Healthy People 2010Focus Area 3

Cancer Progress Review

October 16, 2002

Population without cancer

Prevention Detection Treatment

Professionals, Public

Research

Education, Information, Infrastructure

Cases

Survival

Deaths

Policy

Cancer Objectives: Framework

Population with cancer

Population with cancer--detected

Population with cancer

--treated

Reduction in Cancer Deaths

All Cancer

Lung

Breast

Uterine cervix

Colorectal

Oropharyngeal

Prostate

Melanoma

Distribution of the HP2010 Cancer Mortality Objectives, 2000

Lung

Colorectal

Breast

Prostate

Oropharyngeal

Melanoma

Cervical

Remaining

Remaining cancer mortality

Specific HP2010 objective

Cancer Mortality

Other MortalitySource: National Vital Statistics System-Mortality (NVSS-M), CDC, NCHS.

Distribution of the HP2010 Cancer Mortality Objectives, 2000

Lung

Colorectal

Breast

Prostate

Oropharyngeal

Melanoma

Cervical

Remaining

Remaining cancer mortality

Specific HP2010 objective

Source: National Vital Statistics System-Mortality (NVSS-M), CDC, NCHS.

Cancer mortality: by site, 2000

201.0

56.5

29.7 27.120.9

2.8 2.7 2.70

25

50

75

100

125

150

175

200

225Age-adjusted rate per 100,000 standard population

2010 Target

Overall Lung Prostate Breast(Female)

Colorectal Cervical Oro-pharyngeal

Melanoma

Source: National Vital Statistics System-Mortality (NVSS-M), CDC, NCHS.

Overall cancer mortality: by race/ethnicity, 2000

127.3 125.0 120.8

256.8

202.6

0

50

100

150

200

250

300

Age-adjusted rate per 100,000 standard population

2010 Target

American Indian/Alaska Native

Asian/Pacific Islander

Hispanic Black, not Hispanic

White, notHispanic

Note: See the data sections (summary and slides) for information on data sources and issues.

Overall cancer mortality: by sex, 1950-2000

1950 1960 1970 1980 1990 2000

0

150

200

250

300

2010 Target

Age-adjusted rate per 100,000 standard population

Male

Total

Female

Source: National Vital Statistics System-Mortality (NVSS-M), CDC, NCHS.

Lung cancer mortality:by race/ethnicity, 2000

32.728.9

22.0

66.1

58.9

0

10

20

30

40

50

60

70

Age-adjusted rate per 100,000 standard population

2010 Target

American Indian/Alaska Native

Asian/Pacific Islander

Hispanic Black, not Hispanic

White, not Hispanic

Note: See the data sections (summary and slides) for information on data sources and issues.

Lung cancer mortality: by sex, 1950-2000

0

20

40

60

80

100

1950 1960 1970 1980 1990 2000

Age-adjusted rate per 100,000 standard population

2010 Target

Female

Male

Total

Source: National Vital Statistics System-Mortality (NVSS-M), CDC, NCHS.

10.1

16.8

10.3

16.6

10.2

15.5

25.1

35.3

17.7

24.7

0

10

20

30

40

Colorectal cancer mortality: by sex, race/ethnicity, 2000

Age-adjusted rate per 100,000 standard population

American Indian/Alaska Native

Asian/Pacific Islander

Hispanic Black, not Hispanic

White, not Hispanic

2010 Target

Female Male

Note: See the data sections (summary and slides) for information on data sources and issues.

3.12.9

3.8

5.7

2.4

0

1

2

3

4

5

6

Cervical cancer mortality:by race/ethnicity, 2000

Age-adjusted rate per 100,000 standard population

American Indian/Alaska Native

Asian/Pacific Islander

Hispanic Black, not Hispanic

White, not Hispanic

2010 Target

Note: See the data sections (summary and slides) for information on data sources and issues.

US = 3.07/100,0005.38 - 11.78 (highest 10%)4.63 - 5.374.15 - 4.623.82 - 4.143.53 - 3.813.24 - 3.522.95 - 3.232.67 - 2.942.34 - 2.661.19 - 2.33 (lowest 10%)Sparse data (< 12 observed deaths; 1,490 counties; 7.04% of deaths)

Cancer Mortality Rates by County (Age-adjusted 1970 US Population)Cervix Uteri: White Females, 1970-98

US = 8.04/100,00013.29 - 23.82 (highest 10%)11.86 - 13.2810.77 - 11.859.93 - 10.769.23 - 9.928.62 - 9.227.69 - 8.617.01 - 7.685.97 - 7.003.00 - 5.96 (lowest 10%)Sparse data (< 12 observed deaths; 2,625 counties; 13.1% of deaths)

Cancer Mortality Rates by County (Age-adjusted 1970 US Population)Cervix Uteri: Black Females, 1970-98

Cervical Cancer Mortality Rates by County, 1970-1998

White Females

Black Females

(age-adjusted 1970 US Population)

Cancer SitePercent of

Cancer Mortality EAPC* Required Change to Meet 2010 Target

Evaluation of 2010 Target Attainment

*Estimated Annual Percent Change.**Based on EAPC, found at www.seer.cancer.gov in either the SEER Cancer Statistics Review, 1973-1999 or Fast Stats. The most current group of years was used for the projection.

Cervical 0.8% -5.4% Target would be reached 2006 (projected)**

Prostate 6% -4.4% Target would be reached 2001 (projected)**

Breast 8% -3.2% Target would be reached 2006 (projected)**

Oropharyngeal 1% -2.9% Target met (2000)

Lung 28% -1.9% -2.3%Colorectal 10% -1.7% -4.0%All Sites 100% -1.1% -2.3%Melanoma 1% -0.6% Target would be reached 2010 (projected)**

Cancer Site EAPC*Specific EAPC Years Used For Evaluation

of Target Attainment**

Evaluation of 2010 Target Attainment

*Estimated Annual Percent Change.**Based on EAPC, found at www.seer.cancer.gov in either the SEER Cancer Statistics Review, 1973-1999 or Fast Stats. The most current group of years was used for the projection.

Cervical -5.4% 1997-1999

Prostate -4.4% 1995-1999

Breast -3.2% 1995-1999

Oropharyngeal -2.9% 1995-1999

Lung -1.9% 1997-1999

Colorectal -1.7% 1995-1999

All Sites -1.1% 1995-1999

Melanoma -0.6% 1995-1999

Evaluation of 2010 Target Attainment: Overall Cancer Mortality

125

150

175

200

225

1990 1995 2000 2005 2010

Age-adjusted rate per 100,000 standard population

Projected Annual Change*

Required Annual Change

2010 Target

0

(-1.1%)

(-2.3%)

Actual

**Based on EAPC, found at www.seer.cancer.gov, Fast Stats. The most current group of years was used for the projection.

Evaluation of 2010 Target Attainment:Colorectal Cancer

10

15

20

25

30

35

1990 1995 2000 2005 2010

Projected annual change*

Required annual change

2010 Target

0

Age-adjusted rate per 100,000 standard population

White Population

Black Population

(-0.6%)

(-6.9%)

(-1.8%)

(-3.7%)

**Based on EAPC, found at www.seer.cancer.gov, Fast Stats. The most current group of years was used for the projection.

Cancer Prevention

Sun Protection

Cigarette Smoking

Physical Activity

Cancer prevention - Adults

0

10

20

30

40

50

60

70

80

Age-adjusted percent

Sun protection(2000)

Current smoker Moderatephysical activity

Baseline 2001 2010 Target

Note: See the data sections (summary and slides) for information on data sources and issues. Physical activity data can be found at www.cdc.gov/nchs/hphome.htm.

Cancer prevention - students in grades 9-12

0

10

20

30

40

50

60

70

80

90

Percent

Sunscreen use Current cigarettesmoking

Vigorousphysical activity

**

**Developmental objective, target to be determined.

1999 baseline 2001 2010 Target

Note: See the data sections (summary and slides) for information on data sources and issues.

Vigorous physical activity data can be found at www.cdc.gov/nchs/hphome.htm.

Current cigarette smoking : Adults age 18 and older, and students in grades 9-12

0

10

20

30

40

50

Percent

2010 Target: Students

StudentsAdults

2010 Target: Adults

1970 1975 1980 20001965 1985 1990 1995 2001

Note: See the data sections (summary and slides) for information on data sources and issues.Earlier adult data found in: National Center for Health Statistics. Health, United States, 2002

Screening/Early Detection

Pap smear

FOBT

Proctoscopic exam

Mammography

Early cancer detection procedures:by family income level, 2000

0

20

40

60

80

100Age-adjusted percent

Mammogram:Females 40+

Pap test:Females 18+

Fecal occult blood test:Adults 50+

Exam*:Adults 50+ (ever)

Poor Near poor Middle/High 2010 Target

*Includes sigmoidoscopy, colonoscopy, proctoscopy.

Note: See the data sections (summary and slides) for information on data sources and issues.

Cervical and breast cancer screening, 2000American Indian/ Alaska Native

Asian /Pacific Islander

Hispanic Black, not Hispanic

White, notHispanic

0

20

40

60

80

100Age-adjusted percent

Mammogram (past 2 years)Pap test (past 3 years)

2010 Target

2010 Target

Note: See the data sections (summary and slides) for information on data sources and issues.

Colorectal cancer screening:Adults age 50 and over, by race/ethnicity, 2000

0

5

10

15

20

25

30

35

40

45

50

552010 Target

Age

-adj

uste

d pe

rcen

t

American Indian/Alaska Native

Asian /Pacific Islander

HispanicBlack, not Hispanic White, not Hispanic

Exam* (ever) Fecal occult blood test (past 2 years)*Includes sigmoidoscopy, colonoscopy, proctoscopy.

Note: See the data sections (summary and slides) for information on data sources and issues.

Cervical and breast cancer screening, by family income level, and race/ethnicity, 2000

Black, not Hispanic White, not Hispanic Hispanic

0

20

40

60

80

100

Ag

e-a

dju

ste

d p

erce

nt

Mammogram (past 2 years)Pap Test (past 3 years)2010 Target

2010 Target

Near poorPoor Middle/High

Poor Near poor Middle/High

Sunscreen use by students in grades 9-12, 2001*

Always or most of the time use sunscreen%

Black, not Hispanic White, not HispanicTotal Hispanic0

5

10

15

20

25

Total Female Male

*Target to be determined

Source: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

Persons with invasive cancer (any type), 5 years or longer survival

0

10

20

30

40

50

60

70

Total Black White Female Male

1989-95 1992-19985-Year Relative Survival (percent)2010 Target

Source: Surveillance, Epidemiology, and End Results (SEER) Program, NIH, NCI.

Remaining Cancer Objectives

Increase counseling on tobacco use cessation, physical activity, and cancer screening (8 sub-objectives) to 85 percent, current range is 12-59 percent.

Increase the number of States that have a statewide population-based cancer registry on at least 95 percent of the expected number of reportable cancers to 45, 1999 baseline is 29 States + D.C.

Progress review data slidescan be found on the web

at:

http://www.cdc.gov/nchs/hphome.htm