Cancer incidence and mortality trends among whites in the United States, 1947-84.

Cancer incidence trends from the late 1940s to 1983-84 were assessed among white residents of five geographic areas (Atlanta, Connecticut, Detroit, Iowa, San Francisco-Oakland) by means of data derived from several National Cancer Institute surveys, the Connecticut Tumor Registry, and the Surveillance, Epidemiology, and End Results Program. Incidence trends were compared with mortality trends for the entire United States and for the same five study areas. This study documented rising incidence and mortality rates for four cancers: lung cancer, melanoma of the skin, multiple myeloma, and non-Hodgkin's lymphomas. Increases in lung cancer continued through the early 1980s, but the rate of increase has been moderating during recent years, particularly among males and at younger ages for whom recent declines are evident. Overall, lung cancer incidence rates increased more than 220 and 400% among males and females, respectively. Although much rarer than lung cancer, melanoma of the skin and multiple myeloma increased greatly until the early 1980s among both males and females. The overall rate of increase in melanoma incidence among males was greater than that for lung cancer, and the rate of increase in multiple myeloma mortality among females was exceeded only by that for lung cancer. Increases of 70-120% were observed for non-Hodgkin's lymphomas. Increases in incidence and mortality rates for pancreatic cancer were apparent during the early years but less conspicuous in recent years. Laryngeal and kidney cancer rates generally increased substantially, although the changes were not remarkable for laryngeal cancer mortality among males and kidney cancer mortality among females. The rates for cancers of the mouth and pharynx increased among females but not males. Prostate, colon, and bladder cancer incidence rates increased more than 65% among males, whereas mortality rates changed only moderately. The incidence of thyroid cancer increased more than 75% among both sexes until the late 1970s, but mortality rates have declined during the period of study. Breast cancer incidence increased 30%, whereas mortality rates remained remarkably constant. The incidence of corpus uteri cancer increased dramatically during the mid-1970s and decreased substantially thereafter; these changes were not reflected in the mortality rates, which continually declined during the entire time period. The incidence of testicular cancer increased more than 90% and that of Hodgkin's disease did not change greatly; however, mortality rates for both cancers declined more than 50% since the late 1960s and early 1970s.(ABSTRACT TRUNCATED AT 400 WORDS)

Patterns of nasopharyngeal cancer mortality in the United States.

We examined the geographic pattern of nasopharyngeal cancer (NP cancer) mortality in the United States using economic sub-regions (ESRs) as the basis for analysis. The distribution of 15,145 deaths from NP cancer over the years 1950-1979 revealed clustering in the 119 ESRs that was not detected in analyses of distribution by the 48 states, 506 state economic areas or 3,056 counties or combinations of counties of the coterminous United States. NP cancer mortality among white males was concentrated on the south-east Atlantic and Gulf coasts. This newly described pattern is not due to any recent changes in mortality rates and should provide leads to further epidemiologic study.

Cancer mortality and radioactive fallout in southwestern Utah.

Cancer mortality was compared between a three-county region in southwestern Utah and the remainder of Utah in an investigation of reported excess cancer risks associated with residence in southwestern Utah during the period of above-ground nuclear tests at the Nevada Test Site. Because most of the fallout in southwestern Utah was deposited during 1953-1957, comparisons were limited to persons born before 1958, and deaths from leukemia and bone cancer during 1955-1980 and from other cancers during 1964-1980. There was no excess risk of cancer mortality in southwestern Utah, for single or grouped sites, with the single exception of leukemia which showed statistically significant odds ratios of 1.45 based on 62 deaths at all ages, and 2.84 based on nine deaths at ages 0-14. The finding for childhood leukemia was based on different time periods and geographic comparisons from those of two earlier studies in which no such excess was found. Mortality from all cancer sites combined was significantly lower in southwestern Utah than in the remainder of the state, even after adjustment for the higher proportion of (lower risk) Mormons in southwestern Utah. The present results, including the positive association for leukemia, are inconsistent with the high excess risks reported by Johnson (JAMA 1984;251:230-6) based on an interview survey of cancer incidence among long-term Mormon residents of southwestern Utah.

Burkitt's lymphoma in the USA: cases reported to the American Burkitt Lymphoma Registry compared with population-based incidence and mortality data.

Since 1971, the American Burkitt Lymphoma Registry (ABLR) has been collecting clinical, epidemiological and laboratory data on patients with Burkitt's lymphoma (BL) diagnosed in the USA. Although the 256 confirmed ABLR cases have the advantage of uniform pathological review, the ABLR is a relatively 'passive' registry, with the majority of cases being submitted by interested physicians. To determine the pattern of BL in the USA on a population basis, we analysed incidence and survival data from the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute (NCI) and mortality data from the National Center for Health Statistics (NCHS). Both SEER and NCHS data demonstrated a more marked predominance of BL in young males than had been found in the ABLR. All three sources of data revealed a broad age spectrum and a relative paucity of cases in the non-white US population. SEER data indicate that the overall incidence of BL in the USA was 1.4 per million for white males and 0.4 per million for white females during 1973-1981. The incidence rate for white males increased over time, perhaps owing to improvements in diagnosis and reporting.

Decline in US childhood cancer mortality. 1950 through 1980.

Cancer mortality among children in the United States, 1950 through 1979, as evaluated by death certificate diagnoses, revealed dramatic declines primarily in the second half of the 30-year interval. The numbers of deaths of persons younger than 15 years, 1965 through 1979, as compared with the number expected at 1950 rates, fell 50% for leukemia, 32% for non-Hodgkin's lymphoma, 80% for Hodgkin's disease, 50% for bone sarcoma, 68% for kidney cancer, and 31% for all other cancer. There were 17,411 fewer deaths from childhood cancer from 1965 through 1979 than expected at the 1950 rate. Leukemia mortality declined by 8,073 deaths and kidney tumor mortality by 2,393. In data subsequently received for 1980, the decline in rates persisted for leukemia and non-Hodgkin's lymphoma, but the rates for the other four cancer categories seem to have reached a plateau. The reduction in mortality is attributed to improved therapy.

Childhood leukemia and fallout from the Nevada nuclear tests.

Cancer mortality data from the National Center for Health Statistics, covering the period 1950 through 1978, were used to test a reported association between childhood leukemia and exposure to radioactive fallout from nuclear weapons tests in Nevada between 1951 and 1958. No pattern of temporal and geographic variation in risk supportive of the reported association was found. Comparison of these results with those presented in support of an association of risk with fallout suggests that the purported association merely reflects an anomalously low leukemia rate in southern Utah during the period 1944 to 1949.

Three-dimensional perspective of U.S. cancer mortality.

Data from U.S. death certificates, 1950--77, can now be displayed as computer-generated three-dimensional graphs. The results provide a panoramic view of the rise and fall in cancer rates by age, sex, and calendar year for Whites and non-Whites. Sample graphs depict the rising rates for lung cancer, the falling rates for stomach cancer, the relatively constant rates for breast cancer, and the dramatic change in rates for childhood leukaemia.

Geographic patterns of large bowel cancer in the United States.

Age-adjusted rates of mortality from colon and rectal cancer during 1950-69 were correlated by sex and race (white and nonwhite) with demographic data for the 3,056 counties of the contiguous United States. Mortality was consistently elevated in counties with large populations, higher income and education levels, and high percentages of residents of Irish, German, or Czechoslovak descent. The urban, socioeconomic, and, ethnic factors were each linked to large bowel cancer, but they only partly explained the predominance of this tumor in the Northern United States. A survey was made of the limited data available on dietary habits by region and on alcohol sales by county, but the concomitant variation with bowel cancer mortality rates was not impressive.

Fluoridated drinking water and the occurrence of cancer.

A recent report by the National Health Federation, a private agency, related cancer mortality patterns in the United States to fluoridation of water supplies, triggering much public health concern and some political response. To clarify the issues raised, we studied cancer mortality and incidence statistics for U.S. counties, 1950-69. No trends could be ascribed to the consumption of water that is artificially or naturally fluoridated.

Cancer by county: new resource for etiologic clues.

Mapping of U. S. cancer mortality by county has revealed patterns of etiologic significance. The patterns for bladder cancer in males point to industrial determinants: some are known (chemical manufacturing) but others (automobile and machinery manufacturing) represent new leads for epidemiologic study. By contrast, the geographic clusters of high rates of stomach cancer in both sexes are consistent with ethnic susceptibility.