Memoranda and "Economic Empowerment"

              CONTENTS
Cancer: Basic Facts 1
Selected Cancers 8
Racial and Ethnic Patterns   18
Tobacco Use 23
Nutrition and Diet    27
Environmental Cancer Risks 28
The American Cancer Society 30
Sources of Statistics
Cancer Deaths. The estimated numbers of US cancer deaths are
calculated by fitting the numbers of cancer deaths for 1979 through
1993 to a statistical model which forecasts the numbers of deaths
that are expected to occur in 1997. The estimated numbers of cancer
deaths for each state are calculated similarly, using state level data.
For both the US and state estimates, data on the numbers of deaths
are obtained from the National Center for Health Statistics (NCHS)
at the Centers for Disease Control and Prevention.
We discourage the use of our estimates to track year-to-year
changes in cancer deaths because the numbers can vary considerably
from year to year, particularly for less common cancers and for
smaller states. Mortality rates reported by NCHS are generally more
informative statistics to use when tracking cancer trends.
Mortality Rates. Mortality rates or death rates are defined as the
number of people per 100,000 dying of a disease during a given year.
In this publication, mortality rates are based on counts of cancer
deaths compiled by NCHS and population data collected by the US
Bureau of the Census.
New Cancer Cases. The estimated numbers of new US cancer cases
are calculated by estimating the numbers of cancer cases that
occurred each year for 1979 through 1993 and fitting these estimates
to a statistical model which forecasts the numbers of cases that are
expected to occur in 1997. Estimates of the numbers of cancer cases
for 1979 through 1993 are used rather than actual case counts
because cancer information is not available for all 50 states. The
estimated numbers of cases for 1979 through 1993 are calculated
using cancer incidence rates from the selected regions of the United
States included in the National Cancer Institute's Surveillance,
Epidemiology, and End Results (SEER) program and population
data collected by the US Bureau of the Census.
State case estimates cannot be calculated using the same modeling
strategy that we use to calculate state death estimates because long-
term data on cancer incidence trends are not available for many
states. Instead, estimates are calculated using data on cancer deaths
occurring in each state for 1993 and US estimates of new cancer
cases for 1997.
Like the method used to calculate death estimates, the modeling
strategy we use to calculate US and state new case estimates can
produce estimates which vary considerably from year to year, particularly for less common cancers and for smaller states. For this reason,
we discourage the use of our estimates to track year-to-year changes
in cancer occurrence. Incidence rates reported by SEER are generally
more informative statistics to use when tracking cancer incidence
trends for the total United States, and rates from state cancer
registries are useful for tracking local trends.
Incidence Rates. Incidence rates are defined as the number of people
per 100,000 who develop disease during a given time period. For this
publication, incidence rates were calculated using data on cancer
cases obtained from the SEER program and population data
collected by the US Bureau of the Census.
Survival. Five-year relative survival rates are presented in this report
for cancer patients diagnosed between 1986 and 1992 and followed
up through 1993. To adjust for normal life expectancy (factors such
as dying of heart disease, accidents, and diseases of old age), these
rates are calculated by dividing 5-year survival rates for cancer
patients by 5-year survival rates for people in the general population
who are similar to the patient group with respect to age, gender, race,
and calendar year of observation. All survival statistics presented in
this publication were originally published in the SEER Cancer
Statistics Review, 1973-1993.
Five-year relative survival rates have several limitations. While they
are reasonable indicators of the average survival experience of cancer
patients in the United States, they are less useful in predicting
survival for individual cancer patients. Although the rates presented
are based on the most recent information available, they include data
from patients whose treatment was state-of-the art at least 8 years
ago and therefore may not reflect the most recent treatment
advances.
Probability of Developing Cancer. Probabilities of developing cancer
are calculated using statistical modeling techniques developed by
the National Cancer Institute's Applied Research Branch. These
probabilities reflect the average experience of people in the United
States and do not take into account individual behaviors and risk
factors. For example, the estimated 1 in 12 women likely to develop
lung cancer is a low estimate for smokers and a high estimate for
nonsmokers.
Additional Information. More detailed information on the methods
used to generate the statistics for this report can be found in the
following publications:
A. For information on data collection methods used by the National
Center for Health Statistics: National Center for Health Statistics.
Vital Statistics of the United States, 1993, Vol II, Mortality, Part A.
Washington: Public Health Service. 1996.
B. For information on data collection methods used by the National
Cancer Institute's Surveillance, Epidemiology and End Results
Program: Ries LAG, Kosary CL, Hankey BF, et al (eds.): SEER
Cancer Statistic Review, 1973-1993: Tables and Graphs. National
Cancer Institute. NIH Publication No. 96-2789. Bethesda, MD,
1996.
C. For information on the methods used to estimate of the numbers
of new cancer cases and deaths for 1997: Parker SL, Tong T, Bolden
S, Wingo PA. Cancer statistics 1996. CA 1996; 46:5-27.
D. For information on the methods used to calculate the probability
of developing cancer: Feuer EJ, Wun L-M, Boring CC et al. The
lifetime risk of developing breast cancer. JNCI1993; 85:892-897.
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