Showing papers by "American Cancer Society published in 1999"

Global cancer statistics

Abstract: The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Based on the GLOBOCAN 2008 estimates, about 12.7 million cancer cases and 7.6 million cancer deaths are estimated to have occurred in 2008; of these, 56% of the cases and 64% of the deaths occurred in the economically developing world. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Lung cancer is the leading cancer site in males, comprising 17% of the total new cancer cases and 23% of the total cancer deaths. Breast cancer is now also the leading cause of cancer death among females in economically developing countries, a shift from the previous decade during which the most common cause of cancer death was cervical cancer. Further, the mortality burden for lung cancer among females in developing countries is as high as the burden for cervical cancer, with each accounting for 11% of the total female cancer deaths. Although overall cancer incidence rates in the developing world are half those seen in the developed world in both sexes, the overall cancer mortality rates are generally similar. Cancer survival tends to be poorer in developing countries, most likely because of a combination of a late stage at diagnosis and limited access to timely and standard treatment. A substantial proportion of the worldwide burden of cancer could be prevented through the application of existing cancer control knowledge and by implementing programs for tobacco control, vaccination (for liver and cervical cancers), and early detection and treatment, as well as public health campaigns promoting physical activity and a healthier dietary intake. Clinicians, public health professionals, and policy makers can play an active role in accelerating the application of such interventions globally.

Body-Mass Index and Mortality in a Prospective Cohort of U.S. Adults

Abstract: Background Body-mass index (the weight in kilograms divided by the square of the height in meters) is known to be associated with overall mortality. We investigated the effects of age, race, sex, smoking status, and history of disease on the relation between body-mass index and mortality. Methods In a prospective study of more than 1 million adults in the United States (457,785 men and 588,369 women), 201,622 deaths occurred during 14 years of follow-up. We examined the relation between body-mass index and the risk of death from all causes in four subgroups categorized according to smoking status and history of disease. In healthy people who had never smoked, we further examined whether the relation varied according to race, cause of death, or age. The relative risk was used to assess the relation between mortality and body-mass index. Results The association between body-mass index and the risk of death was substantially modified by smoking status and the presence of disease. In healthy people who had ne...

Cancer statistics, 1999.

Abstract: The Surveillance Research Program of the American Cancer Society's Department of Epidemiology and Surveillance Research reports its 33rd annual compilation of cancer frequency, incidence, mortality, and survival data for the United States.

Annual Report to the Nation on the Status of Cancer, 1973-1996, With a Special Section on Lung Cancer and Tobacco Smoking

Abstract: Background The American Cancer Society, the National Cancer Institute (NCI), and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS), provide the second annual report to the nation on progress in cancer prevention and control, with a special section on lung cancer and tobacco smoking. Methods Age-adjusted rates (using the 1970 U.S. standard population) were based on cancer incidence data from NCI and underlying cause of death data compiled by NCHS. The prevalence of tobacco use was derived from CDC surveys. Reported P values are two-sided. Results From 1990 through 1996, cancer incidence (-0.9% per year; P = .16) and cancer death (-0.6% per year; P = .001) rates for all sites combined decreased. Among the 10 leading cancer incidence sites, statistically significant decreases in incidence rates were seen in males for leukemia and cancers of the lung, colon/rectum, urinary bladder, and oral cavity and pharynx. Except for lung cancer, incidence rates for these cancers also declined in females. Among the 10 leading cancer mortality sites, statistically significant decreases in cancer death rates were seen for cancers of the male lung, female breast, the prostate, male pancreas, and male brain and, for both sexes, cancers of the colon/rectum and stomach. Age-specific analyses of lung cancer revealed that rates in males first declined at younger ages and then for each older age group successively over time; rates in females appeared to be in the early stages of following the same pattern, with rates decreasing for women aged 40-59 years. Conclusions The declines in cancer incidence and death rates, particularly for lung cancer, are encouraging. However, unless recent upward trends in smoking among adolescents can be reversed, the lung cancer rates that are currently declining in the United States may rise again.

Prospective Study of Intentional Weight Loss and Mortality in Overweight White Men Aged 40–64 Years

Abstract: Although 25% of US men indicate that they are trying to lose weight, the association between intentional weight loss and longevity in men is unknown. The authors analyzed prospective data from 49,337 overweight (initial body mass index > or =27) white men aged 40-64 years who, in 1959-1960, answered questions on weight change direction, amount, time interval, and intent. Vital status was determined in 1972. Proportional hazards regression estimated mortality rate ratios for men who intentionally lost weight compared with men with no weight change. Analyses were stratified by health status and adjusted for age, initial body mass index, smoking status, alcohol intake, education, physical activity, health history, and physical symptoms. Among men with no reported health conditions (n = 36,280), intentional weight loss was not associated with total, cardiovascular (CVD), or cancer mortality, but diabetes-associated mortality was increased 48% (95% confidence interval (CI) -7% to +133%) among those who lost 20 pounds (9.1 kg) or more; this increase was largely related to non-CVD mortality. Among men with reported health conditions (n = 13,057), intentional weight loss had no association with total or CVD mortality, but cancer mortality increased 25% (95% confidence interval -4% to +63%) among those who lost 20 pounds or more. Diabetes-associated mortality was reduced 32% (95% confidence interval -52% to -5%) among those who lost less than 20 pounds and 36% (95% confidence interval -49% to -20%) among those who lost more than 20 pounds. These results and those from our earlier study in women (Williamson et al., Am J Epidemiol 1995;141:1128-41) suggest that intentional weight loss may reduce the risk of dying from diabetes, but not from CVD. In observational studies, however, it is difficult to separate intentional weight loss from unintentional weight loss due to undiagnosed, underlying disease. Well-designed observational studies, as well as randomized controlled trials, are needed to determine whether intentional weight loss reduces CVD mortality.

“I TAKE CARE OF MY KIDS”: Mothering Practices of Substance-Abusing Women

Abstract: This article examines 17 substance-abusing women's perceptions of their mothering practices in the context of a residential substance-abuse treatment program for women with children and pregnant women. Using in-depth semistructured interviews and observations of treatment groups, the participants' cultural knowledge about mothering is explored. Although the women in this study described how their substance-abusing lifestyle had a negative impact on their children, they also detailed practices that illustrated that they felt capable as parents. The women were silent about how race, gender, or class arrangements affected their lives; their stories, however, showed active avoidance and manipulation of the contemporary ideology of mothering.

Reintegration after bone marrow transplantation.

Abstract: objectives: This study examines the problems of bone marrow transplantation (BMT) survivors in returning to “normal” life in the community after BMT. materials and methods: Before being released from The Johns Hopkins Oncology Center, 84 recipients of BMT were interviewed regarding their quality of life and psychosocial adaptation. Survivors were reinterviewed at 6 months, and at 1 year post-BMT, producing considerable qualitative data regarding their problems in living. Eighty-four patients who had received BMT completed qualitative interviews and standardized measures before treatment, before the return home, and at 6 and 12 months post-BMT. The interviews were subjected to a content analysis methodology to establish units and categories to examine the body of material. results: Content analysis of these interviews from the first year after BMT identified three areas of psychosocial morbidity: 1) physical problems, which included fatigue, appearance, troubles in eating, and physical restrictions; 2) psychological problems, which included fears about the future, sense of loss of control, anxiety, and depression; and 3) community reintegration problems, which included difficulty in returning to former social roles, separation from home, family, and friends, difficulty in resuming social relations, dealing with stigmatization, problems with family and children, and financial and employment difficulties. conclusions: Identification of these problems for BMT survivors can be used to guide the development of specific materials and services to prepare recipients of BMTs and their families for life after the transplant. These qualitative results can also be used to direct the development of assessment tools to identify potential patient and family problems.

Epidemiologic studies of fatal and nonfatal cardiovascular disease and ETS exposure from spousal smoking.

Abstract: This article reviews the epidemiologic studies of the association of ischemic heart disease risk and environmental tobacco smoke (ETS) exposure from a spouse who smokes. Seventeen studies (nine coh...

The American Cancer Society challenge goals. How far can cancer rates decline in the U.S. by the year 2015

Abstract: BACKGROUND Cancer incidence and mortality rates both began to decline in the U. S. in the early 1990s. Recognizing the unprecedented potential benefits of accelerating this decline, the American Cancer Society (ACS) has set ambitious challenge goals for the American public for a 25% reduction in cancer incidence rates and a 50% reduction in cancer mortality rates by the year 2015. This analysis examined the feasibility of reaching those goals by estimating future changes in cancer rates that can result from past and future reductions in cancer risk factors. METHODS Estimates for future declines in cancer risk factors in the U. S. under alternative scenarios were applied to conservative population-attributable risk estimates for cancer incidence and mortality rates in 1990 to estimate cancer rate trends in the year 2015. RESULTS If the current trends toward a decline in the prevalence of cancer risk factors continue over the next decade, by the year 2015 one can expect a 13% decline in cancer incidence rates and a 21% decline in cancer mortality rates below their 1990 levels. With redoubled efforts to reduce the prevalence of known cancer risk factors further, by the year 2015 cancer incidence rates could be reduced by 19% and cancer mortality rates reduced by 29%. Such redoubled efforts would equate to approximately 100,000 cancer cases and 60,000 cancer deaths prevented each year by the year 2015. CONCLUSIONS Past reductions in cancer risk factors in the U.S. population have led to recent declines in the rates of cancer incidence and mortality in the U.S. Redoubled efforts to act on current knowledge regarding how to prevent, detect, and treat cancer can result in attaining approximately 80% of the ACS challenge goal for cancer incidence rates and 60% of the ACS challenge goal for cancer mortality rates by the year 2015. New findings from cancer research are needed and will have to be applied quickly if the ACS challenge goals are to be met fully. Cancer 1999;86:715–27. © 1999 American Cancer Society.

An evaluation of a psychosocial intervention for survivors of childhood cancer: paradoxical effects of response shift over time.

Abstract: This study examined the impact of response shift on a psychosocial treatment evaluation of 22 young adult cancer survivors. An age-matched cohort of 54 healthy controls were included in the study to provide a comparison for normative levels and structure of quality-of-life (QOL). It was found that this evaluation of a psychosocial intervention for young adult cancer survivors was notably influenced by response shift phenomenon. Standard analyses suggested that the intervention had no impact on measured aspects of well-being. It did appear to yield an immediate gain in reported global QOL, but seemed to cause a significant decline over time. By considering response shift, it was highlighted that an apparently deleterious effect on QOL was largely a function of response shift. This response shift effect was reflected not only in changes in internal standards, but also in values and in conceptualization of QOL. The intervention seemed to have normalized survivors’ conceptualization of QOL so that it was increasingly similar to their age-matched cohort. Future psychosocial intervention research should explicitly consider response shift in a randomized treatment evaluation. Copyright © 1999 John Wiley & Sons, Ltd.

Deaths from hematopoietic and other cancers in relation to permanent hair dye use in a large prospective study (United States).

Abstract: Objectives: To assess in a large prospective study whether women who used permanent hair dye, especially dark dye for many years, experienced increased death rates from hematopoietic and other cancers that have been associated with hair dye use in some previous reports. Methods: In 1982, 547,586 women provided information on use of permanent hair dye and other lifestyle factors when enrolled in an American Cancer Society (ACS) prospective study. We extended mortality follow-up from 7 to 12 years. Using Cox proportional hazards modeling we compared death rates from hematopoietic and other cancers among women according to their hair dye use at baseline with death rates in unexposed women. Results: The adjusted death rate from all cancers combined was marginally lower among women who ever used hair dye than nonusers (relative risk [RR] = 0.9; 95% confidence interval [CI] = 0.9–1.0). Mortality from all hematopoietic cancers was marginally higher among users than nonusers (RR = 1.1; CI = 1.0–1.2), and increased with an index that combined duration of use and darker coloration (test of trend p = 0.02). Women who used black or brown dye for 10 or more years experienced somewhat higher death rates from non-Hodgkin's lymphoma and (for black dye only) multiple myeloma. The temporal increase in death rates from non-Hodgkin's lymphoma and multiple myeloma between 1982–88 and 1989–94 was similar for women in our study who never used hair dyes to the increase among all US women. Conclusions: If prolonged use of dark permanent hair dyes contributes to death rates from non-Hodgkin's lymphoma and multiple myeloma, then the increase is small and difficult to detect reliably even in large prospective studies. The use of permanent hair dye is unlikely to be a major contributor to the temporal rise in non-Hodgkin's lymphoma and multiple myeloma in the US.

Mutational activation of K-ras in nonneoplastic exocrine pancreatic lesions in relation to cigarette smoking status.

Abstract: BACKGROUND Cigarette smoking is among the few unequivocal risk factors for the development of pancreatic ductal adenocarcinoma (PDAC). Activating mutations in codon 12 of the K-ras protooncogene is a frequent and early molecular event in the pathogenesis of PDAC and a variety of nonmalignant ductal pancreatic lesions. The molecular epidemiologic relation between heavy cigarette smoking and mutational activation of K-ras in PDAC has been examined to a limited extent. The authors have examined the mutational status of K-ras in nonneoplastic pancreata in relation to cigarette smoking status. METHODS Archival formalin fixed paraffin embedded specimens of nonneoplastic pancreata (n = 39) were obtained from the American Cancer Society and evaluated histopathologically. Specimens from age- and gender-matched individuals were stratified into three groups: 1) those who never smoked cigarettes (n = 16), 2) those who smoked 1–2 packs/day for more than 20 years (n = 10 cases), and 3) those who smoked more than 2 packs/day for 20 or more years (n = 13). Cases were preselected from 77 specimens based on the quality, suitability, and cellularity of the archival tissues for analyses. Furthermore, none of the patients died of primary PDAC or had evidence of pancreatic metastases from an extrapancreatic primary tumor. Tissue sections were microdissected and deparaffinized, and genomic DNA was purified by standard proteinase K-phenol-chloroform extraction techniques. Genomic DNA was analyzed for mutations in codon 12 of the K-ras protooncogene by two mutant-allele-enriched polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) assays and by multiplex PCR-based ligase chain reaction (LCR) analyses. RESULTS Analyses of multiple microdissected pancreata specimens from 39 cases revealed wild-type K-ras codon 12 sequences in both nonsmoking individuals and those who smoked 1–2 packs/day for 20 or more years. K-ras codon 12 mutations were confirmed by PCR-RFLP and PCR-LCR assays in 5 of 13 pancreata cases (39%) obtained from individuals who smoked more than 2 packs of cigarettes/day for 20 years or more (P < 0.005). The K-ras mutation spectra revealed two GT transversions, one GC transversion and two GA transitions. There was no clear relation between the incidence or spectra of mutations and pancreatic histopathology, as overtly normal pancreata as well as pancreata with squamous metaplasia, periductal fibrosis, and ductal atypia revealed reproducible K-ras alterations. Similarly, among those 34 cases in which a wild-type K-ras sequence was revealed by both approaches, a similar histopathologic profile was evident. CONCLUSIONS Mutational activation of codon 12 of the K-ras protooncogene was confirmed reproducibly by mutant allele-enriched PCR-RFLP and multiplex PCR-LCR analyses in 39% (5 of 13) of archival nonneoplastic pancreata from age- and gender-matched individuals who smoked more than 2 packs of cigarettes/day for 20 or more years. The presence of a mutated or wild-type or K-ras was independent of the histopathologic profile of the 39 cases examined. The data provide further suggestive molecular epidemiologic evidence of an association between a major and unequivocal risk factor for PDAC (heavy cigarette smoking) and mutations in a molecular target (K-ras), the activation of which is an important and early event Cancer 1999;85:326–32. © 1999 American Cancer Society.

Clinical highlights from the National Cancer Data Base, 1999.

Abstract: The National Cancer Data Base (NCDB), a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society, collects and analyzes data from a wide variety of sources throughout the United States, including small community hospitals. Due to this unique reporting system, individual facilities can compare their own data with the aggregate data from the NCDB, using their findings to evaluate local patient care practices. This article highlights the principal findings of the NCDB and Patient Care Evaluation articles published in 1998 on breast, prostate, cervical, endometrial, gallbladder, head and neck, nasopharyngeal, rectal, thyroid, and vaginal cancers, as well as on melanoma, brain tumors, and Hodgkin's disease. With more than five million cancer cases in the NCDB for the years between 1985 and 1995, sufficient numbers of even rare cancers have been accrued to permit some types of epidemiologic and clinical assessments.

Cigar smoking and death from coronary heart disease in a prospective study of US men.

Abstract: Context The prevalence of cigar smoking has increased rapidly in the United States since 1993. Although cigarette smoking is known to be an important cause of coronary heart disease (CHD) mortality, the relationship between cigar smoking and CHD mortality is unclear. Objective To determine whether cigar smoking increases risk of CHD mortality. Design Prospective cohort study with follow-up for mortality from 1982 through 1991. Setting United States. Participants A total of 121 278 men, aged 30 years and older, in the American Cancer Society's nationwide Cancer Prevention Study II cohort who completed a baseline questionnaire on smoking history and other risk factors in 1982, had never smoked cigarettes or pipes, and had no diagnosed heart disease or diabetes at baseline. Main Outcome Measure Death from CHD recorded as the underlying cause of death on the death certificate. Results There were 2508 deaths from CHD from 1982 through 1991. The association between cigar smoking and death from CHD was stronger among younger men and current rather than former smokers, as is observed with cigarette smoking. No increased risk was observed among current cigar smokers aged 75 years or older, or for former cigar smokers of any age. For men younger than 75 years who were current cigar smokers at baseline, the adjusted rate ratio for CHD mortality was 1.30 (95% confidence interval, 1.05-1.62). Conclusions These results suggest that smoking cigars increases risk of early death from CHD. Any adverse effect of cigars on CHD is of particular importance given the rapidly rising prevalence of cigar smoking in the United States.

Patients' psychosocial concerns following stem cell transplantation.

Abstract: Information regarding the nature, frequency, correlates and temporal trajectory of concerns of stem cell transplantation (SCT) recipients is critical to the development of interventions to enhance quality of life (QOL) in these individuals. This study examined psychosocial concerns in 110 SCT (87% autologous) recipients drawn from two SCT centers. Participants were a mean of 46 years of age and 17 months post-SCT (range 3–62 months). Information regarding current and past SCT-related concerns, performance status, and demographic characteristics was collected by telephone interview or questionnaire. Recipients reported a wide variety of psychosocial concerns following SCT. Recipients who were younger, female and evidenced a poorer performance status reported a larger number of post-SCT concerns. Examination of the temporal trajectory of concerns suggests that some concerns are salient throughout the course of post-SCT recovery (eg disease recurrence, energy level, ‘returning to normal’), some are salient early in the course of recovery (eg quality of medical care, overprotectiveness by others), and others emerge later in the course of recovery (eg feeling tense or anxious, sexual life, sleep, relationship with spouse/partner, ability to be affectionate). Implications for the development of interventions to enhance post-SCT QOL are identified.

U.S. cancer incidence, mortality and survival: 1973-1996.

Abstract: Earlier predictions of morbidity and mortality improvements for the four leading sites of cancer are beginning to occur. After decades of increases, incidence and mortality rates for all cancers combined have declined since 1992. Between 1990 and 1996 the age-adjusted death rates for all cancers had dropped 3.7 percent to 166.9 per 100,000 and incidence rates had decreased 2.8 percent to 388.6. The overall decreases were greater among men than women; male mortality rates dropped 6.2 percent and incidence dropped 5.2 percent for men versus 1.8 and 1.9 percent, respectively, for women. Lung cancer incidence among men continued its more than 10-year decline in age-adjusted rates and mortality rates dropped for a fifth consecutive year to 68.2 per 100,000 population. Among women, lung cancer incidence rates began to plateau in the mid-1990s similar to the pattern experienced by men a decade earlier. The rates of prostate cancer have begun to decrease but remain 65 to 75 percent higher among black men than white. Mortality rates dropped 9.5 percent among white men but only 2.0 percent among blacks since 1990. By 1996 even breast cancer death rates were declining ahead of the predicted decrease by the end of the century. Mortality rates for all women combined was 24.3 per 100,000 population, 24.0 for white women and 30.8 for blacks, 11.3, 12.1 and 2.5 percent, respectively lower than in 1990. The previously noted decreases in colorectal cancer mortality and incidence continue with age-adjusted rates dropping to 16.8 and 42.7 per 100,000 population, respectively, in 1996.

Cancer statistics, 1999: challenges in minority populations.

Abstract: 6 Ca—A cancer Journal for Clinicians Each year for more than two decades, the American Cancer Society’s Department of Epidemiology and Surveillance Research has provided an up-to-date perspective on the occurrence of cancer in the United States through publication of a series of articles in CA titled “Cancer Statistics.” The tradition continues in this issue .1 In 1999, Landis et al estimate that about 1,221,800 new cases of invasive cancer will be diagnosed in the US.1 Although this seems like a large number, there is an apparent overall downward trend in cancer incidence rates. The incidence rates of breast cancer in young women and lung cancer in men are down, as are those of colon and rectal cancer in both men and women. It is important to note that this 1.2 million estimate does not include more than 1 million cases of basal and squamous cell cancer of the skin (the most prevalent of all human cancers) or carcinoma in situ of sites other than the urinary bladder. Although these underreported cancers are not often fatal in humans, medical management is associated with considerable morbidity and adds tremendously to the ever-increasing cost of medical care. In 1999 an estimated 563,100 US citizens are expected to die of cancer.1 US cancer death rates are declining in all major sites. At first glance, these new figures on incidence and mortality are comforting and speak well for our increasing efforts in cancer control. A closer look reveals these successes have taken place mainly in the majority community. Among major ethnic groups, African Americans continue to have higher incidence rates of cancer, with 445.8 cancers per 100,000 population.1 They are also at greater risk of dying of cancer than is any other racial or ethnic group, with a mortality rate of 224.8 per 100,000. On a more poignant note, we need only look at the record in two major cancer sites. Although African-American women are less likely to develop breast cancer than are white women, the rate of African-American women dying of breast cancer is greater. Also, AfricanAmerican men are 1.5 times more likely to develop prostate cancer than are white men and twice as likely to die of the disease. Rather than being encouraging, these new figures from “Cancer Statistics, 1999” are quite disconcerting. Cancer incidence and mortality of the magnitude experienced by African Americans and other underserved populations pose a Dr. McDonald is President of the American Cancer Society; Professor of Medical Science and Chairman, Department of Dermatology, Brown University; and Physician-in-Chief, Department of Dermatology, Rhode Island Hospital, Providence, RI.

Dietary change and cancer prevention: What don't we know and when didn't we know it?

Abstract: We have arrived at a watershed in cancer prevention and control. After two decades of increases, US cancer incidence rates (for all sites combined) decreased an average of 0.7% per year (p>0.05), and cancer mortality rates (for all sites combined) decreased an average of 0.5% per year between 1990 and 1995 (p<0.05). Death rates and incidence rates decreased for three of the four major cancers, i.e., lung, prostate, and colorectal cancers. And for female breast cancer, incidence rates stopped increasing and leveled off from 1990 to 1995, while the death rate decreased significantly.1 These trends are variously due to a mix of interventions relating to cancer risk factors, most notably tobacco control, screening, treatment, and access to advanced cancer care across the entire spectrum of site-specific cancers. Although decreasing mortality rates might be attributable to the slew of interventions outlined above, declines in incidence are related exclusively to individual and population-wide efforts to reduce, if not entirely eliminate, the more common risk factors in the genesis of cancer.

Comments on the importance of diet and nutrition in cancer prevention and the role of the 2nd international science symposium on tea and human health

Abstract: The American Cancer Society was honored to serve with the American Heart Association and the American Health Foundation, as a cosponsor of The 2nd International Scientific Symposium on Tea and Human Health held September 14—15, 1998, at the United States Department of Agriculture, Washington, DC. The American Cancer Society hopes that symposia such as this will identify progress in research that contributes to an understanding of the benefits diet and nutrition can provide in cancer control and prevention. The 2nd International Tea Symposium provided both a timely and informative assessment of current research concerning the beneficial impact of tea consumption on human health. As the articles presented here demonstrate, significant advances have been made in our knowledge of tea. Chief among these advances are studies providing fundamental biochemical information about tea, which supports a further expansion of research into its health benefits. Examples include: 1) the identification of new cell functio...