
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Susan Scott
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jiemin Ma
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Robert N. Anderson
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | | | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Hannah K. Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Denise Riedel Lewis
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Recinda L. Sherman
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vicki B. Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C. Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Kathleen Cronin
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Betsy A. Kohler
- North American Association of Central Cancer Registries, Springfield, Illinois
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Ellington TD, Henley SJ, Senkomago V, O'Neil ME, Wilson RJ, Singh S, Thomas CC, Wu M, Richardson LC. Trends in Incidence of Cancers of the Oral Cavity and Pharynx - United States 2007-2016. MMWR Morb Mortal Wkly Rep 2020; 69:433-438. [PMID: 32298244 PMCID: PMC7755056 DOI: 10.15585/mmwr.mm6915a1] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cancers of the oral cavity and pharynx account for 3% of cancers diagnosed in the United States* each year. Cancers at these sites can differ anatomically and histologically and might have different causal factors, such as tobacco use, alcohol use, and infection with human papillomavirus (HPV) (1). Incidence of combined oral cavity and pharyngeal cancers declined during the 1980s but began to increase around 1999 (2,3). Because tobacco use has declined in the United States, accompanied by a decrease in incidence of many tobacco-related cancers, researchers have suggested that the increase in oral cavity and pharynx cancers might be attributed to anatomic sites with specific cell types in which HPV DNA is often found (4,5). U.S. Cancer Statistics† data were analyzed to examine trends in incidence of cancers of the oral cavity and pharynx by anatomic site, sex, race/ethnicity, and age group. During 2007-2016, incidence rates increased for cancers of the oral cavity and pharynx combined, base of tongue, anterior tongue, gum, tonsil, oropharynx, and other oral cavity and pharynx. Incidence rates declined for cancers of the lip, floor of mouth, soft palate and uvula, hard palate, hypopharynx, and nasopharynx, and were stable for cancers of the cheek and other mouth and salivary gland. Ongoing implementation of proven population-based strategies to prevent tobacco use initiation, promote smoking cessation, reduce excessive alcohol use, and increase HPV vaccination rates might help prevent cancers of the oral cavity and pharynx.
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Affiliation(s)
- Taylor D Ellington
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Virginia Senkomago
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Mary Elizabeth O'Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Simple Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Cheryll C Thomas
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Henley SJ, Thomas CC, Lewis DR, Ward EM, Islami F, Wu M, Weir HK, Scott S, Sherman RL, Ma J, Kohler BA, Cronin K, Jemal A, Benard VB, Richardson LC. Annual report to the nation on the status of cancer, part II: Progress toward Healthy People 2020 objectives for 4 common cancers. Cancer 2020; 126:2250-2266. [PMID: 32162329 DOI: 10.1002/cncr.32801] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/17/2020] [Accepted: 01/31/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The Centers for Disease Control and Prevention, the American Cancer Society, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate to provide annual updates on cancer occurrence and trends in the United States and to address a special topic of interest. Part I of this report focuses on national cancer statistics, and part 2 characterizes progress in achieving select Healthy People 2020 cancer objectives. METHODS For this report, the authors selected objectives-including death rates, cancer screening, and major risk factors-related to 4 common cancers (lung, colorectal, female breast, and prostate). Baseline values, recent values, and the percentage change from baseline to recent values were examined overall and by select sociodemographic characteristics. Data from national surveillance systems were obtained from the Healthy People 2020 website. RESULTS Targets for death rates were met overall and in most sociodemographic groups, but not among males, blacks, or individuals in rural areas, although these groups did experience larger decreases in rates compared with other groups. During 2007 through 2017, cancer death rates decreased 15% overall, ranging from -4% (rural) to -22% (metropolitan). Targets for breast and colorectal cancer screening were not yet met overall or in any sociodemographic groups except those with the highest educational attainment, whereas lung cancer screening was generally low (<10%). Targets were not yet met overall for cigarette smoking, recent smoking cessation, excessive alcohol use, or obesity but were met for secondhand smoke exposure and physical activity. Some sociodemographic groups did not meet targets or had less improvement than others toward reaching objectives. CONCLUSIONS Monitoring trends in cancer risk factors, screening test use, and mortality can help assess the progress made toward decreasing the cancer burden in the United States. Although many interventions to reduce cancer risk factors and promote healthy behaviors are proven to work, they may not be equitably applied or work well in every community. Implementing cancer prevention and control interventions that are sustainable, focused, and culturally appropriate may boost success in communities with the greatest need, ensuring that all Americans can access a path to long, healthy, cancer-free lives.
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Affiliation(s)
- S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C Thomas
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Denise Riedel Lewis
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Elizabeth M Ward
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah K Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan Scott
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Recinda L Sherman
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Jiemin Ma
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Betsy A Kohler
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Kathleen Cronin
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Vicki B Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Richards TB, Soman A, Thomas CC, VanFrank B, Henley SJ, Gallaway MS, Richardson LC. Screening for Lung Cancer - 10 States, 2017. MMWR Morb Mortal Wkly Rep 2020; 69:201-206. [PMID: 32106215 PMCID: PMC7367073 DOI: 10.15585/mmwr.mm6908a1] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Lung cancer is the leading cause of cancer death in the United States; 148,869 lung cancer-associated deaths occurred in 2016 (1). Mortality might be reduced by identifying lung cancer at an early stage when treatment can be more effective (2). In 2013, the U.S. Preventive Services Task Force (USPSTF) recommended annual screening for lung cancer with low-dose computed tomography (CT) for adults aged 55-80 years who have a 30 pack-year* smoking history and currently smoke or have quit within the past 15 years (2).† This was a Grade B recommendation, which required health insurance plans to cover lung cancer screening as a preventive service.§ To assess the prevalence of lung cancer screening by state, CDC used Behavioral Risk Factor Surveillance System (BRFSS) data¶ collected in 2017 by 10 states.** Overall, 12.7% adults aged 55-80 years met the USPSTF criteria for lung cancer screening. Among those meeting USPSTF criteria, 12.5% reported they had received a CT scan to check for lung cancer in the last 12 months. Efforts to educate health care providers and provide decision support tools might increase recommended lung cancer screening.
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Lipscomb J, Escoffery C, Gillespie TW, Henley SJ, Smith RA, Chociemski T, Almon L, Jiang R, Sheng X, Goodman M, Ward KC. Improving Screening Uptake among Breast Cancer Survivors and Their First-Degree Relatives at Elevated Risk to Breast Cancer: Results and Implications of a Randomized Study in the State of Georgia. Int J Environ Res Public Health 2020; 17:ijerph17030977. [PMID: 32033227 PMCID: PMC7037204 DOI: 10.3390/ijerph17030977] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/20/2020] [Accepted: 01/24/2020] [Indexed: 11/24/2022]
Abstract
Women diagnosed with breast cancer at a relatively early age (≤45 years) or with bilateral disease at any age are at elevated risk for additional breast cancer, as are their female first-degree relatives (FDRs). We report on a randomized trial to increase adherence to mammography screening guidelines among survivors and FDRs. From the Georgia Cancer Registry, breast cancer survivors diagnosed during 2000–2009 at six Georgia cancer centers underwent phone interviews about their breast cancer screening behaviors and their FDRs. Nonadherent survivors and FDRs meeting all inclusion criteria were randomized to high-intensity (evidence-based brochure, phone counseling, mailed reminders, and communications with primary care providers) or low-intensity interventions (brochure only). Three and 12-month follow-up questionnaires were completed. Data analyses used standard statistical approaches. Among 1055 survivors and 287 FDRs who were located, contacted, and agreed to participate, 59.5% and 62.7%, respectively, reported breast cancer screening in the past 12 months and were thus ineligible. For survivors enrolled at baseline (N = 95), the proportion reporting adherence to guideline screening by 12 months post-enrollment was similar in the high and low-intensity arms (66.7% vs. 79.2%, p = 0.31). Among FDRs enrolled at baseline (N = 83), screening was significantly higher in the high-intensity arm at 12 months (60.9% vs. 32.4%, p = 0.03). Overall, about 72% of study-eligible survivors (all of whom were screening nonadherent at baseline) reported screening within 12 months of study enrollment. For enrolled FDRs receiving the high-intensity intervention, over 60% reported guideline screening by 12 months. A major conclusion is that using high-quality central cancer registries to identify high-risk breast cancer survivors and then working closely with these survivors to identify their FDRs represents a feasible and effective strategy to promote guideline cancer screening.
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Affiliation(s)
- Joseph Lipscomb
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
- Winship Cancer Institute of Emory University; Atlanta, GA 30322, USA;
- Correspondence: ; Tel.: +404-727-4513; Fax: +404-727-9198
| | - Cam Escoffery
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
- Winship Cancer Institute of Emory University; Atlanta, GA 30322, USA;
| | - Theresa W. Gillespie
- Winship Cancer Institute of Emory University; Atlanta, GA 30322, USA;
- Department of Surgery and Department of Hematology and Medical Oncology, Emory University School of Medicine; Atlanta, GA 30322, USA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, U.S. Centers for Disease Control and Prevention; Atlanta, GA 30341, USA;
| | - Robert A. Smith
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
- Cancer Control Program, American Cancer Society; Atlanta, GA 30303, USA
| | - Toni Chociemski
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
| | - Lyn Almon
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
| | - Renjian Jiang
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
| | - Xi Sheng
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
| | - Michael Goodman
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
- Winship Cancer Institute of Emory University; Atlanta, GA 30322, USA;
| | - Kevin C. Ward
- Rollins School of Public Health, Emory University; Atlanta, GA 30322, USA; (C.E.); (R.A.S.); (T.C.); (L.A.); (R.J.); (X.S.); (M.G.); (K.C.W.)
- Winship Cancer Institute of Emory University; Atlanta, GA 30322, USA;
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Cummings KJ, Becich MJ, Blackley DJ, Deapen D, Harrison R, Hassan R, Henley SJ, Hesdorffer M, Horton DK, Mazurek JM, Pass HI, Taioli E, Wu XC, Zauderer MG, Weissman DN. Workshop summary: Potential usefulness and feasibility of a US National Mesothelioma Registry. Am J Ind Med 2020; 63:105-114. [PMID: 31743489 PMCID: PMC7427840 DOI: 10.1002/ajim.23062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 01/29/2023]
Abstract
The burden and prognosis of malignant mesothelioma in the United States have remained largely unchanged for decades, with approximately 3200 new cases and 2400 deaths reported annually. To address care and research gaps contributing to poor outcomes, in March of 2019 the Mesothelioma Applied Research Foundation convened a workshop on the potential usefulness and feasibility of a national mesothelioma registry. The workshop included formal presentations by subject matter experts and a moderated group discussion. Workshop participants identified top priorities for a registry to be (a) connecting patients with high-quality care and clinical trials soon after diagnosis, and (b) making useful data and biospecimens available to researchers in a timely manner. Existing databases that capture mesothelioma cases are limited by factors such as delays in reporting, deidentification, and lack of exposure information critical to understanding as yet unrecognized causes of disease. National disease registries for amyotrophic lateral sclerosis (ALS) in the United States and for mesothelioma in other countries, provide examples of how a registry could be structured to meet the needs of patients and the scientific community. Small-scale pilot initiatives should be undertaken to validate methods for rapid case identification, develop procedures to facilitate patient access to guidelines-based standard care and investigational therapies, and explore approaches to data sharing with researchers. Ultimately, federal coordination and funding will be critical to the success of a National Mesothelioma Registry in improving mesothelioma outcomes and preventing future cases of this devastating disease.
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Affiliation(s)
- Kristin J. Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Michael J. Becich
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David J. Blackley
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Dennis Deapen
- Los Angeles Cancer Surveillance Program, Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, California
| | - Raffit Hassan
- Thoracic and GI Malignancies Branch, National Cancer Institute, Bethesda, Maryland
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary Hesdorffer
- Mesothelioma Applied Research Foundation, Washington, District of Columbia
| | - D. Kevin Horton
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jacek M. Mazurek
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Harvey I. Pass
- Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, New York
| | - Emanuela Taioli
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Xiao-Cheng Wu
- Louisiana Tumor Registry, Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Marjorie G. Zauderer
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David N. Weissman
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
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Abstract
Background: Asbestos is an established cause of several cancers, including mesothelioma and ovarian cancer. Incidence of mesothelioma, the sentinel asbestos-associated cancer, varies by state, likely reflecting different levels of asbestos exposure. We hypothesized that states with high mesothelioma incidence may also have high ovarian cancer incidence. Materials and Methods: Using data from the Centers for Disease Control and Prevention National Program for Cancer Registries and the National Cancer Institute Surveillance, Epidemiology, and End Results Program, we examined the geographic co-occurrence of mesothelioma and ovarian cancer incidence rates by U.S. state for 2003-2015. Results: By state, mesothelioma incidence ranged from 0.5 to 1.3 cases per 100,000 persons and ovarian cancer incidence ranged from 9 to 12 cases per 100,000 females. When states were grouped by quartile of mesothelioma incidence, the average ovarian cancer incidence rate was 10% higher in states with the highest mesothelioma incidence than in states with the lowest mesothelioma incidence. Ovarian cancer incidence tended to be higher in states with high mesothelioma incidence (Pearson correlation r = 0.54; p < 0.0001). Conclusions: Data from state cancer registries show ovarian cancer incidence was positively correlated with mesothelioma incidence, suggesting asbestos may be a common exposure. The potential for asbestos exposure has declined since the 1970s because fewer products contain asbestos; however, some products, materials, and buildings may still release asbestos and thousands of workers may be exposed. Ensuring that people are protected from exposure to asbestos in their workplaces, homes, schools, and communities may reduce the risk of several cancers.
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Affiliation(s)
- S. Jane Henley
- Division of Cancer Prevention and Control, National Center
for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, GA
| | - Lucy A. Peipins
- Division of Cancer Prevention and Control, National Center
for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, GA
| | - Sun Hee Rim
- Division of Cancer Prevention and Control, National Center
for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, GA
| | - Theodore C. Larson
- Division of Toxicology and Human Health Sciences, Agency
for Toxic Substances and Disease Registry, Atlanta, GA
| | - Jacqueline W. Miller
- Division of Cancer Prevention and Control, National Center
for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, GA
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Henley SJ, Jemal A. Rural Cancer Control: Bridging the Chasm in Geographic Health Inequity. Cancer Epidemiol Biomarkers Prev 2019; 27:1248-1251. [PMID: 30385497 DOI: 10.1158/1055-9965.epi-18-0807] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 01/25/2023] Open
Affiliation(s)
- S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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O'Neil ME, Henley SJ, Rohan EA, Ellington TD, Gallaway MS. Lung Cancer Incidence in Nonmetropolitan and Metropolitan Counties - United States, 2007-2016. MMWR Morb Mortal Wkly Rep 2019; 68:993-998. [PMID: 31697655 PMCID: PMC6837473 DOI: 10.15585/mmwr.mm6844a1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Lung and bronchus (lung) cancer is the leading cause of cancer death in the United States (1). In 2016, 148,869 lung cancer deaths were reported.* Most lung cancers can be attributed to modifiable exposures, such as tobacco use, secondhand smoke, radon, and asbestos (1). Exposure to lung cancer risk factors vary over time and by characteristics such as sex, age, and nonmetropolitan or metropolitan residence that might affect lung cancer rates (1,2). A recent report found that lung cancer incidence rates were higher and decreased more slowly in nonmetropolitan counties than in metropolitan counties (3). To examine whether lung cancer incidence trends among nonmetropolitan and metropolitan counties differed by age and sex, CDC analyzed data from U.S. Cancer Statistics during 2007-2016, the most recent years for which data are available. During the 10-year study period, lung cancer incidence rates were stable among females aged <35, 45-64, and ≥75 years in nonmetropolitan counties, were stable among females aged <35 years in metropolitan counties, and decreased in all other groups. Overall, among males, lung cancer incidence rates decreased from 99 to 82 per 100,000 in nonmetropolitan areas and from 83 to 63 in metropolitan areas; among females, lung cancer incidence rates decreased from 61 to 58 in nonmetropolitan areas and from 57 to 50 in metropolitan areas. A comprehensive approach to lung cancer prevention and control includes such population-based strategies as screening for tobacco dependence, promoting tobacco cessation, implementing comprehensive smoke-free laws, testing all homes for radon and using proven methods to lower high radon levels, and reducing exposure to lung carcinogens such as asbestos (1). Increasing the implementation of these strategies, particularly among persons living in nonmetropolitan counties, might help to reduce disparities in the decline of lung cancer incidence.
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Affiliation(s)
- Mary Elizabeth O'Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Elizabeth A Rohan
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Taylor D Ellington
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - M Shayne Gallaway
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Senkomago V, Henley SJ, Thomas CC, Mix JM, Markowitz LE, Saraiya M. Human Papillomavirus-Attributable Cancers - United States, 2012-2016. MMWR Morb Mortal Wkly Rep 2019; 68:724-728. [PMID: 31437140 PMCID: PMC6705893 DOI: 10.15585/mmwr.mm6833a3] [Citation(s) in RCA: 242] [Impact Index Per Article: 48.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Krebs P, Rogers E, Greenspan A, Goldfeld K, Lei L, Ostroff JS, Garrett BE, Momin B, Henley SJ. Utility of Using Cancer Registry Data to Identify Patients for Tobacco Treatment Trials. J Registry Manag 2019; 46:30-36. [PMID: 32010425 PMCID: PMC6993933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Many tobacco dependent cancer survivors continue to smoke after diagnosis and treatment. This study investigated the extent to which hospital-based cancer registries could be used to identify smokers in order to offer them assistance in quitting. The concordance of tobacco use coded in the registry was compared with tobacco use as coded in the accompanying Electronic Health Records (EHRs). METHODS We gathered data from three hospital-based cancer registries in New York City during June 2014 to December 2016. For each patient identified as a current combustible tobacco user in the cancer registries, we abstracted tobacco use data from their EHR to independently code and corroborate smoking status. We calculated the proportion of current smokers, former smokers, and never smokers as indicated in the EHR for the hospitals, cancer site, cancer stage, and sex. We used a logistic regression model to estimate the log odds of the registry-based smoking status correctly predicting the EHR-based smoking status. RESULTS Agreement in current smoking status between the registry-based smoking status and the EHR-based smoking status was 65%, 71%, and 90% at the three participating hospitals. Logistic regression results indicated that agreement in smoking status between the registry and the EHRs varied by hospital, cancer type, and stage, but not by age and sex. CONCLUSIONS The utility of using tobacco use data in cancer registries for population-based tobacco treatment interventions is dependent on multiple factors including accurate entry into EHR systems, updated data, and consistent smoking status definitions and registry coding protocols. Our study found that accuracy varied across the three hospitals and may not be able to inform interventions at these hospitals at this time. Several changes may be needed to improve the coding of tobacco use status in EHRs and registries.
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Affiliation(s)
| | | | | | | | - Lei Lei
- NYU School of Medicine, New York, NY
| | | | - Bridgette E Garrett
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Behnoosh Momin
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Henley SJ, Miller JW, Dowling NF, Benard VB, Richardson LC. Uterine Cancer Incidence and Mortality - United States, 1999-2016. MMWR Morb Mortal Wkly Rep 2018; 67:1333-1338. [PMID: 30521505 PMCID: PMC6329484 DOI: 10.15585/mmwr.mm6748a1] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Uterine cancer is one of the few cancers with increasing incidence and mortality in the United States, reflecting, in part, increases in the prevalence of overweight and obesity since the 1980s (1). It is the fourth most common cancer diagnosed and the seventh most common cause of cancer death among U.S. women (1). To assess recent trends in uterine cancer incidence and mortality by race and ethnicity, CDC analyzed incidence data from CDC's National Program of Cancer Registries (NPCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and mortality data from the National Vital Statistics System (2). Most recent data available are through 2015 for incidence and through 2016 for mortality. Uterine cancer incidence rates increased 0.7% per year during 1999-2015, and death rates increased 1.1% per year during 1999-2016, with smaller increases observed among non-Hispanic white (white) women than among women in other racial/ethnic groups. In 2015, a total of 53,911 new uterine cancer cases, corresponding to 27 cases per 100,000 women, were reported in the United States, and 10,733 uterine cancer deaths (five deaths per 100,000 women) were reported in 2016. Uterine cancer incidence was higher among non-Hispanic black (black) and white women (27 cases per 100,000) than among other racial/ethnic groups (19-23 per 100,000). Uterine cancer deaths among black women (nine per 100,000) were higher than those among other racial/ethnic groups (four to five per 100,000). Public health efforts to help women achieve and maintain a healthy weight and obtain sufficient physical activity can reduce the risk for developing cancer of the endometrium (the lining of the uterus), the most common uterine cancer. Abnormal vaginal bleeding, including bleeding between periods or after sex or any unexpected bleeding after menopause, is an important symptom of uterine cancer (3). Through programs such as CDC's Inside Knowledge* campaign, promoting awareness among women and health care providers of the need for timely evaluation of abnormal vaginal bleeding can increase the chance that uterine cancer is detected early and treated appropriately.
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Affiliation(s)
- S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jacqueline W Miller
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Nicole F Dowling
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Vicki B Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Fantanas D, Brunton A, Henley SJ, Dorey RA. Investigation of the mechanism for current induced network failure for spray deposited silver nanowires. Nanotechnology 2018; 29:465705. [PMID: 30179165 DOI: 10.1088/1361-6528/aadeda] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Silver nanowires are one of the prominent candidates for the replacement of the incumbent indium tin oxide in thin and flexible electronics applications. Their main drawback is their inferior electrical robustness. Here, the mechanism of the short duration direct current induced failure in large networks is investigated by current stress tests and by examining the morphology of failures. It is found that the failures are due to the heating of the film and they initiate at the nanowire junctions, indicating that the main failure mechanism is based on the Joule heating of the junctions. This failure mechanism is different than what has been seen in literature for single nanowires and sparse networks. In addition, finite element heating simulations are performed to support the findings. Finally, we suggest ways of improving these films, in order to make them more suitable for device applications.
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Affiliation(s)
- D Fantanas
- EPSRC CDT in MiNMaT, University of Surrey, Guildford GU2 7XH, United Kingdom. M-Solv Ltd, Oxonian Park, Kidlington OX5 1FP, United Kingdom
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Gallaway MS, Henley SJ, Steele CB, Momin B, Thomas CC, Jamal A, Trivers KF, Singh SD, Stewart SL. Surveillance for Cancers Associated with Tobacco Use - United States, 2010-2014. MMWR Surveill Summ 2018; 67:1-42. [PMID: 30383737 PMCID: PMC6220819 DOI: 10.15585/mmwr.ss6712a1] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PROBLEM/CONDITION Tobacco use is the leading preventable cause of cancer, contributing to at least 12 types of cancer, including acute myeloid leukemia (AML) and cancers of the oral cavity and pharynx; esophagus; stomach; colon and rectum; liver; pancreas; larynx; lung, bronchus, and trachea; kidney and renal pelvis; urinary bladder; and cervix. This report provides a comprehensive assessment of recent tobacco-associated cancer incidence for each cancer type by sex, age, race/ethnicity, metropolitan county classification, tumor characteristics, U.S. census region, and state. These data are important for initiation, monitoring, and evaluation of tobacco prevention and control measures. PERIOD COVERED 2010-2014. DESCRIPTION OF SYSTEM Cancer incidence data from CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results program were used to calculate average annual age-adjusted incidence rates for 2010-2014 and trends in annual age-adjusted incidence rates for 2010-2014. These cancer incidence data cover approximately 99% of the U.S. POPULATION This report provides age-adjusted cancer incidence rates for each of the 12 cancer types known to be causally associated with tobacco use, including liver and colorectal cancer, which were deemed to be causally associated with tobacco use by the U.S. Surgeon General in 2014. Findings are reported by demographic and geographic characteristics, percentage distributions for tumor characteristics, and trends in cancer incidence by sex. RESULTS During 2010-2014, approximately 3.3 million new tobacco-associated cancer cases were reported in the United States, approximately 667,000 per year. Age-adjusted incidence rates ranged from 4.2 AML cases per 100,000 persons to 61.3 lung cancer cases per 100,000 persons. By cancer type, incidence rates were higher among men than women (excluding cervical cancer), higher among non-Hispanics than Hispanics (for all cancers except stomach, liver, kidney, and cervical), higher among persons in nonmetropolitan counties than those in metropolitan counties (for all cancers except stomach, liver, pancreatic, and AML), and lower in the West than in other U.S. census regions (all except stomach, liver, bladder, and AML). Compared with other racial/ethnic groups, certain cancer rates were highest among whites (oral cavity and pharyngeal, esophageal, bladder, and AML), blacks (colon and rectal, pancreatic, laryngeal, lung and bronchial, cervical, and kidney), and Asians/Pacific Islanders (stomach and liver). During 2010-2014, the rate of all tobacco-associated cancers combined decreased 1.2% per year, influenced largely by decreases in cancers of the larynx (3.0%), lung (2.2%), colon and rectum (2.1%), and bladder (1.3%). INTERPRETATION Although tobacco-associated cancer incidence decreased overall during 2010-2014, the incidence remains high in several states and subgroups, including among men, whites, blacks, non-Hispanics, and persons in nonmetropolitan counties. These disproportionately high rates of tobacco-related cancer incidence reflect overall demographic patterns of cancer incidence in the United States and also reflect patterns of tobacco use. PUBLIC HEALTH ACTION Tobacco-associated cancer incidence can be reduced through prevention and control of tobacco use and comprehensive cancer-control efforts focused on reducing cancer risk, detecting cancer early, and better assisting communities disproportionately affected by cancer. Ongoing surveillance to monitor cancer incidence can identify populations with a high incidence of tobacco-associated cancers and evaluate the effectiveness of tobacco control programs and policies. Implementation research can be conducted to achieve wider adoption of existing evidence-based cancer prevention and screening programs and tobacco control measures, especially to reach groups with the largest disparities in cancer rates.
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Affiliation(s)
- M. Shayne Gallaway
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
- Commissioned Corps, U.S. Public Health Service, Rockville, Maryland
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - C. Brooke Steele
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Behnoosh Momin
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Ahmed Jamal
- Office on Smoking and Health, National Center for Chronic Disease and Prevention and Health Promotion, CDC
| | - Katrina F. Trivers
- Office on Smoking and Health, National Center for Chronic Disease and Prevention and Health Promotion, CDC
| | - Simple D. Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Sherri L. Stewart
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Abstract
November marks Lung Cancer Awareness Month, and reminds us that lung cancer is the leading cause of cancer death among women in the United States. In this brief report, we highlight CDC resources that can be used to examine the most recent data on lung cancer incidence, survival, prevalence, and mortality among women. Using the U.S. Cancer Statistics Data Visualizations tool, we report that in 2015, 104,992 new cases of lung cancer and 70,073 lung cancer deaths were reported among women in the United States. The 5-year relative survival among females diagnosed with lung cancer was 22%, and as of 2015, ∼185,759 women were living with a lung cancer diagnosis. We also describe ways CDC works to collect and disseminate quality cancer surveillance data, prevent initiation of tobacco use, promote cessation, eliminate exposure to secondhand smoke, identify and eliminate disparities, promote lung cancer screening, and help cancer survivors live longer by improving health outcomes.
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Affiliation(s)
- S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Shayne Gallaway
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Mary Elizabeth O'Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Behnoosh Momin
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Thomas B Richards
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
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Van Dyne EA, Henley SJ, Saraiya M, Thomas CC, Markowitz LE, Benard VB. Trends in Human Papillomavirus-Associated Cancers - United States, 1999-2015. MMWR Morb Mortal Wkly Rep 2018; 67:918-924. [PMID: 30138307 PMCID: PMC6107321 DOI: 10.15585/mmwr.mm6733a2] [Citation(s) in RCA: 309] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Human papillomavirus (HPV) is a known cause of cervical cancer, as well as some oropharyngeal, vulvar, vaginal, penile, and anal cancers. To assess trends, characterized by average annual percent change (AAPC), in HPV-associated cancer incidence during 1999–2015, CDC analyzed data from cancer registries covering 97.8% of the U.S. population. A total of 30,115 new cases of HPV-associated cancers were reported in 1999 and 43,371 in 2015. During 1999–2015, cervical cancer rates decreased 1.6% per year; vaginal squamous cell carcinoma (SCC) rates decreased 0.6% per year; oropharyngeal SCC rates increased among both men (2.7%) and women (0.8%); anal SCC rates also increased among both men (2.1%) and women (2.9%); vulvar SCC rates increased (1.3%); and penile SCC rates remained stable. In 2015 oropharyngeal SCC (15,479 cases among men and 3,438 among women) was the most common HPV-associated cancer. Continued surveillance through high-quality cancer registries is important to monitor cancer incidence and trends in these potentially preventable cancers.
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Negoita S, Feuer EJ, Mariotto A, Cronin KA, Petkov VI, Hussey SK, Benard V, Henley SJ, Anderson RN, Fedewa S, Sherman RL, Kohler BA, Dearmon BJ, Lake AJ, Ma J, Richardson LC, Jemal A, Penberthy L. Annual Report to the Nation on the Status of Cancer, part II: Recent changes in prostate cancer trends and disease characteristics. Cancer 2018; 124:2801-2814. [PMID: 29786851 PMCID: PMC6005761 DOI: 10.1002/cncr.31549] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/16/2018] [Accepted: 04/24/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Temporal trends in prostate cancer incidence and death rates have been attributed to changing patterns of screening and improved treatment (mortality only), among other factors. This study evaluated contemporary national-level trends and their relations with prostate-specific antigen (PSA) testing prevalence and explored trends in incidence according to disease characteristics with stage-specific, delay-adjusted rates. METHODS Joinpoint regression was used to examine changes in delay-adjusted prostate cancer incidence rates from population-based US cancer registries from 2000 to 2014 by age categories, race, and disease characteristics, including stage, PSA, Gleason score, and clinical extension. In addition, the analysis included trends for prostate cancer mortality between 1975 and 2015 by race and the estimation of PSA testing prevalence between 1987 and 2005. The annual percent change was calculated for periods defined by significant trend change points. RESULTS For all age groups, overall prostate cancer incidence rates declined approximately 6.5% per year from 2007. However, the incidence of distant-stage disease increased from 2010 to 2014. The incidence of disease according to higher PSA levels or Gleason scores at diagnosis did not increase. After years of significant decline (from 1993 to 2013), the overall prostate cancer mortality trend stabilized from 2013 to 2015. CONCLUSIONS After a decline in PSA test usage, there has been an increased burden of late-stage disease, and the decline in prostate cancer mortality has leveled off. Cancer 2018;124:2801-2814. © 2018 American Cancer Society.
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Affiliation(s)
- Serban Negoita
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMaryland
| | - Eric J. Feuer
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMaryland
| | - Angela Mariotto
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMaryland
| | - Kathleen A. Cronin
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMaryland
| | - Valentina I. Petkov
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMaryland
| | - Sarah K. Hussey
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMaryland
| | - Vicki Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGeorgia
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGeorgia
| | - Robert N. Anderson
- National Center for Health Statistics, Centers for Disease Control and PreventionHyattsvilleMaryland
| | - Stacey Fedewa
- Surveillance and Health Services Research, American Cancer SocietyAtlantaGeorgia
| | - Recinda L. Sherman
- North American Association of Central Cancer RegistriesSpringfieldIllinois
| | - Betsy A. Kohler
- North American Association of Central Cancer RegistriesSpringfieldIllinois
| | | | | | - Jiemin Ma
- Surveillance and Health Services Research, American Cancer SocietyAtlantaGeorgia
| | - Lisa C. Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGeorgia
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer SocietyAtlantaGeorgia
| | - Lynne Penberthy
- Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaMaryland
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Siegel DA, Li J, Henley SJ, Wilson RJ, Lunsford NB, Tai E, Van Dyne EA. Geographic Variation in Pediatric Cancer Incidence - United States, 2003-2014. MMWR Morb Mortal Wkly Rep 2018; 67:707-713. [PMID: 29953430 PMCID: PMC6023185 DOI: 10.15585/mmwr.mm6725a2] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Cronin KA, Lake AJ, Scott S, Sherman RL, Noone AM, Howlader N, Henley SJ, Anderson RN, Firth AU, Ma J, Kohler BA, Jemal A. Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics. Cancer 2018; 124:2785-2800. [PMID: 29786848 PMCID: PMC6033186 DOI: 10.1002/cncr.31551] [Citation(s) in RCA: 756] [Impact Index Per Article: 126.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND 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) collaborate to provide annual updates on cancer occurrence and trends in the United States. METHODS Incidence data were obtained from the CDC-funded and NCI-funded population-based cancer registry programs and compiled by NAACCR. Data on cancer deaths were obtained from the National Center for Health Statistics National Vital Statistics System. Trends in age-standardized incidence and death rates for all cancers combined and for the leading cancer types by sex, race, and ethnicity were estimated by joinpoint analysis and expressed as the annual percent change. Stage distribution and 5-year survival by stage at diagnosis were calculated for breast cancer, colon and rectum (colorectal) cancer, lung and bronchus cancer, and melanoma of the skin. RESULTS Overall cancer incidence rates from 2008 to 2014 decreased by 2.2% per year among men but were stable among women. Overall cancer death rates from 1999 to 2015 decreased by 1.8% per year among men and by 1.4% per year among women. Among men, incidence rates during the most recent 5-year period (2010-2014) decreased for 7 of the 17 most common cancer types, and death rates (2011-2015) decreased for 11 of the 18 most common types. Among women, incidence rates declined for 7 of the 18 most common cancers, and death rates declined for 14 of the 20 most common cancers. Death rates decreased for cancer sites, including lung and bronchus (men and women), colorectal (men and women), female breast, and prostate. Death rates increased for cancers of the liver (men and women); pancreas (men and women); brain and other nervous system (men and women); oral cavity and pharynx (men only); soft tissue, including heart (men only); nonmelanoma skin (men only); and uterus. Incidence and death rates were higher among men than among women for all racial and ethnic groups. For all cancer sites combined, black men and white women had the highest incidence rates compared with other racial groups, and black men and black women had the highest death rates compared with other racial groups. Non-Hispanic men and women had higher incidence and mortality rates than those of Hispanic ethnicity. Five-year survival for cases diagnosed from 2007 through 2013 ranged from 100% (stage I) to 26.5% (stage IV) for female breast cancer, from 88.1% (stage I) to 12.6% (stage IV) for colorectal cancer, from 55.1% (stage I) to 4.2% (stage IV) for lung and bronchus cancer, and from 99.5% (stage I) to 16% (stage IV) for melanoma of the skin. Among children, overall cancer incidence rates increased by 0.8% per year from 2010 to 2014, and overall cancer death rates decreased by 1.5% per year from 2011 to 2015. CONCLUSIONS For all cancer sites combined, cancer incidence rates decreased among men but were stable among women. Overall, there continue to be significant declines in cancer death rates among both men and women. Differences in rates and trends by race and ethnic group remain. Progress in reducing cancer mortality has not occurred for all sites. Examining stage distribution and 5-year survival by stage highlights the potential benefits associated with early detection and treatment. Cancer 2018;124:2785-2800. © 2018 American Cancer Society.
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Affiliation(s)
- Kathleen A Cronin
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Andrew J Lake
- Information Management Services, Inc., Rockville, Maryland
| | - Susan Scott
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Recinda L Sherman
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Anne-Michelle Noone
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Nadia Howlader
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert N Anderson
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Albert U Firth
- Information Management Services, Inc., Rockville, Maryland
| | - Jiemin Ma
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Betsy A Kohler
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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Gadzinski A, Henley SJ, Odisho A, Porten S, Carroll P, Cooperberg M. MP44-12 RURAL DIFFERENCES IN STAGE AT DIAGNOSIS FOR UROLOGICAL MALIGNANCIES. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tai EW, Guy GP, Steele CB, Henley SJ, Gallaway MS, Richardson LC. Cost of Tobacco-related Cancer Hospitalizations in the U.S., 2014. Am J Prev Med 2018; 54:591-595. [PMID: 29397279 PMCID: PMC6080196 DOI: 10.1016/j.amepre.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 11/22/2017] [Accepted: 12/06/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Smoking has been causally linked to 12 tobacco-related cancers: oral cavity and pharynx, esophagus, stomach, colon and rectum, liver, pancreas, larynx, lung, cervix, bladder, kidney, and acute myeloid leukemia. Tobacco-related cancers-related morbidity and mortality have been well described, but little is known about the prevalence of tobacco-related cancer hospitalizations and associated costs. This study estimates the annual number of tobacco-related cancer hospitalizations and their associated direct medical costs in the U.S. METHODS This study examined data from the 2014 National Inpatient Sample, the largest publicly available all-payer inpatient care database in the U.S. The authors calculated number of hospitalizations, total costs, length of stay, and cost per stay for tobacco-related cancer hospitalizations and cancer hospitalizations not related to tobacco. RESULTS In 2014, there were an estimated 461,295 annual tobacco-related cancer hospitalizations at a cost of $8.2 billion in the U.S. Tobacco-related cancers accounted for 45% of total cancer hospitalizations and cancer hospitalization costs. Compared with cancer hospitalizations not related to tobacco, tobacco-related cancer hospitalizations had a longer mean length of stay (6.8 vs 5.7 days). CONCLUSIONS The burden of tobacco-related cancer hospitalizations is substantial in the U.S. These findings highlight the importance of tobacco prevention and cessation efforts to decrease the burden of tobacco-related cancers in the U.S.
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Affiliation(s)
- Eric W Tai
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Gery P Guy
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - C Brooke Steele
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael S Gallaway
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Siegel DA, Henley SJ, Wike JM, Ryerson AB, Johnson CJ, Rees JR, Pollack LA. Capture of tobacco use among population-based registries: Findings from 10 National Program of Cancer Registries states. Cancer 2018; 124:2381-2389. [PMID: 29579317 DOI: 10.1002/cncr.31326] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/23/2018] [Accepted: 02/10/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Tobacco use data are important when the epidemiology and prognosis of tobacco-associated cancers are being defined. Central cancer registries in 10 National Program of Cancer Registries states pilot-tested the collection of standardized tobacco use variables. This study evaluated the capture of tobacco use data and examined smoking prevalence among cancer patients. METHODS Participating registries collected data about the use of tobacco-cigarettes, other smoked tobacco, and smokeless tobacco-for cases diagnosed during 2011-2013. The percentage of cases with known tobacco variable values was calculated, and the prevalence of tobacco use was analyzed by the primary cancer site and state. RESULTS Among 1,646,505 incident cancer cases, 51% had known cigarette use data: 18% were current users, 31% were former users, and 51% reported never using. The percentage of cases with a known status for both other smoked tobacco and smokeless tobacco was 43%, with 97% and 98% coded as never users, respectively. The percent known for cigarette use ranged from 27% to 81% by state and improved from 47% in 2011 to 59% in 2013 for all 10 states combined. The percent known for cigarette use and the prevalence of ever smoking cigarettes were highest for laryngeal cancer and tracheal, lung, and bronchus cancer. CONCLUSIONS Cancer registrars ascertained cigarette use for slightly more than half of all new cancer cases, but other tobacco-related fields were less complete. Studies to evaluate the validity of specific tobacco-related variables and the ability of cancer registries to capture this information from the medical record are needed to gauge the usefulness of collecting these variables through cancer surveillance systems. Cancer 2018;124:2381-9. © 2018 American Cancer Society.
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Affiliation(s)
- David A Siegel
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.,Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer M Wike
- DB Consulting Group, Inc, CDC-NPCR Contractor, Atlanta, Georgia
| | - A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Judy R Rees
- New Hampshire State Cancer Registry, Lebanon, New Hampshire.,Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Lori A Pollack
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Berkowitz Z, Zhang X, Richards TB, Peipins L, Henley SJ, Holt J. Multilevel Small-Area Estimation of Multiple Cigarette Smoking Status Categories Using the 2012 Behavioral Risk Factor Surveillance System. Cancer Epidemiol Biomarkers Prev 2018; 25:1402-1410. [PMID: 27697795 DOI: 10.1158/1055-9965.epi-16-0244] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/17/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Smoking is the leading preventable cause of death; however, small-area estimates for detailed smoking status are limited. We developed multilevel small-area estimate mixed models to generate county-level estimates for six smoking status categories: current, some days, every day, former, ever, and never. METHOD Using 2012 Behavioral Risk Factor Surveillance System (BRFSS) data (our sample size = 405,233 persons), we constructed and fitted a series of multilevel logistic regression models and applied them to the U.S. Census population to generate county-level prevalence estimates. We mapped the estimates by sex and aggregated them into state and national estimates. We conducted comparisons for internal consistency with BRFSS states' estimates using Pearson correlation coefficients, and external validation with the 2012 National Health Interview Survey current smoking prevalence. RESULTS Correlation coefficients ranged from 0.908 to 0.982, indicating high internal consistency. External validation indicated complete agreement (prevalence = 18.06%). We found large variations in current and former smoking status between and within states and by sex. County prevalence of former smokers was highest among men in the Northeast, North, and West. Utah consistently had the lowest smoking prevalence. CONCLUSIONS Our models, which include demographic and geographic characteristics, provide reliable estimates that can be applied to multiple category outcomes and any demographic group. County and state estimates may help understand the variation in smoking prevalence in the United States and provide information for control and prevention. IMPACT Detailed county and state smoking category estimates can help identify areas in need of tobacco control and prevention and potentially allow planning for health care. Cancer Epidemiol Biomarkers Prev; 25(10); 1402-10. ©2016 AACR.
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Affiliation(s)
- Zahava Berkowitz
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Chamblee, Georgia.
| | - Xingyou Zhang
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Chamblee, Georgia
| | - Thomas B Richards
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Chamblee, Georgia
| | - Lucy Peipins
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Chamblee, Georgia
| | - S Jane Henley
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Chamblee, Georgia
| | - James Holt
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Chamblee, Georgia
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Richards TB, Henley SJ, Puckett MC, Weir HK, Huang B, Tucker TC, Allemani C. Lung cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:5079-5099. [PMID: 29205305 DOI: 10.1002/cncr.31029] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Results from the second CONCORD study (CONCORD-2) indicated that 5-year net survival for lung cancer was low (range, 10%-20%) between 1995 and 2009 in most countries, including the United States, which was at the higher end of this range. METHODS Data from CONCORD-2 were used to analyze net survival among patients with lung cancer (aged 15-99 years) who were diagnosed in 37 states covering 80% of the US population. Survival was corrected for background mortality using state-specific and race-specific life tables and age-standardized using International Cancer Survival Standard weights. Net survival was estimated for patients diagnosed between 2001 and 2003 and between 2004 and 2009 at 1, 3, and 5 years after diagnosis by race (all races, black, and white); Surveillance, Epidemiology, and End Results Summary Stage 2000; and US state. RESULTS Five-year net survival increased from 16.4% (95% confidence interval, 16.3%-16.5%) for patients diagnosed 2001-2003 to 19.0% (18.8%-19.1%) for those diagnosed 2004-2009, with increases in most states and among both blacks and whites. Between 2004 and 2009, 5-year survival was lower among blacks (14.9%) than among whites (19.4%) and ranged by state from 14.5% to 25.2%. CONCLUSIONS Lung cancer survival improved slightly between the periods 2001-2003 and 2004-2009 but was still low, with variation between states, and persistently lower survival among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment should reduce the differences in survival by race and state. Cancer 2017;123:5079-99. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Thomas B Richards
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary C Puckett
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah K Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bin Huang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Thomas C Tucker
- Markey Cancer Center, Kentucky Cancer Registry, and College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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