CANCER of TRACHEA, BRONCHUS, LUNG, PLEURA
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1 CANCER of TRACHEA, BRONCHUS, LUNG, PLEURA Data Highlights There were 10,025 cases of cancer of the trachea, bronchus, lung and pleura diagnosed among Pennsylvania residents in 1996, the highest annual number ever recorded by the Pennsylvania Cancer Registry. The 1996 age-adjusted incidence rate was 85.1 per 100,000 for males and 42.4 for females. National Cancer Institute SEER rates (for invasive lung and bronchus cases) for 1996 were lower for males (70.0) but similar for females (42.3). In Pennsylvania, the average annual ( ) age-adjusted incidence rate for black males (122.3) was 51 percent higher than the corresponding rate of 81.0 for white males. This major cancer site accounted for the second largest number of cancer cases among males (6,025) and females (4,000) in The annual age-adjusted incidence rates for white males from 1987 through 1996 have remained fairly stable while the rates have been on the increase for black males since 1993 and for both white and black females since 1988/89. During the period of , almost 69 percent of the cases were diagnosed among residents age 65 years of age or older. Black males had the highest average annual ( ) incidence rates for nearly every age group. Almost 74 percent of all cancers of the trachea, bronchus, lung and pleura reported for 1996 were diagnosed at the regional or distant stages of the disease. Because lung cancer is very difficult to detect early, survival is poor, and mortality rates in the population approach the incidence rates. The average annual age-adjusted death rate was 48.0, compared to 58.6 for the corresponding incidence rate. In 1996, almost 32 percent of all cancer deaths in males were from lung cancer (4,977) while the proportion was over 21 percent (3,137) in females, making this site the leading cause of cancer mortality in Cigarette smoking accounted for about 85 percent of these deaths. The annual age-adjusted mortality rates from 1987 to 1996 showed increases among females of both races and declines among males of both races. FIGURE 9 Average Annual Age-Adjusted Incidence and Mortality Rates* by Sex and Race, Incidence Mortality Race/Sex All Cases/Deaths All Males All Females Risk Factors Cigarette, cigar and pipe smoking. Diet low in vitamin A is suggestive. Family history of cancers of the trachea, bronchus, lung and pleura Age-Adjusted Rate Early Detection Neither sputum cytology nor x-rays have proven to be effective. *per 100, U.S. standard million population. Exposure to ionizing radiation, asbestos, mustard gas, nickel, polycyclic hydrocarbons, chromium, inorganic arsenic or chloromenthyl ethers. Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 84
2 Cancer of the Trachea, Bronchus, Lung, Pleura: INCIDENCE TABLE 9-A Number of Cancer Cases, Age-Adjusted Incidence Rates and Range for 95% Confidence Intervals by Sex, Race and Year, Pennsylvania Residents, All Cases* All Races* White Black All Races* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , * Includes any unknowns. NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). 140 FIGURE 9-A Age-Adjusted Incidence Rates by Sex and Race Pennsylvania Residents, Rate per 100, Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 85
3 Cancer of the Trachea, Bronchus, Lung, Pleura: INCIDENCE TABLE 9-B Average Annual Age-Specific Incidence Rates by Sex and Race Age Group All Cases All Races White Black All Races White Black Total Under NOTE: Rates are per 100,000 population ( ) for each specified group. 1,000 FIGURE 9-B Average Annual Age-Specific Incidence Rates by Sex and Race 800 Rate per 100, Under Age Group 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 86
4 Cancer of the Trachea, Bronchus, Lung, Pleura: INCIDENCE TABLE 9-C Total Number of Cancer Cases by Age, Sex and Race Age Group All Cases* All Races* White Black All Races* White Black Total 47,740 29,271 26,339 2,694 18,469 16,573 1,782 Under , ,418 1,435 1, ,885 2,439 2, ,446 1, ,186 3,939 3, ,247 1, ,290 5,878 5, ,412 3, ,740 6,075 5, ,665 3, ,570 4,563 4, ,007 2, ,195 2,455 2, ,740 1, ,969 1,085 1, * Includes any unknowns. FIGURE 9-C Stage of Disease at Diagnosis, Percent by Sex and Race Pennsylvania Residents, In Situ Local Regional Distant 40 Percent Number and Percent of Cases Microscopically Confirmed: 9, % Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 87
5 Cancer of the Trachea, Bronchus, Lung, Pleura: MORTALITY TABLE 9-D Number of Deaths, Age-Adjusted Death Rates and Range for 95% Confidence Intervals by Sex, Race and Year, Pennsylvania Residents, All Deaths* All Races* White Black All Races* White Black Year No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/- No. Rate CI+/ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , * Includes any unknowns. NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). FIGURE 9-D Age-Adjusted Death Rates by Sex and Race Pennsylvania Residents, Rate per 100, Year Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 88
6 Cancer of the Trachea, Bronchus, Lung, Pleura: MORTALITY TABLE 9-E Number of Deaths and Average Annual Age-Specific Death Rates by Sex and Race All Deaths* All Races* White Black All Races* White Black Age Group No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate Total* 40, , , , , , , Under , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , * Includes any unknowns. NOTE: Rates are per 100,000 population ( ) for each specified group. FIGURE 9-E Average Annual Age-Specific Death Rates by Sex and Race Rate per 100, Under Age Group Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 89
7 Cancer of the Trachea, Bronchus, Lung, Pleura: INCIDENCE TABLE 9-F Number of Cases, Average Annual Age-Adjusted Incidence Rates and Range for 95% Confidence Intervals by County and Sex, Total Total County Cases No. Rate CI+/- No. Rate CI+/- County Cases No. Rate CI+/- No. Rate CI+/- All Counties 47,740 29, , Adams Juniata Allegheny 6,531 3, , Lackawanna Armstrong Lancaster 1, Beaver Lawrence Bedford Lebanon Berks 1, Lehigh Blair Luzerne 1, Bradford Lycoming Bucks 1,872 1, McKean Butler Mercer Cambria Mifflin Cameron Monroe Carbon Montgomery 2,586 1, , Centre Montour Chester 1, Northampton Clarion Northumberland Clearfield Perry Clinton Philadelphia 7,602 4, , Columbia Pike Crawford Potter Cumberland Schuylkill Dauphin Snyder Delaware 2,304 1, Somerset Elk Sullivan Erie Susquehanna Fayette Tioga Forest Union Franklin Venango Fulton Warren Greene Washington Huntingdon Wayne Indiana Westmoreland 1,653 1, Jefferson Wyoming York 1, NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 90
8 Cancer of the Trachea, Bronchus, Lung, Pleura: MORTALITY TABLE 9-G Number of Deaths, Average Annual Age-Adjusted Death Rates and Range for 95% Confidence Intervals By County and Sex, Total Total County Deaths No. Rate CI+/- No. Rate CI+/- County Deaths No. Rate CI+/- No. Rate CI+/- All Counties 40,350 24, , Adams Juniata Allegheny 5,535 3, , Lackawanna Armstrong Lancaster 1, Beaver Lawrence Bedford Lebanon Berks 1, Lehigh Blair Luzerne 1, Bradford Lycoming Bucks 1, McKean Butler Mercer Cambria Mifflin Cameron Monroe Carbon Montgomery 2,062 1, Centre Montour Chester 1, Northampton Clarion Northumberland Clearfield Perry Clinton Philadelphia 6,405 3, , Columbia Pike Crawford Potter Cumberland Schuylkill Dauphin Snyder Delaware 2,024 1, Somerset Elk Sullivan Erie Susquehanna Fayette Tioga Forest Union Franklin Venango Fulton Warren Greene Washington Huntingdon Wayne Indiana Westmoreland 1, Jefferson Wyoming York NOTES: Age-adjusted rates are per 100,000 and are computed by the direct method using the 1970 U.S. standard million population. Rates based on less than 20 events are considered statistically unreliable. The value of CI+/- added to and subtracted from the age-adjusted rate = 95% confidence interval. The value of CI+/- was calculated using a formula for estimating the standard error or SE (see Technical Notes). Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 91
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