Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer
A Superficial Introduction
Gabor Fichtinger, Queen’s University
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – some definitionsMedical term: malignant neoplasmClass of diseases in which a group of cells display:
• uncontrolled growth (division beyond the normal limits)
• invasion (intrusion on and destruction of adjacent tissues)
• sometimes metastasis (spread to other locations in the body via lymph or blood)
• The above differentiate cancer from non-malignant (benign) growth• Most cancers are solid and form a tumor. • Some, like leukemia, do not. • This course deals mostly solid cancer i.e. tumor.
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – known causes
• Mutation: chemical carcinogens• tobacco smoke, some artificial
sweeteners, some food preservatives…• Mutation: ionizing radiation• Viral or bacterial infection• Hormonal imbalances• Immune system dysfunction• Heredity• Other causes
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancers – in this course
• Prostate• Breast• Gynecological• Liver• Bone / spine• Head and Neck• Brain• Kidney• Leukemia• Lymph nodes
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – known causes
• Mutation: chemical carcinogens• tobacco smoke, some artificial
sweeteners, some food preservatives…• Mutation: ionizing radiation• Viral or bacterial infection• Hormonal imbalances• Immune system dysfunction• Heredity• Other causes
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – diagnosis• Non-invasive:
• Blood serum• Palpation (i.e. feel a lump under your finger)• Imaging (CT, MRI, Ultrasound, PET, SPECT)
• Tissue biopsy• Pathologist – the doctor who examines it• Histology or histopathology – the process• “Pattern classification” problem
• Diagnosis• Staging of the disease• Treatment options…
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer imaging – CTLiver cancer
Kidney cancer Prostate cancer
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer imaging – CT
Glioblastomamultiform
Metastatic brain lesions Metastatic spine cancer
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Cancer imaging – MRI
prostate breast
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer imaging – contrast imaging
Issues:• Toxicity• Uptake• Washout
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer imaging – ultrasoundProstate - TransrectalUltrasound (TRUS)
Liver - Transcutaneous Ultrasound
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer imaging – SPECT
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Biopsy - the tools - ‘cutting’
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Biopsy - the tools - ‘suction’Aspiration for serial semen analyses
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Biopsy - ‘drilling & suction’Bone marrow biopsy needle
Bone biopsy needle
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Biopsy - the tissue (examples)
Primary liver cancer in laparoscopy camera and pathology
Liver mets from testicular (left) and breast cancer (right)
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – Diagnosisspecificity and sensitivity
IDEAL?yes
?BADno
yesno
sensitivity
specificity
Sensitivity = can I see it if it is there?Specificity = can I recognize it if I see it?
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – treatment• Chemotherapy (realm of medical oncology)• Surgery
• Resection• Growth inhibition
•Thermal Ablation•Cryotherapy (freezing)•Injection•Embolization
• Radiation therapy• External beam (EBRT)• Implanted sources (brachytherapy)
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – MIS tools - RFA
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – MIS tools - cryo
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – MIS tools - microwave
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – MIS tools – HIFU needle
P o w e r L e a d W i r e s
C o o l i n g F l o w
T e m p e r a t u r e S e n s o r s
C o n t r o l l e d U l t r a s o u n d
O u t p u t U l t r a s o u n d T r a n s d u c e r s ( T u b u l a r )
O u t e r S u p p o r t S h a f t
I n s e r t i o n T i p
a )
3 Needles + Catheter-cooling
3 ACOUSTTiC™ Needles
coagulation boundary
3 Needles + Catheter
ACOUSTTiC™
Acousticx® Acoustic Medsystems, Inc
0
3
6
9
12
151
2
3
4
5
6
7
8
9
1 0
1 1
1 2
1 3
1 4
1 5
1 6
1 7
1 8
1 9
2 0
2 1
2 2
2 3
2 4
2 5
2 6
2 7
2 8
2 9
3 0
3 1
3 2
3 3
3 4
3 5
3 6
0
3
6
9
12
15 2 3 45
67
891011
1213
1415
16171819
20212223
2425
2627282930
3132
3334 35 36
0
3
6
9
12
15 2 34
56
7
8
9
1
1
12
13
1415
1617182021
2223
24
25
26
7
8
9
30
31
3233
3435 36
270o
sector
0
3
6
9
12
151
2 34
56
7
8
9
10
11
12
1314
1516
1718202122
2324
25
26
27
28
29
30
3132
3334
35 36
R di l D h f
90o
sector200o
sector
360o
sector
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer – HDR brachytherapy
Cancer Statistics 2007A Presentation From the American Cancer Society
©2007, American Cancer Society, Inc.
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
US Mortality, 2004
Source: US Mortality Public Use Data Tape 2004, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.
1. Heart Diseases 652,486 27.2
2. Cancer 553,888 23.1
3. Cerebrovascular diseases 150,074 6.3
4. Chronic lower respiratory diseases 121,987 5.1
5. Accidents (Unintentional injuries) 112,012 4.7
6. Diabetes mellitus 73,138 3.1
7. Alzheimer disease 65,965 2.8
8. Influenza & pneumonia 59,664 2.5
9. Nephritis 42,480 1.8
10. Septicemia 33,373 1.4
Rank Cause of DeathNo. of deaths
% of all deaths
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Change in the US Death Rates* by Cause, 1950 & 2004
* Age-adjusted to 2000 US standard population.Sources: 1950 Mortality Data - CDC/NCHS, NVSS, Mortality Revised.2004 Mortality Data: US Mortality Public Use Data Tape, 2004, NCHS, Centers for Disease Control and Prevention, 2006
19.8
180.7
48.1
586.8
193.9
50.0
185.8217.0
0
100
200
300
400
500
600
HeartDiseases
CerebrovascularDiseases
Pneumonia/Influenza
Cancer
19502004
Rate Per 100,000
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
2007 Estimated US Cancer Deaths*
ONS=Other nervous system.Source: American Cancer Society, 2007.
Men289,550
Women270,100
26% Lung & bronchus
15% Breast
10% Colon & rectum
6% Pancreas
6% Ovary
4% Leukemia
3% Non-Hodgkinlymphoma
3% Uterine corpus
2% Brain/ONS
2% Liver & intrahepaticbile duct
23% All other sites
Lung & bronchus 31%
Prostate 9%
Colon & rectum 9%
Pancreas 6%
Leukemia 4%
Liver & intrahepatic 4%bile duct
Esophagus 4%
Urinary bladder 3%
Non-Hodgkin 3% lymphoma
Kidney 3%
All other sites 24%
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Trends in the Number of Cancer Deaths Among Men and Women, US, 1930-2004
0
50,000
100,000
150,000
200,000
250,000
300,000
1930 1940 1950 1960 1970 1980 1990 2000
Women
Men
Num
ber o
f Can
cer D
eath
s
265,000
270,000
275,000
280,000
285,000
290,000
2000 2001 2002 2003 2004
Men
Women
Source: US Mortality Public Use Data Tape, 2004, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer Death Rates*, All Sites Combined, All Races, US, 1975-2003
*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Mortality - All COD, Public-Use With State, Total U.S. (1969-2003), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2006. Underlying mortality data provided by NCHS (www.cdc.gov/nchs).
0
50
100
150
200
250
300
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002
Men
Both Sexes
Rate Per 100,000
Women
Cancer Death Rates*, for Men, US,1930-2003
*Age-adjusted to the 2000 US standard population.Source: US Mortality Public Use Data Tapes 1960-2003, US Mortality Volumes 1930-1959,National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.
0
20
40
60
80
10019
30
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Lung & bronchus
Colon & rectum
Stomach
Rate Per 100,000
Prostate
Pancreas
LiverLeukemia
Cancer Death Rates*, for Women, US,1930-2003
*Age-adjusted to the 2000 US standard population.Source: US Mortality Public Use Data Tapes 1960-2003, US Mortality Volumes 1930-1959,National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.
0
20
40
60
80
10019
30
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Lung & bronchus
Colon & rectum
Uterus
Stomach
Breast
Ovary
Pancreas
Rate Per 100,000
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
239.2
144.9 153.4163.4192.4
98.8 111.6 108.8
331.0
166.4
0
50
100
150
200
250
300
350
400
White AfricanAmerican
Asian/PacificIslander
AmericanIndian/ Alaskan
Native
Hispanic†
Men Women
*Per 100,000, age-adjusted to the 2000 US standard population.† Persons of Hispanic origin may be of any race.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
Cancer Death Rates*, by Race and Ethnicity, US,1999-2003
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
All sites 331.0 239.2 1.4Prostate 65.1 26.7 2.4Larynx 5.1 2.2 2.3Stomach 12.4 5.4 2.3Myeloma 8.6 4.4 2.0 Oral cavity and pharynx 6.9 3.8 1.8Esophagus 10.7 7.6 1.4Liver and intrahepatic bile duct 9.6 6.3 1.5Small intestine 0.7 0.4 1.8Colon and rectum 33.6 23.7 1.4Lung and bronchus 98.4 73.8 1.3Pancreas 15.7 12.0 1.3
Cancer Sites in Which African American Death Rates* Exceed White Death Rates* for Men, US, 1999-2003
*Per 100,000, age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control and Population Sciences, National Cancer Institute, 2006.
Site African American White Ratio of African American/White
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
All sites 192.4 163.4 1.2Stomach 6.0 2.7 2.2Myeloma 6.4 2.9 2.2Uterine cervix 5.1 2.4 2.1Esophagus 3.0 1.7 1.8 Larynx 0.9 0.5 1.8Uterine corpus 7.1 3.9 1.8Small intestine 0.5 0.3 1.7Pancreas 12.5 9.0 1.4Colon and rectum 23.7 16.4 1.4Liver and intrahepatic bile duct 3.8 2.8 1.4Breast 34.4 25.4 1.4Urinary bladder 2.9 2.3 1.3Gallbladder 1.0 0.8 1.3Oral cavity and pharynx 1.8 1.5 1.2
Cancer Sites in Which African American Death Rates* Exceed White Death Rates* for Women, US, 1999-2003
*Per 100,000, age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control and Population Sciences, National Cancer Institute, 2006.
Site African American WhiteRatio of African American/White
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
0
50
100
150
200
250
300
350
400
450
500
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002
African American men
White men
African American women
White women
Rate Per 100,000
Cancer Death Rates* by Sex and Race, US, 1975-2003
*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
2007 Estimated US Cancer Cases*
*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.Source: American Cancer Society, 2007.
Men766,860
Women678,060
26% Breast
15% Lung & bronchus
11% Colon & rectum
6% Uterine corpus
4% Non-Hodgkinlymphoma
4% Melanoma of skin
4% Thyroid
3% Ovary
3% Kidney
3% Leukemia
21% All Other Sites
Prostate 29%
Lung & bronchus 15%
Colon & rectum 10%
Urinary bladder 7%
Non-Hodgkin 4% lymphoma
Melanoma of skin 4%
Kidney 4%
Leukemia 3%
Oral cavity 3%
Pancreas 2%
All Other Sites 19%
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer Incidence Rates*, All Sites Combined, All Races, 1975-2003
*Age-adjusted to the 2000 US standard population and adjusted for delay in reporting.Source: Surveillance, Epidemiology, and End Results Program, 1973-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
0
100
200
300
400
500
600
700
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002
Both Sexes
Men
Women
Rate Per 100,000
Cancer Incidence Rates* for Men, 1975-2003
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
0
50
100
150
200
250
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002
Prostate
Lung & bronchus
Colon and rectum
Urinary bladder
Non-Hodgkin lymphoma
Rate Per 100,000
Melanoma of the skin
Cancer Incidence Rates* for Women, 1975-2003
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
0
50
100
150
200
250
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002
Colon and rectum
Rate Per 100,000
Breast
Lung & bronchus
Uterine CorpusOvary
Non-Hodgkin lymphoma
Cancer Incidence Rates* by Race and Ethnicity, 1999-2003
*Age-adjusted to the 2000 US standard population.†Person of Hispanic origin may be of any race.Sources: Howe HL, et al. Annual report to the nation on the status of cancer 1975-2003; SEER, 1975-2003,Division of Cancer Control and Population Sciences, National Cancer Institute, 2006.
555.0
385.5 359.9421.1
383.8
303.3 305.0 327.2
639.8
444.1
0
100
200
300
400
500
600
700
800
White African American Asian/Pacific Islander American Indian/Alaska Native
Hispanic†
Men Women
Rate Per 100,000
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer Incidence Rates* by Sex and Race, All Sites, 1975-2003
*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
0
100
200
300
400
500
600
700
800
900
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002
African-American men
White men
White women
African-American women
Rate Per 100,000
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
* For those free of cancer at beginning of age interval. Based on cancer cases diagnosed during 2001 to 2003.
Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.1.1 Statistical Research and Applications Branch, NCI, 2006. http://srab.cancer.gov/devcan
Lifetime Probability of Developing Cancer, by Site, Men, 2001-2003*
† All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder.
Site RiskAll sites† 1 in 2Prostate 1 in 6Lung and bronchus 1 in 12Colon and rectum 1 in 17Urinary bladder‡ 1 in 28Non-Hodgkin lymphoma 1 in 47Melanoma 1 in 49Kidney 1 in 61Leukemia 1 in 67Oral Cavity 1 in 72Stomach 1 in 89
‡ Includes invasive and in situ cancer cases
Lifetime Probability of Developing Cancer, by Site, Women, US, 2001-2003*
Site RiskAll sites† 1 in 3Breast 1 in 8Lung & bronchus 1 in 16Colon & rectum 1 in 19Uterine corpus 1 in 40Non-Hodgkin lymphoma 1 in 55Ovary 1 in 69Melanoma 1 in 73Pancreas 1 in 79Urinary bladder‡ 1 in 87Uterine cervix 1 in 138
Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.1.1 Statistical Research and Applications Branch, NCI, 2006. http://srab.cancer.gov/devcan
* For those free of cancer at beginning of age interval. Based on cancer cases diagnosed during 2001 to 2003.† All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder.‡ Includes invasive and in situ cancer cases
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
All Sites 68 57 11Breast (female) 90 77 13Colon 66 54 12Esophagus 17 12 5Leukemia 50 39 11Non-Hodgkin lymphoma 64 56 8Oral cavity 62 40 22Prostate 100 98 2Rectum 66 59 7Urinary bladder 83 65 18Uterine cervix 75 66 9Uterine corpus 86 61 25
Cancer Survival*(%) by Site and Race,1996-2002
*5-year relative survival rates based on cancer patients diagnosed from 1996 to 2002 and followed through 2003. Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
Site White%
DifferenceAfrican
American
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Five-year Relative Survival (%)* during Three Time Periods By Cancer Site
*5-year relative survival rates based on follow up of patients through 2003. †Recent changes in classification of ovarian cancer have affected 1996-2002 survival rates.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2006.
Site 1975-1977 1984-1986 1996-2002All sites 50 53 66Breast (female) 75 79 89Colon 51 59 65Leukemia 35 42 49Lung and bronchus 13 13 16Melanoma 82 86 92Non-Hodgkin lymphoma 48 53 63Ovary 37 40 45Pancreas 2 3 5Prostate 69 76 100Rectum 49 57 66Urinary bladder 73 78 82
†
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Cancer Incidence & Death Rates* in Children 0-14 Years, 1975-2003
0
2
4
6
8
10
12
14
16
18
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002
Incidence
Mortality
Rate Per 100,000
*Age-adjusted to the 2000 Standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2003, Division of Cancer Control and Population Sciences, National Cancer Institute, 2006.
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Tobacco Use in the US, 1900-2003
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
1900
1905
1910
1915
1920
1925
1930
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Year
Per C
apita
Cig
aret
te C
onsu
mpt
ion
0
10
20
30
40
50
60
70
80
90
100
Age-
Adj
uste
d Lu
ng C
ance
r Dea
th
Rat
es*
*Age-adjusted to 2000 US standard population. Source: Death rates: US Mortality Public Use Tapes, 1960-2003, US Mortality Volumes, 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2005. Cigarette consumption: US Department of Agriculture, 1900-2003.
Per capita cigarette consumption
Male lung cancer death rate
Female lung cancer death rate
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Trends in Cigarette Smoking Prevalence* (%), by Gender, Adults 18 and Older, US, 1965-2005
*Redesign of survey in 1997 may affect trends.Source: National Health Interview Survey, 1965-2005, National Center for Health Statistics, Centers for DiseaseControl and Prevention, 2006.
0
10
20
30
40
50
60
1965
1974
1979
1983
1985
1990
1992
1994
1995
1997
1998
1999
2000
2001
2002
2003
2004
2005
Year
Pre
vale
nce
(%)
Men
Women
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Trends in per capita cigarette consumption for selected states and the average consumption across all states, 1980-2003
0
20
40
60
80
100
120
140
1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002
Year
Per C
apita
Sal
es (#
of P
acks
) United States
MassachusettsCalifornia
Data from: Orzechowski W, Walker RC. The tax burden on tobacco: historical compilation 2003: Volume 36. Arlington (VA): Orzechowski and Walker; 2003.
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Trends in Prevalence (%) of No Leisure-Time Physical Activity, by Educational Attainment, Adults 18 and Older, US, 1992-2005
Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Educational attainment is for adults 25 and older.Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape (2000, 2002, 2004, 2005), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001, 2003, 2005, 2006.
05
1015202530354045505560
1992
1994
1996
1998
2000
2002
2003
2004
2005
Year
Prev
alen
ce (%
)
Adults with less than a high school education
All adults
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2004†
*Obesity is defined as a body mass index of 30 kg/m2 or greater. † Age adjusted to the 2000 US standard population. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002, 2004. 2003-2004: National Health and Nutrition Examination Survey Public Use Data Files, 2003-2004, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.
1311
161512
1715
13
17
2321
26
3128
3433 3235
0
5
10
15
20
25
30
35
40
45
Both sexes Men Women
Prev
alen
ce (%
)
NHES I (1960-62) NHANES I (1971-74) NHANES II (1976-80)NHANES III (1988-94) NHANES 1999-2002 NHANES 2003-2004
Copyright © Gabor Fichtinger, 2009Laboratory for Percutaneous Surgery – The Perk Lab
Trends in Overweight* Prevalence (%), Adults 18 and Older, US, 1992-2005
1992 1995
1998
Less than 50% 50 to 55% More than 55% State did not participate in survey
*Body mass index of 25.0 kg/m2or greater. Source: Behavioral Risk Factor Surveillance System, CD-ROM (1984-1995, 1998) and Public Use Data Tape (2004, 2005), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 2000, 2005, 2006.
2005