us cancer burden epi 242 cancer epidemiology binh goldstein, ph.d. october 7, 2009
TRANSCRIPT
US Cancer BurdenUS Cancer Burden
Epi 242 Cancer EpidemiologyEpi 242 Cancer Epidemiology
Binh Goldstein, Ph.D.Binh Goldstein, Ph.D.October 7, 2009October 7, 2009
US Mortality, 2006
*Includes nephrotic syndrome and nephrosis.Source: US Mortality Data 2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.
1. Heart Diseases 631,636 26.0
2. Cancer 559,888 23.1
3. Cerebrovascular diseases 137,119 5.7
4. Chronic lower respiratory diseases 124,583 5.1
5. Accidents (unintentional injuries) 121,599 5.0
6. Diabetes mellitus 72,449 3.0
7. Alzheimer disease 72,432 3.0
8. Influenza & pneumonia 56,326 2.3
9. Nephritis* 45,344 1.9
10. Septicemia 34,234 1.4
Rank Cause of DeathNo. of deaths
% of all deaths
Change in US Death Rates* from 1991 to 2006
* Age-adjusted to 2000 US standard population.Sources: US Mortality Data, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.
17.8
63.3
34.8
313.0
215.1
43.6
180.7200.2
0
100
200
300
400
Heart diseases Cerebrovasculardiseases
Influenza &pneumonia
Cancer
1991
2006
Rate Per 100,000
Age Standardized Incidence Rates
USMore developed
countriesLess developed
countries
Site Males Females Males Females Males Females
Lung 61.9 36.1 54.9 17.0 25.9 9.4
Breast ─ 101.1 ─ 67.8 ─ 23.8
Colon/Rectum 44.6 33.1 40.0 26.6 10.2 7.7
Stomach 7.2 3.3 22.3 10.0 21.5 10.4
Liver 5.5 2.0 8.5 3.0 18.5 7.1
Prostate 124.8 ─ 56.2 ─ 9.4 ─
Cervix ─ 7.7 ─ 10.3 ─ 19.1
Esophagus 4.9 1.3 6.7 1.3 12.8 6.5
Source: GLOBOCAN 2002Source: GLOBOCAN 2002
Ten Leading Cancer Types for New Cancer Cases2009 Estimates
Number of New Cases
Site Both Male Female
Lung & Bronchus 219,440 116,090 103,350
Breast 194,280 1,910 192,370
Prostate 192,280 192,280 --
Colon/Rectum 146,970 75,590 71,380
Bladder 70,980 52,810 18,170
Skin Melanoma 68,720 39,080 29,640
Non-Hodgkin Lymphoma 65,980 35,990 29,990
Kidney 57,760 35,430 22,330
Leukemia 44,790 25,630 19,160
Pancreas 42,470 21,050 21,420
All Sites 1,479,350 766,130 713,220
2009 Estimated US Cancer Cases*
*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.Source: American Cancer Society, 2009.
Men766,130
Women713,220
27% Breast
14% Lung & bronchus
10% Colon & rectum
6% Uterine corpus
4% Non-Hodgkin lymphoma
4% Melanoma of skin
4% Thyroid
3% Kidney & renal pelvis
3% Ovary
3% Pancreas
22% All Other Sites
Prostate 25%
Lung & bronchus 15%
Colon & rectum 10%
Urinary bladder 7%
Melanoma of skin 5%
Non-Hodgkin5% lymphoma
Kidney & renal pelvis 5%
Leukemia 3%
Oral cavity 3%
Pancreas 3%
All Other Sites 19%
Cancer Incidence Rates* by Sex, US, 1975-2005
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.Source: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database: SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2005, National Cancer Institute, 2008.
0
100
200
300
400
500
600
700
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
Both Sexes
Men
Women
Rate Per 100,000
Cancer Incidence Rates* Among Men, US, 1975-2005
0
50
100
150
200
250
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
Prostate
Lung & bronchus
Colon and rectum
Urinary bladder
Non-Hodgkin lymphoma
Rate Per 100,000
Melanoma of the skin
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.Source: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database: SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2005, National Cancer Institute, 2008.
Cancer Incidence Rates* Among Women, US, 1975-2005
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.Source: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database: SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2005, National Cancer Institute, 2008.
0
50
100
150
200
250
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
Colon and rectum
Rate Per 100,000
Breast
Lung & bronchus
Uterine CorpusOvary
Non-Hodgkin lymphoma
Cancer Incidence Rates* by Race and Ethnicity, 2001-2005
*Age-adjusted to the 2000 US standard population.†Person of Hispanic origin may be of any race.Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2008.
551.4
354.0 336.6
423.6398.9
287.8 296.4317.8
651.5
419.4
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
Cancer Incidence Rates* by Sex and Race, US,1975-2005
*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database: SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2005, National Cancer Institute, 2008.
0
100
200
300
400
500
600
700
800
900
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
African American men
White men
White women
African American women
Rate Per 100,000
Ten Leading Cancer Types for Cancer Deaths 2009 Estimates
Number of Deaths
Site Both Male Female
Lung & Bronchus 159,390 88,900 70,490
Colon/Rectum 49,920 25,240 24,680
Breast 40,610 440 40,170
Pancreas 35,240 18,030 17,210
Prostate 27,360 27,360 --
Leukemia 21,870 12,590 9,280
Non-Hodgkin Lymphoma 19,500 9,830 9,670
Liver 18,160 12,090 6,070
Ovary 14,600 -- 14,600
Esophagus 14,530 11,490 3,040
All Sites 562,340 292,540 269,800
2009 Estimated US Cancer Deaths*
ONS=Other nervous system.Source: American Cancer Society, 2009.
Men292,540
Women269,800
26% Lung & bronchus
15% Breast
9% Colon & rectum
6% Pancreas
5% Ovary
4% Non-Hodgkin lymphoma
3% Leukemia
3% Uterine corpus
2% Liver & intrahepaticbile duct
2% Brain/ONS
25% All other sites
Lung & bronchus 30%
Prostate 9%
Colon & rectum 9%
Pancreas 6%
Leukemia 4%
Liver & intrahepatic 4%bile duct
Esophagus 4%
Urinary bladder 3%
Non-Hodgkin 3% lymphoma
Kidney & renal pelvis 3%
All other sites 25%
Cancer Death Rates* by Sex, US, 1975-2005
*Age-adjusted to the 2000 US standard population.Source: US Mortality Data 1960-2005, National Center for Health Statistics, Centers for Disease Control and Prevention, 2008.
0
50
100
150
200
250
300
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
Men
Both Sexes
Rate Per 100,000
Women
Trends in the Number of Cancer Deaths Among Men and Women, US, 1930-2006
0
50,000
100,000
150,000
200,000
250,000
300,000
1930 1940 1950 1960 1970 1980 1990 2000
Women
Men
Nu
mb
er o
f C
ance
r D
eath
s
265,000
270,000
275,000
280,000
285,000
290,000
295,000
2000
2001
2002
2003
2004
2005
2006
Men
Women
Source: US Mortality Data, 1930-2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.
Cancer Death Rates* Among Men, US,1930-2005
*Age-adjusted to the 2000 US standard population.Source: US Mortality Data 1960-2005, US Mortality Volumes 1930-1959,National Center for Health Statistics, Centers for Disease Control and Prevention, 2008.
0
20
40
60
80
10019
30
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
Lung & bronchus
Colon & rectum
Stomach
Rate Per 100,000
Prostate
Pancreas
LiverLeukemia
Cancer Death Rates* Among Women, US,1930-2005
*Age-adjusted to the 2000 US standard population.Source: US Mortality Data 1960-2005, US Mortality Volumes 1930-1959,National Center for Health Statistics, Centers for Disease Control and Prevention, 2008.
0
20
40
60
80
10019
30
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
Lung & bronchus
Colon & rectum
Uterus
Stomach
Breast
Ovary
Pancreas
Rate Per 100,000
230.7
138.8
190.0
159.2186.7
95.6
142.0
105.2
313.0
159.0
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, 1975-2005, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2008.
Cancer Death Rates* by Race and Ethnicity, US, 2001-2005
0
50
100
150
200
250
300
350
400
450
500
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
African American men
White men
African American women
White women
Rate Per 100,000
Cancer Death Rates* by Sex and Race, US, 1975-2005
*Age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2008.
All sites 313.0 230.7 1.4
Prostate 59.4 24.6 2.4
Larynx 4.8 2.1 2.3
Stomach 11.5 5.0 2.3
Myeloma 8.3 4.3 1.9
Oral cavity and pharynx 6.7 3.8 1.8
Small intestine 0.7 0.4 1.8
Liver and intrahepatic bile duct 10.3 6.7 1.5
Colon and rectum 31.8 22.1 1.4
Esophagus 9.8 7.8 1.3
Lung and bronchus 93.1 71.3 1.3
Pancreas 15.4 12.1 1.3
Cancer Sites in Men for Which African American Death Rates* Exceed White Death Rates*, US, 2001-2005
*Per 100,000, age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2008.
Site African American WhiteRatio of African American/White
All sites 186.7 159.2 1.2
Stomach 5.5 2.5 2.2
Myeloma 6.0 2.8 2.1
Uterine cervix 4.7 2.3 2.0
Esophagus 2.8 1.6 1.8
Uterine corpus 7.1 3.9 1.8
Small intestine 0.5 0.3 1.7
Larynx 0.8 0.5 1.6
Colon and rectum 22.4 15.3 1.5
Pancreas 12.4 9.0 1.4
Breast 33.5 24.4 1.4
Gallbladder 1.0 0.8 1.3
Urinary bladder 2.8 2.2 1.3
Liver and intrahepatic bile duct 3.9 2.9 1.3
Cancer Sites in Women for Which African American Death Rates* Exceed White Death Rates*, US, 2001-2005
*Per 100,000, age-adjusted to the 2000 US standard population.Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control and Population Sciences, National Cancer Institute, 2008.
Site African American WhiteRatio of African American/White
* For those free of cancer at beginning of age interval.
Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.3.0 Statistical Research and Applications Branch, NCI, 2008. http://srab.cancer.gov/devcan
Lifetime Probability of Developing Cancer, Men, 2003-2005*
† All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder .
Site Risk
All sites† 1 in 2
Prostate 1 in 6
Lung and bronchus 1 in 13
Colon and rectum 1 in 18
Urinary bladder‡ 1 in 27
Melanoma§ 1 in 39
Non-Hodgkin lymphoma 1 in 45
Kidney 1 in 57
Leukemia 1 in 67
Oral Cavity 1 in 72
Stomach 1 in 90
‡ Includes invasive and in situ cancer cases§ Statistic for white men.
Lifetime Probability of Developing Cancer, Women, US, 2003-2005*
Site Risk
All sites† 1 in 3
Breast 1 in 8
Lung & bronchus 1 in 16
Colon & rectum 1 in 20
Uterine corpus 1 in 40
Non-Hodgkin lymphoma 1 in 53
Urinary bladder‡ 1 in 84
Melanoma§ 1 in 58
Ovary 1 in 72
Pancreas 1 in 75
Uterine cervix 1 in 145
Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.3.0 Statistical Research and Applications Branch, NCI, 2008. http://srab.cancer.gov/devcan
* For those free of cancer at beginning of age interval. † All Sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder .‡ Includes invasive and in situ cancer cases§ Statistic for white women.
All Sites 68 58 10
Breast (female) 91 78 13
Colon 66 55 11
Esophagus 18 11 7
Leukemia 52 42 10
Non-Hodgkin lymphoma 66 58 8
Oral cavity 62 42 20
Prostate 99 96 3
Rectum 67 59 8
Urinary bladder 82 66 16
Uterine cervix 74 65 9
Uterine corpus 86 61 25
Cancer Survival*(%) by Race,1996-2004
*5-year relative survival rates based on cancer patients diagnosed from 1996 to 2004 and followed through 2005. Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2008.
Site WhiteAbsolute Difference
AfricanAmerican
Trends in Five-year Relative Survival (%)* Rates, US, 1975-2004
*5-year relative survival rates based on follow up of patients through 2005. Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control andPopulation Sciences, National Cancer Institute, 2008.
Site 1975-1977 1984-1986 1996-2004All sites 50 54 66
Breast (female) 75 79 89
Colon 52 59 65
Leukemia 35 42 51
Lung and bronchus 13 13 16
Melanoma 82 87 92
Non-Hodgkin lymphoma 48 53 65
Ovary 37 40 46
Pancreas 3 3 5
Prostate 69 76 99
Rectum 49 57 67
Urinary bladder 74 78 81
Tobacco Use in the US, 1900-2005
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
2005
Year
Per
Cap
ita
Cig
aret
te C
on
sum
pti
on
0
10
20
30
40
50
60
70
80
90
100
Ag
e-A
dju
sted
Lu
ng
Can
cer
Dea
th
Rat
es*
*Age-adjusted to 2000 US standard population.
Source: Death rates: US Mortality Data, 1960-2005, US Mortality Volumes, 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006. Cigarette consumption: US Department of Agriculture, 1900-2007.
Per capita cigarette consumption
Male lung cancer death rate
Female lung cancer death rate
Trends in Cigarette Smoking Prevalence* (%), by Sex, Adults 18 and Older, US, 1965-2007
*Redesign of survey in 1997 may affect trends.Source: National Health Interview Survey, 1965-2007, National Center for Health Statistics, Centers for Disease Control and Prevention, 2008.
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
2006
2007
Year
Pre
vale
nce
(%
)
Men
Women
Trends in Obesity* Prevalence (%), Children and Adolescents, by Age Group, US, 1971-2006
*Body mass index (BMI) at or above the sex-and age-specific 95th percentile BMI cutoff points from the 2000 sex-specific BMI-for-age CDC Growth Charts. Note: Previous editions of Cancer Statistics used the term “overweight” to describe youth in this BMI category.Source: 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. 2003-2006: Ogden CL, et al. High Body Mass Index for Age among US Children and Adolescents, 2003-2006. JAMA 2008; 299 (20): 2401-05.
54
65
7
5
7
11 1110
16 16
12
1718
0
5
10
15
20
2 to 5 years 6 to 11 years 12 to 19 years
Pre
va
len
ce
(%
)
NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94)
NHANES 1999-2002 NHANES 2003-2006
Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2006†
*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, 2005-2006: National Health and Nutrition Examination Survey Public Use Data Files, 2003-2004, 2005-2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006, 2007.
1311
1615
12
1715
13
17
2321
26
3128
3433 323535
3436
0
5
10
15
20
25
30
35
40
45
Both sexes Men Women
Pre
vale
nce
(%)
NHES I (1960-62) NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94)
NHANES 1999-2002 NHANES 2003-2004 NHANES 2005-2006
Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2006†
*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, 2005-2006: National Health and Nutrition Examination Survey Public Use Data Files, 2003-2004, 2005-2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006, 2007.
1311
1615
12
1715
13
17
2321
26
3128
3433 323535
3436
0
5
10
15
20
25
30
35
40
45
Both sexes Men Women
Pre
vale
nce
(%)
NHES I (1960-62) NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94)
NHANES 1999-2002 NHANES 2003-2004 NHANES 2005-2006
Trends in Overweight* Prevalence (%), Adults 18 and Older, US, 1992-2007
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 (2004-2007), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 2000, 2005, 2007, 2008.
2007
Screening Guidelines for the Early Detection of Breast Cancer, American Cancer Society
Yearly mammograms are recommended starting at age 40.
A clinical breast exam should be part of a periodic health examination, about every 3 years for women in their 20s and 30s. Asymptomatic women aged 40 and older should continue to undergo a clinical breast exam, preferably annually*.
Beginning in their early 20s, women should be told about the benefits and limitations of breast-self examination. Women should know how their breasts normally feel and report any breast changes promptly to their health care providers.
__________
* Beginning at age 40 years, annual CBE should be performed prior to mammography
Mammogram Prevalence (%), by Educational Attainment and Health Insurance Status, Women 40 and Older, US, 1991-2006
*A mammogram within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States.Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use Data Tape (2000, 2002, 2004, 2006), National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2000, 2001, 2003, 2005, 2007.
0
10
20
30
40
50
60
70
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2002 2004 2006
Year
Pre
va
len
ce
(%
)
Women with less than a high school education
Women with no health insurance
All women 40 and older
Screening Guidelines for the Early Detection of Cervical Cancer, American Cancer Society
Screening should begin approximately three years after a women begins having vaginal intercourse, but no later than 21 years of age.
Screening should be done every year with regular Pap tests or every two years using liquid-based tests.
At or after age 30, women who have had three normal test results in a row may get screened every 2-3 years with cervical cytology (either conventional or liquid-based Pap test) alone, or every 3 years with a human papillomavirus DNA test plus cervical cytology.
Women 70 and older who have had three or more consecutive Pap tests in the last ten years may choose to stop cervical cancer screening.
Screening after a total hysterectomy (with removal of the cervix) is not necessary unless the surgery was done as a treatment for cervical cancer.
Trends in Recent* Pap Test Prevalence (%), by Educational Attainment and Health Insurance Status, Women 18 and Older, US, 1992-2006
* A Pap test within the past three years. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Educational attainment is for women 25 and older.Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use Data Tape (2000, 2002, 2004, 2006), National Center for Chronic Disease Prevention and Health Promotion, Center for Disease Control and Prevention, 1997, 1999, 2000, 2000, 2001, 2003, 2005, 2007.
0
20
40
60
80
100
1992 1993 1994 1995 1996 1997 1998 1999 2000 2002 2004 2006Year
Pre
vale
nce
(%
)
Women with no health insurance
Women with less than a high school education
All women 18 and older
Screening Guidelines for the Early Detection of Colorectal Cancer and Adenomas, American Cancer Society 2008
Beginning at age 50, men and women should follow one of the following examination schedules:
A flexible sigmoidoscopy (FSIG) every five years
A colonoscopy every ten years
A double-contrast barium enema every five years
A Computerized Tomographic (CT) colonography every five years
A guaiac-based fecal occult blood test (FOBT) or a fecal immunochemical test (FIT) every year
A stool DNA test (interval uncertain)
Tests that detect adenomatous polyps and cancer Tests that primarily detect cancer
People who are at moderate or high risk for colorectal cancer should talk with a doctor about a different testing schedule
20
16
8
21
16
9
18
12
22
16
9
19
14
9
16
12
8
24
0
5
10
15
20
25
30
Total Less than a high schooleducation
No health insurance
Pre
va
len
ce
(%
)
1997 1999 2001 20022004 2006
Trends in Recent* Fecal Occult Blood Test Prevalence (%), by Educational Attainment and Health Insurance Status, Adults 50 Years and Older, US, 1997-2006
*A fecal occult blood test within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System CD-ROM (1996-1997, 1999) and Public Use Data Tape (2001, 2002, 2004, 2006), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention and Prevention, 1999, 2000, 2002, 2003, 2005, 2007.
44
37
22
44
36
21
45
36
21
50
41
22
56
43
25
0
10
20
30
40
50
60
Total Less than a high schooleducation
No health insurance
Pre
vale
nce
(%
)
1999 2001 2002 2004 2006
Trends in Recent* Flexible Sigmoidoscopy or Colonoscopy Prevalence (%), by Educational Attainment and Health Insurance Status, Adults 50 Years and Older, US, 1997-2006
*A flexible sigmoidoscopy or colonoscopy within the past ten years. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System CD-ROM (1996-1997, 1999) and Public Use Data Tape (2001, 2002, 2004, 2006), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention and Prevention, 1999, 2000, 2002, 2003, 2005, 2007.
Screening Guidelines for the Early Detection of Prostate Cancer, American Cancer Society
Beginning at age 50, to men who have a life expectancy of at least 10 years, health care providers should discuss the potential benefits and limitations of prostate cancer early detection testing with men and offer the PSA blood test and the digital rectal examination.*
___________
* Information should be provided to men regarding the benefits and limitations of testing so that an informed decision concerning testing can be made with the clinician’s assistance.
58
46
30
42
28
52
39
25
54
40
27
55
0
10
20
30
40
50
60
70
Total Less than a high schooleducation
No health insurance
Pre
va
len
ce
(%
)
2001 20022004 2006
Recent* Prostate-Specific Antigen (PSA) Test Prevalence (%), by Educational Attainment and Health Insurance Status, Men 50 Years and Older, US, 2001-2006
*A prostate-specific antigen (PSA) test within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System Public Use Data Tape (2001, 2002, 2004, 2006), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2002, 2003, 2005, 2007.
57
44
29
53
42
26
50
37
22
50
35
23
0
10
20
30
40
50
60
Total Less than a high schooleducation
No health insurance
Pre
va
len
ce
(%
)
2001 20022004 2006
Recent* Digital Rectal Examination (DRE) Prevalence (%), by Educational Attainment and Health Insurance Status, Men 50 Years and Older, US, 2001-2006
*A digital rectal examination (DRE) within the past year. Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Source: Behavioral Risk Factor Surveillance System Public Use Data Tape (2001, 2002, 2004, 2006), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2002, 2003, 2005, 2007.
Resources
American Cancer Society• Cancer Facts & Figures• www.cancer.org