Numerous states have achieved Healthy People 2020 goals for colorectal and cervical cancer incidence, and the proportion of persons with cancer who survive at least 5 years after diagnosis has reached 65%, but racial disparities in survival persist, according to a Centers for Disease Control and Prevention report.
An analysis of data from the U.S. Cancer Statistics for 2011 – the most recent data available – showed that a total of 1,532,066 invasive cancers were reported to cancer registries in the United States that year (annual incidence rate, 451 per 100,000 persons). Invasive cancers were considered all cancers except in situ cancers (excluding situ cancers in the urinary bladder) and basal and squamous cell cancers.
Incidence rates were higher for men than for women (508 vs. 410 per 100,000), and were highest among blacks (458 per 100,000). The 5-year survival rate, calculated for cases diagnosed between 2003 and 2010, was similar among men and women at 65%, but lower among blacks (60%) for every cancer site, S. Jane Henley of the National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta and her colleagues reported in the March 13 issue of the Morbidity and Mortality Weekly Report.
Survival was highest among those diagnosed before age 45 years (81%) and decreased with increasing age.
The most common cancer reported was prostate cancer (128 per 100,000 men), followed by female breast cancer (122 per 100,000 women), lung and bronchus cancer (61 per 100,000 persons), and colon and rectum cancer (40 per 100,000 persons). Together these cancers accounted for half of those diagnosed in 2011, and 5-year relative survival in patients diagnosed with these cancers was highest for prostate cancer (97%) and breast cancer (88%), the investigators said (MMWR 2015;63:237-42).
Survival was intermediate for colorectal cancer (63%) and lowest for lung cancer (18%).
The cervical cancer incidence rate was 7.5 per 100,000 the authors noted.
A geographic breakdown shows that incidence ranged from 374 per 100,000 persons in New Mexico to 509 per 100,000 persons in Washington, D.C.
“Healthy People 2020 targets were reached in 37 states for incidence of colorectal cancer and in 28 states for incidence of cervical cancer,” they wrote, noting that this report is the first to include incidence rates in Puerto Rico; those rates were lower for all cancer sites, compared with the states and the District of Columbia (339 per 100,000 persons) – a finding that reflects screening practices and risk factors that may differ from in the states.
The inclusion of survival data is also a first and provides a basis for tracking progress.
“Cancer incidence and survival data can guide the planning and evaluation of cancer prevention and control programs,” the authors said, adding that such data can also assist in long-term planning for cancer diagnostic and treatment services, and help public health officials set priorities for allocating health resources.
Though limited by potential systematic misclassification of race and ethnicity, by the possibility that cancer reporting was delayed thus leading to underestimation of certain cancers, and by the fact that relative survival rates were calculated only for white and black racial groups due to lack of accurate life tables for other racial/ethnic groups, the findings are nonetheless important for helping public health officials to monitor cancer incidence, mortality, and survival and to identify populations that might benefit most from targeted prevention and control efforts, they said.
The findings can also help guide the planning of health care allocation and support services and track progress toward Healthy People 2020 goals, they added.
Dr. Lisa Richardson, the director of the CDC’s Division of Cancer Prevention and Control further stressed the value of monitoring cancer incidence and survival rates in a statement.
“These data are an important reminder that a key to surviving with cancer is making sure everyone has access to care from early diagnosis to treatment. We know, for example, that early detection of colorectal cancer has had the largest impact on long-term survival rates,” she said.