Hannah Weir | Mississippi State University (original) (raw)

Papers by Hannah Weir

The Lancet Child & Adolescent Health

BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3,... more BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. FINDINGS 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. INTERPRETATION This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. FUNDING Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.

Journal of registry management, 2020

Introduction The number of cancer cases in the United States continues to grow as the number of o... more Introduction The number of cancer cases in the United States continues to grow as the number of older adults increases. Accurate, reliable and detailed incidence data are needed to respond effectively to the growing human costs of cancer in an aging population. The purpose of this study was to examine the characteristics of incident cases and evaluate the impact of death-certificate-only (DCO) cases on cancer incidence rates in older adults. Methods Using data from 47 cancer registries and detailed population estimates from the Surveillance, Epidemiology and End Results (SEER) Program, we examined reporting sources, methods of diagnosis, tumor characteristics, and calculated age-specific incidence rates with and without DCO cases in adults aged 65 through ≥95 years, diagnosed 2011 through 2015, by sex and race/ethnicity. Results The percentage of cases (all cancers combined) reported from a hospital decreased from 90.6% (ages 65-69 years) to 69.1% (ages ≥95 years) while the percenta...

MMWR. Surveillance Summaries, 2018

Problem/Condition: Tobacco use is the leading preventable cause of cancer, contributing to at lea... more 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.

Background: Misclassification of American Indians/Alaska Natives (AI/AN) as non-AI/AN has been de... more Background: Misclassification of American Indians/Alaska Natives (AI/AN) as non-AI/AN has been described in mortality and cancer incidence data resulting in the underestimation of disease burden in this population. Linkages of data from cancer registries in the CDC's National Program of Cancer Registries (NPCR) or the National Cancer Institute's Surveillance and End Results Program (SEER) with Indian Health Service (IHS) registration data have improved estimates of cancer incidence. We conducted linkages of death certificate data with IHS to also improve accuracy of health indicators and to inform program planning/resource allocation. Methods: Data from the linkage of IHS registration records with all NPCR/SEER cancer registry records (variable years) and linkage with death certificate data from 1990 to 2008 in the National Death Index (NDI) were used to improve race classification. Results: Cancer registry records revealed 106,033 AI/AN cases over the time period. Matching ...

Male-Mediated Developmental Toxicity, 1994

Page 353. OCCUPATIONS OF FATHERS BEFORE CONCEPTION AND THE RISK OF TESTICULAR CANCER IN THEIR SON... more Page 353. OCCUPATIONS OF FATHERS BEFORE CONCEPTION AND THE RISK OF TESTICULAR CANCER IN THEIR SONS Julia A. Knight, Loraine D. Marrett, and Hannah K. Weir Department of Preventive Medicine and ...

Journal of registry management, 2010

In this article, we report results from the cost analysis of 5 central cancer registries funded b... more In this article, we report results from the cost analysis of 5 central cancer registries funded by the National Program of Cancer Registries (NPCR). To estimate the true economic costs of operating a cancer registry, we used a cost-assessment tool (CAT) to collect data on all registry activities, not just those funded by the NPCR. Data were collected on actual, rather than budgeted, expenditures, including personnel, consultants, information technology (IT) support, and other factors influencing costs. Factors that can affect registry costs include the amount of consolidation from abstract to incident cases, the method of data reporting, the number of edits that must be performed manually versus electronically, and the amount of interstate data exchange required of a registry. Expenditures were allocated to specific surveillance and data enhancement and analysis activities. Our study confirmed that cost per case varies across registry activities. The cost of surveillance activities ...

American Journal of Public Health, 2014

Objectives. We describe rates and trends in kidney cancer incidence and mortality and identify di... more Objectives. We describe rates and trends in kidney cancer incidence and mortality and identify disparities between American Indian/Alaska Native (AI/AN) and White populations. Methods. To improve identification of AI/AN race, incidence and mortality data were linked with Indian Health Service (IHS) patient records. Analysis focused on residents of IHS Contract Health Service Delivery Area counties; Hispanics were excluded. We calculated age-adjusted kidney cancer incidence (2001–2009) and death rates (1990–2009) by sex, age, and IHS region. Results. AI/AN persons have a 1.6 times higher kidney cancer incidence and a 1.9 times higher kidney cancer death rate than Whites. Despite a significant decline in kidney cancer death rates for Whites (annual percentage change [APC] = −0.3; 95% confidence interval [CI] = −0.5, 0.0), death rates for AI/AN persons remained stable (APC = 0.4; 95% CI = −0.7, 1.5). Kidney cancer incidence rates rose more rapidly for AI/AN persons (APC = 3.5; 95% CI =...

Preventing Chronic Disease, 2014

Introduction Cancer registries link incidence data to state death certificates to update vital st... more Introduction Cancer registries link incidence data to state death certificates to update vital status and identify missing cases; they also link these data to the National Death Index (NDI) to update vital status among patients who leave the state after their diagnosis. This study explored the use of information from NDI linkages to identify potential duplicate cancer cases registered in both Florida and New York. Methods The Florida Cancer Data System (FCDS) and the New York State Cancer Registry (NYSCR) linked incidence data with state and NDI death records from 1996 through 2005. Information for patients whose death occurred in the reciprocal state (the death state) was exchanged. Potential duplicate cases were those that had the same diagnosis and the same or similar diagnosis date. Results NDI identified 4,657 FCDS cancer patients who died in New York and 2,740 NYSCR cancer patients who died in Florida. Matching identified 5,030 cases registered in both states; 508 were death certificate-only (DCO) cases in the death state's registry, and 3,760 (74.8%) were potential duplicates. Among FCDS and NY-SCR patients who died and were registered in the registry of the reciprocal state, more than 50% were registered with the same cancer diagnosis, and approximately 80% had similar diagnosis dates (within 1 year). Conclusion NDI identified DCO cases in the death state's cancer registry and a large proportion of potential duplicate cases. Standards are needed for assigning primary residence when multiple registries report the same case. The registry initiating the NDI linkage should consider sharing relevant information with death state registries so that these registries can remove erroneous DCO cases from their databases.

Journal of Adolescent and Young Adult Oncology, 2011

Purpose: Thyroid cancer incidence has been increasing for several decades, but the reasons are no... more Purpose: Thyroid cancer incidence has been increasing for several decades, but the reasons are not fully understood. Previous surveillance reports have covered less than 26% of the U.S. population. More recent, nationwide data are needed. This study examines thyroid cancer incidence among younger women by age, race/ethnicity, geography, and tumor size. Patients and Methods: Our study uses nationwide surveillance data to describe incidence rates and recent trends in thyroid cancer among adults aged 20-39 years in the United States during 1999-2007, with a focus on females. Results: Incidence rates were more than five times higher among females (16.4 per 100,000; 95% confidence interval [CI]: 16.2-16.6) than among males (3.1 per 100,000; 95% CI: 3.1-3.2). Among females, rates were higher among non-Hispanic whites than among other racial/ethnic groups and higher in the Northeast compared with other regions (p < 0.05). During 1999-2007, incidence rates increased 5.3% each year among females (95% CI: 4.7-5.9). This increase was observed across five-year age groups, racial/ethnic groups (except American Indians/Alaska Natives), geographic regions, and tumor sizes. Conclusion: The increase in rates across all tumor sizes suggests that the observed increases cannot be attributed solely to changes in diagnostics or surveillance. In addition, the continued increase in incidence rates in recent years among persons born after 1960 suggests that other, more contemporary factors than those previously proposed may play a contributing role.

The Lancet Oncology, 2008

Background Cancer survival varies widely between countries. The CONCORD study provides survival e... more Background Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1•9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 populationbased cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate racespecific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control.

Journal of the American Academy of Dermatology, 2011

Please note this is one article that is part of a 16-article CME supplement. CME credit should on... more Please note this is one article that is part of a 16-article CME supplement. CME credit should only be claimed after reading the entire supplement which can be accessed via the ''Melanoma Supplement'' tab under the ''Collections By Type'' pulldown menu on http://www.jaad.org. This journal supplement is a CME activity (enduring material) co-sponsored by the American Academy of Dermatology and the Centers for Disease Control and Prevention and is made up of four phases: 1. Reading of the CME Information (delineated below) 2. Reading all the articles in this supplement 3. Achievement of a 70% or higher on the online Post Test 4. Completion of the CME Evaluation CME INFORMATION AND DISCLOSURES Statement of Need: Healthcare providers continue to underreport melanoma even though cancer reporting requirements mandate such reporting. Additionally, providers may be unaware of recent trends and descriptive epidemiology regarding melanoma which includes the fact that nonwhites have a higher mortality rate from melanoma than do whites.

International Journal of Cancer, 2000

The present case-control study was undertaken to investigate the association between exposure to ... more The present case-control study was undertaken to investigate the association between exposure to maternal hormones and risk of testicular germ-cell cancer by histologic subgroups. Cases were males, aged 16 to 59 years, diagnosed with testicular germ-cell cancer in Ontario between 1987 and 1989. Histologic review was performed on all eligible cases for the purpose of categorizing cases as seminoma or nonseminoma (the latter classified 2 ways, with and without tumors containing seminoma). Risk factor data were collected on 502 cases, 346 case mothers, 975 age-matched controls, and 522 control mothers. Exogenous hormone exposure was associated with elevated risk (OR ‫؍‬ 4.9, 95% CI 1.7-13.9). Several additional risk factors were associated with risk of testicular cancer: bleeding and threatened miscarriage (OR ‫؍‬ 0.6, 95% CI 0.3-1.0), maternal cigarette smoking (12؉ cigarettes/day OR ‫؍‬ 0.6, 95% CI 0.4-1.0). pre-term birth (OR ‫؍‬ 1.6, 95% CI 1.0-2.5), and treatment for undescended testicle (OR ‫؍‬ 8.0, 95% CI 3.2-20.0). First births were associated with elevated risk (OR ‫؍‬ 1.7, 95% CI 1.0-2.8) among mothers below the age of 24 years at conception. There was little evidence that risk factors differed by histologic subgroup. We found evidence that exposure to maternal hormones, particularly estrogens, is associated with testicular germ-cell cancer risk. Not only does exposure to elevated levels (exogenous hormone use, pre-term birth, and first births among young mothers) increase risk but also exposure to relatively lower levels (heavy cigarette consumption and, perhaps, bleeding and threatened miscarriage) may decrease cancer risk.

Journal of the American Academy of Dermatology, 2011

Skin cancer is the most common form of cancer in the United States. Melanoma skin cancer is parti... more Skin cancer is the most common form of cancer in the United States. Melanoma skin cancer is particularly deadly; more than 8000 US residents die from it each year. Although recent reports suggest that melanoma incidence rates have been increasing, these apparent increases could be caused by an increase in reporting and/or screening, and by an actual increase in the occurrence of melanoma.

Canadian Medical Association Journal, 2010

C ancers in adolescents and young adults (aged 15-29 years) represent a transition between the no... more C ancers in adolescents and young adults (aged 15-29 years) represent a transition between the nonepithelial types, especially acute leukemias and embryonal tumours, that are common during childhood and the epithelial types (i.e., carcinomas) that account for most cancers in older adults. The embryonal tumours that are common in children, such as neuroblastoma, Wilms tumour, retinoblastoma, medulloblastoma and hepatoblastoma, are rare among adolescents and young adults. Similarly, the most common carcinomas in older adults, such as lung, breast, prostate and colorectal cancers, have a much lower incidence among young people. The differences relative to other age groups is such that the classification system used to report cancer incidence in adolescents and young adults is a blend of those used for cancers in childhood and adult life. 1 Adolescents and young adults account for about 2% of all patients with a new diagnosis of invasive cancer in Canada. 2 Although the annual number of cases is small relative to those in older adults, a diagnosis of cancer during adolescence or young adulthood can have a major impact on future quality of life and life expectancy, as well as disrupting normal trajectories of development (e.g., physical, psychological and social) and life goals related to family and careers. 3 Selfimage among young cancer patients can be compromised by the adverse effects of therapy (e.g., loss of hair, gain or loss of weight, impairment of sexuality, mutilating surgery). Social relationships are also challenged by the strain caused by a diagnosis of cancer and subsequent therapy. Medical professionals are often ill-equipped to deal with the psychosocial challenges faced by young people with cancer. Our objective was to examine current Canadian data on cancer in adolescents and young adults and to review the literature on the obstacles that patients in this age group face in receiving adequate care. Methods We obtained cancer incidence data from the July 2009 version of the Canadian Cancer Registry, a dynamic, populationbased database maintained by Statistics Canada. The Canadian Cancer Registry contains information on cases diagnosed from 1992 onward, based on reports from every provincial and territorial cancer registry. Cases from this database are routinely linked at the national level to identify persons with more than one primary tumour. We classified incident cancers in adolescents and young adults according to the morphology-based classification system proposed by Birch and colleagues. 4 This system uses 10 major diagnostic groups defined by the International Classification of Diseases for Oncology morphology codes. We obtained mortality data from the Canadian Vital Statistics-Death Database, also maintained by Statistics Canada. These data are based on information provided by the vital statistics registrars in each province and territory. We obtained population estimates from Statistics Canada's Demographics Estimates Compendium 2008. 5 We report here the number of new cancer cases for the most recent five years of available data (2002-2006). Incidence rates were available for 1992-2006, and we examined overall trends, as well as trends for individual cancers, for the period 1997-2006 (i.e., the most recent 10 years of available data). We report the number of deaths for the most recent five years of data (2001-2005). Mortality rates were available for

Cancer Epidemiology, 2013

Background-In order to ensure accurate survival estimates, population-based cancer registries mus... more Background-In order to ensure accurate survival estimates, population-based cancer registries must ascertain all, or nearly all, patients diagnosed with cancer in their catchment area, and obtain complete follow-up information on all deaths that occurred among registered cancer patients. In the US, linkage with state death records may not be sufficient to ascertain all deaths. Since 1979, all state vital statistics offices have reported their death certificate information to the National Death Index (NDI). Objective-This study was designed to measure the impact of linkage with the NDI on population-based relative and cancer cause-specific survival rates in the US. Methods-Central cancer registry records for patients diagnosed 1993-1995 from California, Colorado, and Idaho were linked with death certificate information (deaths 1993-2004) from their individual state vital statistics offices and with the NDI. Two databases were created: one contained incident records with deceased patients linked only to state death records and the second database contained incident records with deceased patients linked to both state death records and the NDI. Survival estimates and 95% confidence intervals from each database were compared by state and primary site category.

Cancer Causes & Control, 2005

Three common barriers to the effective use of data to inform decisions and motivate action for th... more Three common barriers to the effective use of data to inform decisions and motivate action for the planning of cancer control are (1) failure to recognize the availability of high-quality data, (2) not presenting the data in a compelling format, and (3) failing to place the data in a historical and action context. Overcoming these barriers will go a long way toward demonstrating that high-quality data can be used to accomplish the desired outcomes in a Comprehensive Cancer Control (CCC) program. The article identifies existing sources of high-quality data, provides examples of effective presentation, and discusses successes in using data for program planning and implementation. The paper is not meant to provide a comprehensive discussion of using data for decision making, instead providing options to help key CCC stakeholders improve the effectiveness of their decisions as CCC plans are developed and implemented.

Cancer Causes & Control, 2011

Although the association between in utero exposure to diethylstilbestrol (DES) and clear cell ade... more Although the association between in utero exposure to diethylstilbestrol (DES) and clear cell adenocarcinoma of the cervix and vagina (CCA) was first reported among young women, subsequent case reports and cohort studies suggest that an elevated risk for CCA may persist with age. Data from the National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology and End Results (SEER) Program were used to construct indirect standardized incidence ratios (SIR) comparing CCA risk among women born during the exposure period 1947 through 1971, when DES was prescribed to pregnant women, to the relevant time period for nonexposed women born before or after DES exposure period. CCA incidence among the women born before the DES exposure period (ages 30-54 at diagnosis of CAA) or after the DES exposure period (ages 15-29 at diagnosis) were used to calculate the expected rates for women born during the DES exposure period. Among women aged 15-29 years, CCA risk increased with age and peaked in the 25-29 year age group, but the risk estimates were unstable (SIR = 6.06; 95% CI: 0.97,-251.07, SEER data). Among women aged 40-54 years, CCA risk was greatest in the 40-44 year age group (SIR = 4.55; 95% CI: 1.11, 40.19, SEER data and SIR = 3.94; 95% CI: 1.06, 33.01, NPCR/SEER data) and remained significantly elevated throughout this age group in the combined data set. Risk was not elevated among women aged 30-39 years. The observed risk of CCA, if causally related to DES exposure, reflects a persistent health impact from in utero exposure that is widespread in the general population. When assessing a woman's cancer risks, whether her mother took DES while pregnant may still be a relevant aspect of the medical history for women born during the period of DES use in pregnancy.

Cancer, 2008

Increased attention to human papillomavirus (HPV)-associated cancers in light of the recent relea... more Increased attention to human papillomavirus (HPV)-associated cancers in light of the recent release of an HPV vaccine, as well as increased availability of cancer registry data that now include reporting from a large proportion of the US population, prompted the current assessment of HPV-associated cancers. This article describes methods used to assess the burden of HPV-associated cervical, vulvar, vaginal, penile, anal, and oral cavity/oropharyngeal cancers in the United States during 1998 through 2003 using cancer registry data, and it provides a brief overview of the epidemiology of these cancers.

Cancer, 2008

Background: Colorectal cancer (CRC) incidence and mortality rates vary across race/ethnicity. Soc... more Background: Colorectal cancer (CRC) incidence and mortality rates vary across race/ethnicity. Socioeconomic status (SES) also influences CRC rates; however, these associations might be inconsistent across racial/ ethnic groups and tumor subsite. We examined associations between area-level SES and CRC incidence and mortality in a population-based registry study of non-Hispanic Whites, African Americans, Hispanics, and Asians/Pacific Islanders from California. Methods: Data on 52,608 incident CRC cases (1998-2002) and 14,515 CRC deaths (1999-2001) aged !50 years were obtained from the California Cancer Registry. Based on 2000 U.S. Census data, each cancer case and death was assigned a multidimensional census tract-level SES index. SES-specific quintiles of CRC incidence and mortality rates, incidence rate ratios (IRR) and mortality rate ratios, and 95% confidence intervals (CI) were estimated. Analyses were stratified by anatomical site, including left-versus right-sided tumors, race/ ethnicity, and stage of disease. Results: Overall CRC incidence and SES did not show a clear association, yet patterns of associations varied across tumor subsite and race/ethnicity. Positive associations between SES and CRC incidence were found in Hispanics [SES Q5 v. Q1: IRR ¼ 1.54, CI ¼ 1.39-1.69], irrespective of the subsite. For Whites [SES Q5 v. Q1: IRR ¼ 0.80, CI ¼ 0.77-0.83], and African Americans [SES Q5 v. Q1: IRR ¼ 0.83, CI ¼ 0.70-0.97] inverse associations were observed, predominantly for left-sided tumors. Mortality rates declined with increasing SES in Whites, whereas in Hispanics mortality rates significantly increased with SES. Conclusions: Our findings show that SES differences in CRC incidence and mortality vary considerably across anatomical subsite and race/ethnicity. Impact: Studies combining area-and individual-level SES information are warranted. Cancer Epidemiol Biomarkers Prev; 21(10); 1814-22. Ó2012 AACR.

Cancer, 2000

BACKGROUND. This annual report to the nation addresses progress in cancer prevention and control ... more BACKGROUND. This annual report to the nation addresses progress in cancer prevention and control in the U.S. with a special section on colorectal cancer. This report is the joint effort of the American Cancer Society, the National Cancer Institute (NCI), the North American Association of Central Cancer Registries (NAACCR), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS). METHODS. Age-adjusted rates were based on cancer incidence data from the NCI and NAACCR and underlying cause of death as compiled by NCHS. Joinpoint analysis was based on NCI Surveillance, Epidemiology, and End Results (SEER) program incidence rates and NCHS death rates for 1973-1997. The prevalence of screening examinations for colorectal cancer was obtained from the CDC's Behavioral Risk Factor Surveillance System and the NCHS's National Health Interview Survey. RESULTS. Between 1990-1997, overall cancer incidence and death rates declined. Joinpoint analyses of cancer incidence and death rates confirmed the declines described in earlier reports. The incidence trends for colorectal cancer have shown recent steep declines for whites in contrast to a leveling off of the rates for blacks. State-to-state variations occurred in colorectal cancer screening prevalence as well as incidence and death rates. CONCLUSIONS. The continuing declines in overall cancer incidence and death rates 2398

The Lancet Child & Adolescent Health

BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3,... more BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. FINDINGS 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. INTERPRETATION This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. FUNDING Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.

Journal of registry management, 2020

Introduction The number of cancer cases in the United States continues to grow as the number of o... more Introduction The number of cancer cases in the United States continues to grow as the number of older adults increases. Accurate, reliable and detailed incidence data are needed to respond effectively to the growing human costs of cancer in an aging population. The purpose of this study was to examine the characteristics of incident cases and evaluate the impact of death-certificate-only (DCO) cases on cancer incidence rates in older adults. Methods Using data from 47 cancer registries and detailed population estimates from the Surveillance, Epidemiology and End Results (SEER) Program, we examined reporting sources, methods of diagnosis, tumor characteristics, and calculated age-specific incidence rates with and without DCO cases in adults aged 65 through ≥95 years, diagnosed 2011 through 2015, by sex and race/ethnicity. Results The percentage of cases (all cancers combined) reported from a hospital decreased from 90.6% (ages 65-69 years) to 69.1% (ages ≥95 years) while the percenta...

MMWR. Surveillance Summaries, 2018

Problem/Condition: Tobacco use is the leading preventable cause of cancer, contributing to at lea... more 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.

Background: Misclassification of American Indians/Alaska Natives (AI/AN) as non-AI/AN has been de... more Background: Misclassification of American Indians/Alaska Natives (AI/AN) as non-AI/AN has been described in mortality and cancer incidence data resulting in the underestimation of disease burden in this population. Linkages of data from cancer registries in the CDC's National Program of Cancer Registries (NPCR) or the National Cancer Institute's Surveillance and End Results Program (SEER) with Indian Health Service (IHS) registration data have improved estimates of cancer incidence. We conducted linkages of death certificate data with IHS to also improve accuracy of health indicators and to inform program planning/resource allocation. Methods: Data from the linkage of IHS registration records with all NPCR/SEER cancer registry records (variable years) and linkage with death certificate data from 1990 to 2008 in the National Death Index (NDI) were used to improve race classification. Results: Cancer registry records revealed 106,033 AI/AN cases over the time period. Matching ...

Male-Mediated Developmental Toxicity, 1994

Page 353. OCCUPATIONS OF FATHERS BEFORE CONCEPTION AND THE RISK OF TESTICULAR CANCER IN THEIR SON... more Page 353. OCCUPATIONS OF FATHERS BEFORE CONCEPTION AND THE RISK OF TESTICULAR CANCER IN THEIR SONS Julia A. Knight, Loraine D. Marrett, and Hannah K. Weir Department of Preventive Medicine and ...

Journal of registry management, 2010

In this article, we report results from the cost analysis of 5 central cancer registries funded b... more In this article, we report results from the cost analysis of 5 central cancer registries funded by the National Program of Cancer Registries (NPCR). To estimate the true economic costs of operating a cancer registry, we used a cost-assessment tool (CAT) to collect data on all registry activities, not just those funded by the NPCR. Data were collected on actual, rather than budgeted, expenditures, including personnel, consultants, information technology (IT) support, and other factors influencing costs. Factors that can affect registry costs include the amount of consolidation from abstract to incident cases, the method of data reporting, the number of edits that must be performed manually versus electronically, and the amount of interstate data exchange required of a registry. Expenditures were allocated to specific surveillance and data enhancement and analysis activities. Our study confirmed that cost per case varies across registry activities. The cost of surveillance activities ...

American Journal of Public Health, 2014

Objectives. We describe rates and trends in kidney cancer incidence and mortality and identify di... more Objectives. We describe rates and trends in kidney cancer incidence and mortality and identify disparities between American Indian/Alaska Native (AI/AN) and White populations. Methods. To improve identification of AI/AN race, incidence and mortality data were linked with Indian Health Service (IHS) patient records. Analysis focused on residents of IHS Contract Health Service Delivery Area counties; Hispanics were excluded. We calculated age-adjusted kidney cancer incidence (2001–2009) and death rates (1990–2009) by sex, age, and IHS region. Results. AI/AN persons have a 1.6 times higher kidney cancer incidence and a 1.9 times higher kidney cancer death rate than Whites. Despite a significant decline in kidney cancer death rates for Whites (annual percentage change [APC] = −0.3; 95% confidence interval [CI] = −0.5, 0.0), death rates for AI/AN persons remained stable (APC = 0.4; 95% CI = −0.7, 1.5). Kidney cancer incidence rates rose more rapidly for AI/AN persons (APC = 3.5; 95% CI =...

Preventing Chronic Disease, 2014

Introduction Cancer registries link incidence data to state death certificates to update vital st... more Introduction Cancer registries link incidence data to state death certificates to update vital status and identify missing cases; they also link these data to the National Death Index (NDI) to update vital status among patients who leave the state after their diagnosis. This study explored the use of information from NDI linkages to identify potential duplicate cancer cases registered in both Florida and New York. Methods The Florida Cancer Data System (FCDS) and the New York State Cancer Registry (NYSCR) linked incidence data with state and NDI death records from 1996 through 2005. Information for patients whose death occurred in the reciprocal state (the death state) was exchanged. Potential duplicate cases were those that had the same diagnosis and the same or similar diagnosis date. Results NDI identified 4,657 FCDS cancer patients who died in New York and 2,740 NYSCR cancer patients who died in Florida. Matching identified 5,030 cases registered in both states; 508 were death certificate-only (DCO) cases in the death state's registry, and 3,760 (74.8%) were potential duplicates. Among FCDS and NY-SCR patients who died and were registered in the registry of the reciprocal state, more than 50% were registered with the same cancer diagnosis, and approximately 80% had similar diagnosis dates (within 1 year). Conclusion NDI identified DCO cases in the death state's cancer registry and a large proportion of potential duplicate cases. Standards are needed for assigning primary residence when multiple registries report the same case. The registry initiating the NDI linkage should consider sharing relevant information with death state registries so that these registries can remove erroneous DCO cases from their databases.

Journal of Adolescent and Young Adult Oncology, 2011

Purpose: Thyroid cancer incidence has been increasing for several decades, but the reasons are no... more Purpose: Thyroid cancer incidence has been increasing for several decades, but the reasons are not fully understood. Previous surveillance reports have covered less than 26% of the U.S. population. More recent, nationwide data are needed. This study examines thyroid cancer incidence among younger women by age, race/ethnicity, geography, and tumor size. Patients and Methods: Our study uses nationwide surveillance data to describe incidence rates and recent trends in thyroid cancer among adults aged 20-39 years in the United States during 1999-2007, with a focus on females. Results: Incidence rates were more than five times higher among females (16.4 per 100,000; 95% confidence interval [CI]: 16.2-16.6) than among males (3.1 per 100,000; 95% CI: 3.1-3.2). Among females, rates were higher among non-Hispanic whites than among other racial/ethnic groups and higher in the Northeast compared with other regions (p < 0.05). During 1999-2007, incidence rates increased 5.3% each year among females (95% CI: 4.7-5.9). This increase was observed across five-year age groups, racial/ethnic groups (except American Indians/Alaska Natives), geographic regions, and tumor sizes. Conclusion: The increase in rates across all tumor sizes suggests that the observed increases cannot be attributed solely to changes in diagnostics or surveillance. In addition, the continued increase in incidence rates in recent years among persons born after 1960 suggests that other, more contemporary factors than those previously proposed may play a contributing role.

The Lancet Oncology, 2008

Background Cancer survival varies widely between countries. The CONCORD study provides survival e... more Background Cancer survival varies widely between countries. The CONCORD study provides survival estimates for 1•9 million adults (aged 15-99 years) diagnosed with a first, primary, invasive cancer of the breast (women), colon, rectum, or prostate during 1990-94 and followed up to 1999, by use of individual tumour records from 101 populationbased cancer registries in 31 countries on five continents. This is, to our knowledge, the first worldwide analysis of cancer survival, with standard quality-control procedures and identical analytic methods for all datasets. Methods To compensate for wide international differences in general population (background) mortality by age, sex, country, region, calendar period, and (in the USA) ethnic origin, we estimated relative survival, the ratio of survival noted in the patients with cancer, and the survival that would have been expected had they been subject only to the background mortality rates. 2800 life tables were constructed. Survival estimates were also adjusted for differences in the age structure of populations of patients with cancer. Findings Global variation in cancer survival was very wide. 5-year relative survival for breast, colorectal, and prostate cancer was generally higher in North America, Australia, Japan, and northern, western, and southern Europe, and lower in Algeria, Brazil, and eastern Europe. CONCORD has provided the first opportunity to estimate cancer survival in 11 states in USA covered by the National Program of Cancer Registries (NPCR), and the study covers 42% of the US population, four-fold more than previously available. Cancer survival in black men and women was systematically and substantially lower than in white men and women in all 16 states and six metropolitan areas included. Relative survival for all ethnicities combined was 2-4% lower in states covered by NPCR than in areas covered by the Surveillance Epidemiology and End Results (SEER) Program. Age-standardised relative survival by use of the appropriate racespecific and state-specific life tables was up to 2% lower for breast cancer and up to 5% lower for prostate cancer than with the census-derived national life tables used by the SEER Program. These differences in population coverage and analytical method have both contributed to the survival deficit noted between Europe and the USA, from which only SEER data have been available until now. Interpretation Until now, direct comparisons of cancer survival between high-income and low-income countries have not generally been available. The information provided here might therefore be a useful stimulus for change. The findings should eventually facilitate joint assessment of international trends in incidence, survival, and mortality as indicators of cancer control.

Journal of the American Academy of Dermatology, 2011

Please note this is one article that is part of a 16-article CME supplement. CME credit should on... more Please note this is one article that is part of a 16-article CME supplement. CME credit should only be claimed after reading the entire supplement which can be accessed via the ''Melanoma Supplement'' tab under the ''Collections By Type'' pulldown menu on http://www.jaad.org. This journal supplement is a CME activity (enduring material) co-sponsored by the American Academy of Dermatology and the Centers for Disease Control and Prevention and is made up of four phases: 1. Reading of the CME Information (delineated below) 2. Reading all the articles in this supplement 3. Achievement of a 70% or higher on the online Post Test 4. Completion of the CME Evaluation CME INFORMATION AND DISCLOSURES Statement of Need: Healthcare providers continue to underreport melanoma even though cancer reporting requirements mandate such reporting. Additionally, providers may be unaware of recent trends and descriptive epidemiology regarding melanoma which includes the fact that nonwhites have a higher mortality rate from melanoma than do whites.

International Journal of Cancer, 2000

The present case-control study was undertaken to investigate the association between exposure to ... more The present case-control study was undertaken to investigate the association between exposure to maternal hormones and risk of testicular germ-cell cancer by histologic subgroups. Cases were males, aged 16 to 59 years, diagnosed with testicular germ-cell cancer in Ontario between 1987 and 1989. Histologic review was performed on all eligible cases for the purpose of categorizing cases as seminoma or nonseminoma (the latter classified 2 ways, with and without tumors containing seminoma). Risk factor data were collected on 502 cases, 346 case mothers, 975 age-matched controls, and 522 control mothers. Exogenous hormone exposure was associated with elevated risk (OR ‫؍‬ 4.9, 95% CI 1.7-13.9). Several additional risk factors were associated with risk of testicular cancer: bleeding and threatened miscarriage (OR ‫؍‬ 0.6, 95% CI 0.3-1.0), maternal cigarette smoking (12؉ cigarettes/day OR ‫؍‬ 0.6, 95% CI 0.4-1.0). pre-term birth (OR ‫؍‬ 1.6, 95% CI 1.0-2.5), and treatment for undescended testicle (OR ‫؍‬ 8.0, 95% CI 3.2-20.0). First births were associated with elevated risk (OR ‫؍‬ 1.7, 95% CI 1.0-2.8) among mothers below the age of 24 years at conception. There was little evidence that risk factors differed by histologic subgroup. We found evidence that exposure to maternal hormones, particularly estrogens, is associated with testicular germ-cell cancer risk. Not only does exposure to elevated levels (exogenous hormone use, pre-term birth, and first births among young mothers) increase risk but also exposure to relatively lower levels (heavy cigarette consumption and, perhaps, bleeding and threatened miscarriage) may decrease cancer risk.

Journal of the American Academy of Dermatology, 2011

Skin cancer is the most common form of cancer in the United States. Melanoma skin cancer is parti... more Skin cancer is the most common form of cancer in the United States. Melanoma skin cancer is particularly deadly; more than 8000 US residents die from it each year. Although recent reports suggest that melanoma incidence rates have been increasing, these apparent increases could be caused by an increase in reporting and/or screening, and by an actual increase in the occurrence of melanoma.

Canadian Medical Association Journal, 2010

C ancers in adolescents and young adults (aged 15-29 years) represent a transition between the no... more C ancers in adolescents and young adults (aged 15-29 years) represent a transition between the nonepithelial types, especially acute leukemias and embryonal tumours, that are common during childhood and the epithelial types (i.e., carcinomas) that account for most cancers in older adults. The embryonal tumours that are common in children, such as neuroblastoma, Wilms tumour, retinoblastoma, medulloblastoma and hepatoblastoma, are rare among adolescents and young adults. Similarly, the most common carcinomas in older adults, such as lung, breast, prostate and colorectal cancers, have a much lower incidence among young people. The differences relative to other age groups is such that the classification system used to report cancer incidence in adolescents and young adults is a blend of those used for cancers in childhood and adult life. 1 Adolescents and young adults account for about 2% of all patients with a new diagnosis of invasive cancer in Canada. 2 Although the annual number of cases is small relative to those in older adults, a diagnosis of cancer during adolescence or young adulthood can have a major impact on future quality of life and life expectancy, as well as disrupting normal trajectories of development (e.g., physical, psychological and social) and life goals related to family and careers. 3 Selfimage among young cancer patients can be compromised by the adverse effects of therapy (e.g., loss of hair, gain or loss of weight, impairment of sexuality, mutilating surgery). Social relationships are also challenged by the strain caused by a diagnosis of cancer and subsequent therapy. Medical professionals are often ill-equipped to deal with the psychosocial challenges faced by young people with cancer. Our objective was to examine current Canadian data on cancer in adolescents and young adults and to review the literature on the obstacles that patients in this age group face in receiving adequate care. Methods We obtained cancer incidence data from the July 2009 version of the Canadian Cancer Registry, a dynamic, populationbased database maintained by Statistics Canada. The Canadian Cancer Registry contains information on cases diagnosed from 1992 onward, based on reports from every provincial and territorial cancer registry. Cases from this database are routinely linked at the national level to identify persons with more than one primary tumour. We classified incident cancers in adolescents and young adults according to the morphology-based classification system proposed by Birch and colleagues. 4 This system uses 10 major diagnostic groups defined by the International Classification of Diseases for Oncology morphology codes. We obtained mortality data from the Canadian Vital Statistics-Death Database, also maintained by Statistics Canada. These data are based on information provided by the vital statistics registrars in each province and territory. We obtained population estimates from Statistics Canada's Demographics Estimates Compendium 2008. 5 We report here the number of new cancer cases for the most recent five years of available data (2002-2006). Incidence rates were available for 1992-2006, and we examined overall trends, as well as trends for individual cancers, for the period 1997-2006 (i.e., the most recent 10 years of available data). We report the number of deaths for the most recent five years of data (2001-2005). Mortality rates were available for

Cancer Epidemiology, 2013

Background-In order to ensure accurate survival estimates, population-based cancer registries mus... more Background-In order to ensure accurate survival estimates, population-based cancer registries must ascertain all, or nearly all, patients diagnosed with cancer in their catchment area, and obtain complete follow-up information on all deaths that occurred among registered cancer patients. In the US, linkage with state death records may not be sufficient to ascertain all deaths. Since 1979, all state vital statistics offices have reported their death certificate information to the National Death Index (NDI). Objective-This study was designed to measure the impact of linkage with the NDI on population-based relative and cancer cause-specific survival rates in the US. Methods-Central cancer registry records for patients diagnosed 1993-1995 from California, Colorado, and Idaho were linked with death certificate information (deaths 1993-2004) from their individual state vital statistics offices and with the NDI. Two databases were created: one contained incident records with deceased patients linked only to state death records and the second database contained incident records with deceased patients linked to both state death records and the NDI. Survival estimates and 95% confidence intervals from each database were compared by state and primary site category.

Cancer Causes & Control, 2005

Three common barriers to the effective use of data to inform decisions and motivate action for th... more Three common barriers to the effective use of data to inform decisions and motivate action for the planning of cancer control are (1) failure to recognize the availability of high-quality data, (2) not presenting the data in a compelling format, and (3) failing to place the data in a historical and action context. Overcoming these barriers will go a long way toward demonstrating that high-quality data can be used to accomplish the desired outcomes in a Comprehensive Cancer Control (CCC) program. The article identifies existing sources of high-quality data, provides examples of effective presentation, and discusses successes in using data for program planning and implementation. The paper is not meant to provide a comprehensive discussion of using data for decision making, instead providing options to help key CCC stakeholders improve the effectiveness of their decisions as CCC plans are developed and implemented.

Cancer Causes & Control, 2011

Although the association between in utero exposure to diethylstilbestrol (DES) and clear cell ade... more Although the association between in utero exposure to diethylstilbestrol (DES) and clear cell adenocarcinoma of the cervix and vagina (CCA) was first reported among young women, subsequent case reports and cohort studies suggest that an elevated risk for CCA may persist with age. Data from the National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology and End Results (SEER) Program were used to construct indirect standardized incidence ratios (SIR) comparing CCA risk among women born during the exposure period 1947 through 1971, when DES was prescribed to pregnant women, to the relevant time period for nonexposed women born before or after DES exposure period. CCA incidence among the women born before the DES exposure period (ages 30-54 at diagnosis of CAA) or after the DES exposure period (ages 15-29 at diagnosis) were used to calculate the expected rates for women born during the DES exposure period. Among women aged 15-29 years, CCA risk increased with age and peaked in the 25-29 year age group, but the risk estimates were unstable (SIR = 6.06; 95% CI: 0.97,-251.07, SEER data). Among women aged 40-54 years, CCA risk was greatest in the 40-44 year age group (SIR = 4.55; 95% CI: 1.11, 40.19, SEER data and SIR = 3.94; 95% CI: 1.06, 33.01, NPCR/SEER data) and remained significantly elevated throughout this age group in the combined data set. Risk was not elevated among women aged 30-39 years. The observed risk of CCA, if causally related to DES exposure, reflects a persistent health impact from in utero exposure that is widespread in the general population. When assessing a woman's cancer risks, whether her mother took DES while pregnant may still be a relevant aspect of the medical history for women born during the period of DES use in pregnancy.

Cancer, 2008

Increased attention to human papillomavirus (HPV)-associated cancers in light of the recent relea... more Increased attention to human papillomavirus (HPV)-associated cancers in light of the recent release of an HPV vaccine, as well as increased availability of cancer registry data that now include reporting from a large proportion of the US population, prompted the current assessment of HPV-associated cancers. This article describes methods used to assess the burden of HPV-associated cervical, vulvar, vaginal, penile, anal, and oral cavity/oropharyngeal cancers in the United States during 1998 through 2003 using cancer registry data, and it provides a brief overview of the epidemiology of these cancers.

Cancer, 2008

Background: Colorectal cancer (CRC) incidence and mortality rates vary across race/ethnicity. Soc... more Background: Colorectal cancer (CRC) incidence and mortality rates vary across race/ethnicity. Socioeconomic status (SES) also influences CRC rates; however, these associations might be inconsistent across racial/ ethnic groups and tumor subsite. We examined associations between area-level SES and CRC incidence and mortality in a population-based registry study of non-Hispanic Whites, African Americans, Hispanics, and Asians/Pacific Islanders from California. Methods: Data on 52,608 incident CRC cases (1998-2002) and 14,515 CRC deaths (1999-2001) aged !50 years were obtained from the California Cancer Registry. Based on 2000 U.S. Census data, each cancer case and death was assigned a multidimensional census tract-level SES index. SES-specific quintiles of CRC incidence and mortality rates, incidence rate ratios (IRR) and mortality rate ratios, and 95% confidence intervals (CI) were estimated. Analyses were stratified by anatomical site, including left-versus right-sided tumors, race/ ethnicity, and stage of disease. Results: Overall CRC incidence and SES did not show a clear association, yet patterns of associations varied across tumor subsite and race/ethnicity. Positive associations between SES and CRC incidence were found in Hispanics [SES Q5 v. Q1: IRR ¼ 1.54, CI ¼ 1.39-1.69], irrespective of the subsite. For Whites [SES Q5 v. Q1: IRR ¼ 0.80, CI ¼ 0.77-0.83], and African Americans [SES Q5 v. Q1: IRR ¼ 0.83, CI ¼ 0.70-0.97] inverse associations were observed, predominantly for left-sided tumors. Mortality rates declined with increasing SES in Whites, whereas in Hispanics mortality rates significantly increased with SES. Conclusions: Our findings show that SES differences in CRC incidence and mortality vary considerably across anatomical subsite and race/ethnicity. Impact: Studies combining area-and individual-level SES information are warranted. Cancer Epidemiol Biomarkers Prev; 21(10); 1814-22. Ó2012 AACR.

Cancer, 2000

BACKGROUND. This annual report to the nation addresses progress in cancer prevention and control ... more BACKGROUND. This annual report to the nation addresses progress in cancer prevention and control in the U.S. with a special section on colorectal cancer. This report is the joint effort of the American Cancer Society, the National Cancer Institute (NCI), the North American Association of Central Cancer Registries (NAACCR), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS). METHODS. Age-adjusted rates were based on cancer incidence data from the NCI and NAACCR and underlying cause of death as compiled by NCHS. Joinpoint analysis was based on NCI Surveillance, Epidemiology, and End Results (SEER) program incidence rates and NCHS death rates for 1973-1997. The prevalence of screening examinations for colorectal cancer was obtained from the CDC's Behavioral Risk Factor Surveillance System and the NCHS's National Health Interview Survey. RESULTS. Between 1990-1997, overall cancer incidence and death rates declined. Joinpoint analyses of cancer incidence and death rates confirmed the declines described in earlier reports. The incidence trends for colorectal cancer have shown recent steep declines for whites in contrast to a leveling off of the rates for blacks. State-to-state variations occurred in colorectal cancer screening prevalence as well as incidence and death rates. CONCLUSIONS. The continuing declines in overall cancer incidence and death rates 2398