declining death rates reflect progress against cancer对癌症死亡率下降反映了进步.pdfVIP

Declining Death Rates Reflect Progress against Cancer 1 1 2 Ahmedin Jemal *, Elizabeth Ward , Michael Thun 1 Surveillance and Health Policy Research, American Cancer Society, Atlanta, Georgia, United States of America, 2 Epidemiology Department, American Cancer Society, Atlanta, Georgia, United States of America Abstract Background: The success of the ‘‘war on cancer’’ initiated in 1971 continues to be debated, with trends in cancer mortality variably presented as evidence of progress or failure. We examined temporal trends in death rates from all-cancer and the 19 most common cancers in the United States from 1970–2006. Methodology/Principal Findings: We analyzed trends in age-standardized death rates (per 100,000) for all cancers combined, the four most common cancers, and 15 other sites from 1970–2006 in the United States using joinpoint regression model. The age-standardized death rate for all-cancers combined in men increased from 249.3 in 1970 to 279.8 in 1990, and then decreased to 221.1 in 2006, yielding a net decline of 21% and 11% from the 1990 and 1970 rates, respectively. Similarly, the all-cancer death rate in women increased from 163.0 in 1970 to 175.3 in 1991 and then decreased to 153.7 in 2006, a net decline of 12% and 6% from the 1991 and 1970 rates, respectively. These decreases since 1990/91 translate to preventing of 561,400 cancer deaths in men and 205,700 deaths in women. The decrease in death rates from all- cancers involved all ages and racial/ethnic groups. Death rates decreased for 15 of the 19 cancer sites, including the four major cancers, with lung, colorectum and prostate cancers in men and breast and colorectum cancers in women. Conclusions/Significance: Progress in reducing cancer death rates