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New data for 1999 show that death rates for all cancers combined continued
to decline in the United States. However, the number of cancer cases can be
expected to increase because of the growth and aging of the population in
coming decades, according to a report released today. The "Annual Report to
the Nation on the Status of Cancer, 1973-1999, Featuring Implications of Age
and Aging on the U.S. Cancer Burden" is published in the May 15, 2002 (Vol.
94, No. 10, pages 2766-2792), issue of "Cancer".*

The report is by the National Cancer Institute (NCI); the American Cancer
Society (ACS); the North American Association of Central Cancer Registries
(NAACCR); the National Institute on Aging (NIA); and the Centers for Disease
Control and Prevention (CDC), including the National Center for Health
Statistics (NCHS) and the National Center for Chronic Disease Prevention and
Health Promotion.

The initial Report to the Nation, issued four years ago, documented the
first sustained decline in cancer death rates. This trend was a notable
reversal from increases that had been seen since the 1930s, which was the
period when record keeping on deaths first included the entire nation.

"The continuing decline in the rate of cancer deaths once again affirms the
progress we've made against cancer, but the report also highlights the need
for an acceleration of research as the population of the United States
ages," said NCI Director Andrew C. von Eschenbach, M.D.

Lung cancer is still the leading cause of cancer death in the United States.
During the most recent reporting period, it accounted for almost one-third
of cancer deaths in men and about one-fourth of cancer deaths in women.
Colorectal cancer is the second leading cause of cancer death, followed by
breast and prostate cancer.

"The good news in this report is the continuing fall in cancer death rates
by slightly more than one percent per year between 1993 and 1999," said John
R. Seffrin, Ph.D., chief executive officer of the American Cancer Society.
"Of special note is the continuing decline in death rates for the four most
common cancers."

According to James S. Marks, M.D., director of CDC's National Center for
Chronic Disease Prevention and Health Promotion, "Another important issue in
the report is that the incidence rate, or rate of new cancers, for all
cancers combined was stable during most of the 1990s, after increasing
during the 1970s through 1980s. These data highlight the need for the rapid,
full application of all we know about prevention, screening, and treatment
of cancer."

The single most important risk factor for cancer is age. Because the U.S.
population is both growing and aging, the authors focused on how, even if
rates of cancer remain constant, the number of people diagnosed with cancer
will increase.

The authors projected the cancer burden in about 50 years from now by
applying U.S. Census Bureau population projections to current cancer
incidence rates. "If cancer rates follow current patterns, we anticipate a
doubling from 1.3 million people in 2000 to 2.6 million people in 2050
diagnosed with cancer," said Holly L. Howe, Ph.D., executive director of
NAACCR. "The number of cancer patients age 85 and over is expected to
increase four-fold in this same time period," said Howe.

NIA Director Richard J. Hodes, M.D., notes that "the data presented in the
report underscore a critical need for expanded and coordinated cancer
control efforts to serve an aging population and reduce the burden of cancer
in the elderly."

Furthermore, the authors posit a number of strategies for dealing with the
future cancer burden. Special considerations in treating cancer in older
people will need to be undertaken due to co-morbid conditions and physical
limitations that haven't been studied fully in older age groups. Increasing
representation of older patients in clinical trials could help answer
questions about how best to treat older people with cancer. The authors also
note, in particular, the growing need for trained cancer care professionals.

Certain changes and limitations in reporting data for this fifth report
preclude comparisons with previous reports. For this report, unlike previous
reports, age adjustment of statistics used the year 2000 standard population