Current Trends Decrease in Lung Cancer Incidence among Males --
United States, 1973-1983
Analysis of lung cancer data from the National Cancer
Institute's
Surveillance, Epidemiology, and End Results Program (SEER)* (1)
indicates that the incidence rate of lung cancer for white males
increased at annual rates of up to 10% per year until the 1970s.
In
the early 1980's, the rate of increase slowed, then leveled. This
was
followed by a 4% decrease in rates from 1982 to 1983 (2). It is
estimated that the leveling and subsequent decrease in lung cancer
incidence has resulted in over 7,000 fewer cases in 1983 alone.
This
estimate was developed by fitting an exponential model to the
incidence data for 1973 through 1978 and extrapolating the expected
numbers from the model to 1983.
Both incidence and mortality due to lung cancer have been
decreasing for men under 45 years of age since at least 1973, and
for
men between 45 and 54 years of age, since 1978. For men over 54
years
of age, the rates have leveled. Data for black males show
age-adjusted incidence rates that are approximately 50% higher than
for whites; however, the trends in rates are similar in the two
groups. Lung cancer mortality data for U.S. men have leveled to an
age-adjusted rate of 71.2 in 1983. Mortality rates for black males
have leveled to an age-adjusted rate of 97.3 in 1983. Because
survival from lung cancer is poor, it is expected that decreases in
lung cancer mortality will be noted in the 1984 data.
Lung cancer incidence and mortality rates for females continued
to
increase markedly during the same period. Age-adjusted incidence
and
mortality rates of 32.6 and 24.3, respectively, represented over
41,000 new cases of lung cancer and over 35,000 deaths among U.S.
women in 1983.
Reported by JW Horm, MS, LG Kessler, PhD, Surveillance and
Operations
Research Br, LP Boss, PhD, Cancer Control Applications Br, Div of
Cancer Prevention and Control, National Cancer Insititute.
Editorial Note
Editorial Note: Approximately 15% of all invasive cancers
diagnosed
annually are cancer of the lung, and roughly 149,000 new cases and
130,000 deaths are expected in 1986 (3). It has long been
established
that cigarette smoking is the primary cause of lung cancer in the
United States. The Surgeon General's report on smoking and health,
published in 1964, was followed in 1966 with congressionally
mandated
warning labels on cigarette packages and in advertising. Smoking
prevalence among adult males in the United States decreased from
52%
before the Surgeon General's report to about 35% in 1983. Such
considerable decreases in smoking prevalence have not been observed
among females; the smoking prevalence among women was 34% in 1965
and
29% in 1983 (4,5). Although smoking prevalence rates for women
have
never been as high as those for men, their rate of decline is about
half that for men. Unfortunately, the percentage of smokers who
smoke
25 or more cigarettes per day was 13% in 1965 and 25% in 1980,
suggesting that the bulk of smoking cessation may have been among
lighter smokers. During the 1960s, smokers began to use
filter-tipped
cigarettes and, in the 1970s, low-tar and -nicotine cigarettes (6).
Both the decrease in prevalence and the changing types of
cigarettes
smoked have been suggested as major reasons for declines in
age-specific and age-adjusted lung cancer rates.
Reports from the Surgeon General's Office on the health
consequences of smoking have continued for almost 2 decades and
have
led to formation of policy on smoking reduction as a major element
of
the health promotion and disease prevention objectives for 1990
(7).
Recently, the National Cancer Institute defined cancer prevention
and
control objectives for the year 2000, which include the following
risk-factor reduction objectives: (1) the proportion of adults who
smoke should be reduced to 15% or less; and (2) the proportion of
children and youth aged 12-18 years who smoke should be reduced to
3%
or less. The attainment of these goals will result in more than a
40%
reduction in deaths due to lung cancer than would be expected if
the
current rates of smoking prevalence continue into the next century.
References
Young JL, Jr, Percy CL, Asire AJ, eds. Surveillance,
Epidemiology, and End Results Program: incidence and mortality
data, 1973-1977. Natl Cancer Inst Monogr 1981;57:1-1082.
Horm JW, Kessler LG. Falling rates of lung cancer in men in
the
United States. Lancet 1986;I:425-6.
American Cancer Society. 1986 cancer facts & figures. New
York:
American Cancer Society, 1986:1-32.
Office on Smoking and Health. The health consequences of
smoking:
cancer. A report of the Surgeon General. Rockville, Maryland:
Public Health Service, US Department of Health and Human
Services,
1982. DHHS publication no. (PHS) 82-50179:1-322.
National Center for Health Statistics. Health--United States
1985. Washington, DC: Public Health Service, 1985. DHHS
publication no. (PHS) 86-1232.
Shopland DR, Brown C. Area review: current trends in smoking
control. Ann Behavioral Med 1985;7:5-8.
U.S. Public Health Service. Promoting health/preventing
disease:
objectives for the nation. Washington, DC: 1980:61-5.
*SEER data are monitored routinely for trends in cancer incidence.
SEER incidence data covers the population of the states of
Connecticut, Hawaii, Iowa, New Mexico, and Utah and the
metropolitan
areas of Atlanta, Detroit, San Francisco-Oakland, and Seattle and
represent approximately 10% of the U.S. population.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
