The Past, Present and Future of the Cancer Burden in the United States:

Transcription

1 The Past, Present and Future of the Cancer Burden in the United States: Hannah K Weir, PhD 1 Ashwini Soman, MBBS, MPH 2 Trevor D Thompson, BS 1 Bjorn Moller, PhD 3 Robert N Anderson, PhD 1 Steve Leadbetter, PhD 1 1 Centers for Disease Control and Prevention 2 Northrop Grumman Corporation 3 Cancer Registry of Norway January 2014 National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control

2 Objectives Characterize the increasing burden of cancer from Project cases and deaths through 2020 Use of projections to inform cancer control Limitations

3 Data SEER -9 incidence data Mortality data Nation Center for Health Statistics US Census Bureau Population estimates (SEER) Population projections

4 Objectives Characterize the increasing burden of cancer from Project cases and deaths through 2020 Use of projections to inform cancer control Limitations

5 Methods characterize the cancer burden from Method: 1999 Canadian Cancer Statistics Estimate 3 sets of counts by race (black, white) and gender Baseline 1975 Population Risk (~ age-adjusted rate) Population Growth Population Aging

6 Cancer Incidence (SEER-9)

7 Cancer Deaths

8 Objectives Characterize the increasing burden of cancer from Project cases and deaths through 2020 Use of projections to inform cancer control Limitations

9 Methods project the cancer burden All sites and top 25 cancers; men and women; all races, white and black Trends in US cancer mortality data : all sites, top 23 cancers; men and women; all races, white and black US Census Population projections ( ) NORDPRED software free from the Cancer Registry of Norway website

10 Age, Period, Birth Cohort Models R ap Age Period = (A a + P p + C c + D p ) 5 (0-4, 5-9, , 85+) ( ) Power link function Goodness of fit test to select # periods Prostate and female breast used most recent 5 year ( )

11 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

12 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

13 Tobacco Related Cancers

14 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

15 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

16 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

17 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

18 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

19 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

20 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

21 Weight/Physical Activity Related Cancers

22 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

23 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

24 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

25 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

26 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

27 Trends in Observed and Projected Ageadjusted Mortality Rates ( )

28 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

29 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

30 Surveillance Related and Screen Detectable Cancers

31 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

32 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

33 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

34 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

35 Trends in Observed and Projected Age-adjusted Incidence Rates ( ) Risk assumed constant from 2009 forward.

36 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

37 Trends in Observed and Projected Age-adjusted Incidence Rates ( ) Risk assumed constant from 2009 forward.

38 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

39 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

40 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

41 Infectious Etiology

42 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

43 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

44 Trends in Observed and Projected Age-adjusted Incidence Rates ( )

45 Trends in Observed and Projected Age-adjusted Mortality Rates ( )

46 Objectives Characterize the increasing burden of cancer from Project cases and deaths through 2020 Uses of projections to inform cancer control Limitations

47 Targeting and Evaluating Primary Prevention Strategies

48 Predicted cancer incident counts (2010 and 2020) Males Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites 813,566 1,009, Colon and Rectum 72,275 81, Kidney and Renal Pelvis 32,998 46, Larynx 8,298 8, Liver and IBD 20,269 32, Lung and Bronchus 98, , Melanoma 44,301 57, Mesothelioma 2,339 2, Pancreas 21,619 29, Prostate 251, , Thyroid 11,476 19,

49 Predicted cancer incident counts (2010 and 2020) Males Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites 813,566 1,009, Colon and Rectum 72,275 81, Kidney and Renal Pelvis 32,998 46, Larynx 8,298 8, Liver and IBD 20,269 32, Lung and Bronchus 98, , Melanoma 44,301 57, Mesothelioma 2,339 2, Pancreas 21,619 29, Prostate 251, , Thyroid 11,476 19,

50 Predicted cancer incident counts (2010 and 2020) Males Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites 813,566 1,009, Colon and Rectum 72,275 81, Kidney and Renal Pelvis 32,998 46, Larynx 8,298 8, Liver and IBD 20,269 32, Lung and Bronchus 98, , Melanoma 44,301 57, Mesothelioma 2,339 2, Pancreas 21,619 29, Prostate 251, , Thyroid 11,476 19,

51 Predicted cancer incident counts (2010 and 2020) Males Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites 813,566 1,009, Colon and Rectum 72,275 81, Kidney and Renal Pelvis 32,998 46, Larynx 8,298 8, Liver and IBD 20,269 32, Lung and Bronchus 98, , Melanoma 44,301 57, Mesothelioma 2,339 2, Pancreas 21,619 29, Prostate 251, , Thyroid 11,476 19,

52 Predicted cancer incident counts (2010 and 2020) Females Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites Combined 755, , Cervix Uteri 10,253 10, Colon and Rectum 70,568 76, Corpus and Uterus, NOS 48,301 63, Female Breast 227, , Kidney and Renal Pelvis 20,162 28, Liver and IBD 7,884 12, Lung and Bronchus 94, , Melanoma 32,984 43, Ovary 22,363 24, Pancreas 21,540 29, Thyroid 36,151 60,

53 Predicted cancer incident counts (2010 and 2020) Females Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites Combined 755, , Cervix Uteri 10,253 10, Colon and Rectum 70,568 76, Corpus and Uterus, NOS 48,301 63, Female Breast 227, , Kidney and Renal Pelvis 20,162 28, Liver and IBD 7,884 12, Lung and Bronchus 94, , Melanoma 32,984 43, Ovary 22,363 24, Pancreas 21,540 29, Thyroid 36,151 60,

54 Predicted cancer incident counts (2010 and 2020) Females Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites Combined 755, , Cervix Uteri 10,253 10, Colon and Rectum 70,568 76, Corpus and Uterus, NOS 48,301 63, Female Breast 227, , Kidney and Renal Pelvis 20,162 28, Liver and IBD 7,884 12, Lung and Bronchus 94, , Melanoma 32,984 43, Ovary 22,363 24, Pancreas 21,540 29, Thyroid 36,151 60,

55 Predicted cancer incident counts (2010 and 2020) Females Overall % Change and due to Cancer Site No. No. % risk pop All Cancer Sites Combined 755, , Cervix Uteri 10,253 10, Colon and Rectum 70,568 76, Corpus and Uterus, NOS 48,301 63, Female Breast 227, , Kidney and Renal Pelvis 20,162 28, Liver and IBD 7,884 12, Lung and Bronchus 94, , Melanoma 32,984 43, Ovary 22,363 24, Pancreas 21,540 29, Thyroid 36,151 60,

56 Resource Planning

57 Short Term Projections Age-standardized incidence rates (ASIR) for selected* cancers, males, Canada, Canadian Cancer Statistics 20 years ASIR (per 100,000) Kidney 15 Stomach 10 Larynx 5 Liver Thyroid

58 Evaluating Health People 2020 Goals: reducing cancer mortality

59 Evaluate Progress Toward Meeting HP 2020 objectives HP 2020 objective Site % change HP2020 Year HP objectives met C-1 All Cancer Sites Combined C-2 Lung and Bronchus C-3 Female Breast C-4 Cervix Uteri C-5 Colon and Rectum C-6 Oral Cavity and Pharynx C-7 Prostate 24, C-8 Melanoma 2.7 2, ,4 -

60 Objectives Characterize the increasing burden of cancer from Project cases and deaths through 2020 Uses of projections to inform cancer control Limitations

61 Are Trends in SEER-9 Comparable to NPCR Trends ( )

62 Conclusions Incident cases will increase 20+% between 2010 and 2020 while risk (i.e., AARs) will stabilize for most of the population Tobacco related case counts will stabilize in men and continue to increase in women while AARs decrease Weight related and other cancer case counts and AARs will go up (i.e., melanoma, thyroid, liver) HP2020 cancer mortality objectives on track with exception of melanoma

63 Thank You Hannah K. Weir, PhD Division of Cancer Prevention and Control Centers for Disease Control and Prevention The findings and conclusions in this presentation are those of the presenter and do not necessarily represent the official position of the Centers for Disease Control and Prevention.