CA CANCER] CLIN 2000;50:7'33
`
`Cancer Statistics, 2000
`
`Robert T. Greenlee, MPH, Taylor Murray, Sherry Bolden, Phyllis A. Wingo, PhD, MS
`
`Abstract
`
`Introduction
`
`The Surveillance Research Program of the
`American Cancer Society’s Department of
`Epidemiology and Surveillance Research
`reports its annual compilation ofestimated
`cancer incidence, mortality, and survival
`data for the United States in the year 2000.
`After 70 years of increases,
`the recorded
`number of total cancer deaths among men
`in the US declined for the first time from
`1996 to 1997. This decrease in overall
`
`male mortality is the result of recent down-
`turns in lung and bronchus cancer deaths,
`prostate cancer deaths, and colon and rec-
`tum cancer deaths.
`
`Despite decreasing numbers of
`deaths from female breast cancer and
`colon and rectum cancer, mortality asso-
`ciated with lung and bronchus cancer
`among women continues to increase.
`Lung cancer is expected to account for
`25% of all female cancer deaths in 2000.
`This report also includes a summary
`of global cancer mortality rates using data
`from the World Health Organization.
`(CA Cancer J Clin 2000,'50:7-33.)
`
`Mr. Greenlee is an Epidemiologist with the
`Surveillance Research Program, Department of
`Epidemiology and Surveillance, American Cancer
`Society, Atlanta, GA.
`Mr. Murray is Manager, Surveillance Data Systems,
`with the Surveillance Research Program, Depart-
`ment of Epidemiology and Surveillance, American
`Cancer Society, Atlanta, GA.
`Ms. Bolden is Manager, Surveillance Information
`Services, with the Surveillance Research Program,
`Department of Epidemiology and Surveillance,
`American Cancer Society, Atlanta, GA.
`Dr. Wingo is Director of the Surveillance Research
`Program, Department
`of Epidemiology
`and
`Surveillance, American Cancer Society, Atlanta, GA.
`The authors thank Cheryll Cardinez, Marlo Corrao,
`April Harris, Elyse Luke, and Kate O’Brien for
`their assistance in preparation of this manuscript.
`This article is also available online at http://www.
`ca—journal.org.
`
`VOL. 50 NO.1]ANUARY/FEBRUARY 2000
`
`Cancer is an important public health con-
`cern in the United States and around the
`
`world. To provide an up-to-date perspec-
`tive on the occurrence of cancer,
`the
`American Cancer Society presents an
`overview of cancer frequency, incidence,
`mortality, and survival statistics for the
`year 2000.
`
`Methods
`ESTIMATED NEW CANCER CASES
`
`Because the US does not have a nation-
`
`wide cancer registry, the exact number of
`new cases of cancer diagnosed each year
`in the US and in individual states is not
`
`known. Consequently, we first estimated
`the number of new cancer cases occurring
`annually in the US from 1979 through
`1996 using population data reported by
`the US Bureau of the Census and age—spe—
`ciftc cancer incidence rates collected by
`the National Cancer Institute’s Surveil-
`
`lance, Epidemiology, and End Results
`(SEER) program} We fitted these annual
`cancer case estimates to an autoregressive
`quadratic model to forecast the number of
`cancer cases expected to be diagnosed in
`the US in the year 2000 (Table 1, Fig. 1)?
`Between 1987 and 1992, the inci-
`dence rate of prostate cancer increased
`85%, followed by a decline of 29% be-
`tween 1992 and 1996.3 The sharp in-
`crease in incidence followed by the de-
`cline in recent years probably reflects
`extensive use of prostate—specific anti-
`gen (PSA) screening in a previously un-
`screened population and the subsequent
`increase in diagnoses at an early stage.4
`We
`assumed that
`the number of
`
`prostate cancer cases would approxi-
`mate the rates observed prior to wide-
`spread use of PSA screening, and there-
`
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`CANCER STATISTICS. 2000
`
`fore, we estimated new cases of prostate
`cancer for 2000 using a linear projection
`based on data from 1979 to 1989.
`Because cancer incidence rates and
`
`case counts for 1979 through 1996 were
`not available for many states, we could
`not use the methods mentioned above to
`estimate new cases for individual states
`
`registration of at least 82%; and 4) a pro-
`portion of deaths with medically certified
`cause of death of at least 95% .8
`
`Selected Findings
`EXPECTED NUMBERS OF NEW CANCER
`CASES
`
`(Table 3). To derive these estimates, we
`assumed that the ratio of cancer deaths to
`cancer cases for each state was the same
`as the ratio for the US .2
`
`In the year 2000, we estimate that about
`1,220,100 new cases of invasive cancer
`will be diagnosed in the US (Table 1).
`This estimate does not include carcinoma
`
`ESTIMATED CANCER DEATHS
`
`We estimated the number of cancer
`
`deaths expected to occur in the US in the
`year 2000 using underlying cause-of-death
`data from death certificates as reported to
`the National Center for Health Statistics
`
`(Table 2, Fig. 2).5 The recorded numbers
`of cancer deaths occurring annually from
`1979 to 1997 were fitted to an autoregres-
`sive quadratic model to forecast the num-
`ber of cancer deaths expected to occur in
`the US in 2000. The estimated number of
`cancer deaths for each state was calculat-
`
`ed with the same modeling procedure
`used for the total US (Table 4).2
`
`OTHER STATISTICS
`
`Mortality statistics for the leading causes
`of death (Tables 6, 7, and 12), the leading
`causes of death from cancer (Tables 8, 9),
`and cancer mortality rates from 1930 to
`1996 (Figs. 5, 6) were obtained using data
`from the National Center for Health Sta-
`
`tistics.5 Incidence rates (Table 10, Figs. 3,
`4), the probability of developing cancer
`(Table 5), and five—year relative survival
`rates (Tables 11, 13; Figs. 7, 8) were ob-
`tained from the SEER program.“ We
`computed global cancer mortality rates
`(Table 14) using data compiled by the
`World Health Organization.7 We includ-
`ed data from countries that have: 1) sub-
`mitted data for at least one of the years
`between 1994 and 1997 using codes from
`the ninth or tenth revision of the Interna-
`
`tional Classification of Diseases; 2) popu-
`lations of 500,000 or more; 3) death
`
`in situ of any site except urinary bladder,
`and it does not include basal and squa-
`mous cell cancers of the skin. Approxi-
`mately 1.3 million cases of basal and
`squamous cell skin cancers, 42,600 cases
`of breast carcinoma in situ, and 28,600
`
`cases of in situ melanoma are expected to
`be newly diagnosed in 2000.
`Among men, the most common can-
`cers in 2000 are expected to be cancers of
`the prostate, lung and bronchus, and colon
`and rectum (Fig. 1). The prostate is the
`leading site for cancer incidence, account-
`ing for 29% of new cancer cases in men.
`This year, 180,400 new cases of prostate
`cancer are expected to be diagnosed.
`Among women, the three most com-
`monly diagnosed cancers are expected to
`be cancers of
`the breast,
`lung and
`bronchus, and colon and rectum (Fig. 1).
`Cancers occurring at these sites are ex-
`pected to account for over 50% of new
`cancer cases in women. Breast cancer
`
`alone is expected to account for 182,800
`new cancer cases (30%) in 2000.
`
`TRENDS IN CANCER INCIDENCE
`
`For all sites combined, SEER cancer inci-
`dence rates appeared to peak in 1992 and
`decreased an average of -2.2% per year
`from 1992 to 1996.9 Similar declines have
`
`been seen recently for specific leading
`cancer sites (Figs. 3 and 4).
`Breast cancer incidence rates have
`
`remained approximately level during the
`1990s; however, they appear to be de-
`creasing in younger women. Decreases in
`colon and rectum cancer incidence rates
`
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`CA CANCER] CLIN 2000;S0:7-33
`
`began in the mid-1980s, and have been
`observed among both males and females
`in all racial/ethnic groups (with the excep-
`tion of American Indian women in whom
`data were not sufficient to make a deter-
`
`mination as to the direction of this trend) .3
`Incidence rates of colon and rectum can-
`
`cer declined significantly between 1990
`and 1996, on average -2.1% per year.9
`A downturn in the incidence of lung
`and bronchus cancer in males began in
`the late 1980s, and between 1990 and
`1996, incidence rates decreased signifi-
`cantly, -2.6% per year. Incidence rates of
`lung and bronchus cancer among females
`are stabilizing, and have begun to decline
`among women aged 40 to 59.9 Prostate
`cancer incidence rates also declined sig-
`nificantly between 1990 and 1996, on
`average -2.0% per year.
`
`EXPECTED NUMBERS OF CANCER DEATHS
`
`In 2000, an estimated 552,200 Americans
`are expected to die of cancer—more than
`1,500 people a day (Table 2). Most can-
`cer deaths in men (52%) in the year 2000
`are expected to be from cancers of the
`lung and bronchus, prostate, and colon
`and rectum (Fig. 2).
`Among women, cancers of the lung
`and bronchus, breast, and colon and rec-
`tum are expected to account for more than
`half of all cancer deaths in 2000 (Fig. 2). In
`1987, lung cancer surpassed breast cancer
`as the leading cause of cancer death in
`Women and is expected to account for
`25% of all female cancer deaths in 2000.
`
`TRENDS IN THE RECORDED NUMBER OF
`CANCER DEATHS
`
`Following more than 70 years of increas-
`es, the recorded number of total cancer
`deaths among men in the US has declined
`for the first time, from a peak of 281,898
`in 1996 to 281,110 in 1997. This promis-
`ing change results from recent downturns
`in each of the top three causes of cancer
`death among men. Lung and bronchus
`cancer deaths among men declined from
`a peak of 92,493 in 1993 to 91,278 in 1997.
`
`VOL. 50 NO. 1 JANUARY/FEBRUARY 2000
`
`Prostate cancer deaths declined from a
`
`peak of 34,902 in 1994 to 32,891 in 1997.
`Colon and rectum cancer deaths among
`men were highest in 1990 at 28,635 and
`have declined to 28,075 in 1997.
`Among women, the recorded num-
`ber of total cancer deaths continues to in-
`
`crease, although the rate of increase has
`diminished in recent years. The upward
`trend among females is primarily due to
`sustained increases in the number of
`
`deaths from lung and bronchus cancer.
`The numbers of deaths from breast and
`
`colorectal cancers among females, how-
`ever, have begun to decline. Breast can-
`cer deaths were highest in 1995 at 43,844
`and have declined to 41,943 in 1997. Col-
`orectal cancer deaths among women
`have declined from a recent peak of
`29,237 in 1995 to 28,621 in 1997, although
`these deaths reached their all—time high in
`1984 at 29,522.
`
`TRENDS IN CANCER DEATH RATES
`
`Death rates for all cancers combined
`
`peaked in 1991 and decreased an average
`-0.7% per year from 1991 to 1996 (Figs. 5
`and 6).9 Significant decreases have been
`seen among both males and females, per-
`sons younger than 65 years of age, and
`among whites, blacks, and Hispanics.
`Breast cancer death rates in females
`
`decreased an average of -1.8% per year
`between 1990 and 1996; decreases were
`more pronounced among white women
`and among younger women. During the
`period from 1990 to 1996, colon and rec-
`tum cancer death rates decreased signifi-
`cantly, on average -1.7% per year.
`Similar to trends in incidence, signifi-
`cant decreases in death rates for lung and
`bronchus cancer have occurred only
`among males (on average -1.6% per year
`between 1990 and 1996); rates among fe-
`males recently have begun to slow and
`appear to be stabilizing. Prostate cancer
`death rates decreased on average -1.6%
`per year during the period between 1990
`and 1996.
`
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`
`CANCER STATISTICS. 2000
`
`TRENDS IN CANCER BY
`RACE/ETHNICITY
`
`Overall rates of cancer incidence vary
`considerably among racial and ethnic
`groups (Table 10). Blacks have the high-
`est cancer incidence rates: They are about
`60% more likely to develop cancer than
`are Hispanics and Asian/Pacific Islanders
`and more than twice as likely to develop
`cancer as American Indians. Between
`
`1990 and 1996, incidence rates decreased
`among whites (-1.2% per year), Hispan-
`ics (-1.7% per year), and American Indi-
`ans (-0.7% per year), and remained rela-
`tively stable among blacks and Asian/
`Pacific Islanders.3
`
`White women are more likely to de-
`velop breast cancer than are women of
`other racial and ethnic groups, and black
`women are more likely to develop can-
`cers of the colon and rectum.3 Black men
`
`have the highest incidence rates for can-
`cers of the colon and rectum, lung and
`bronchus, and prostate. They are also at
`least 50% more likely to develop prostate
`cancer than men of other racial and eth-
`
`nic groups.
`Blacks are about 33% more likely
`to die of cancer than are whites, and
`more than twice as likely to die of cancer
`as are Asian/Pacific Islanders, American
`Indians, and Hispanics. Between 1990
`and 1996, mortality rates decreased sig-
`nificantly among whites
`(-0.5% per
`year), blacks (-0.9% per year), and His-
`panics (-0.6% per year); remained rela-
`tively stable among Asian/Pacific Is-
`landers; and may be increasing among
`American Indians.3
`
`Black women are more likely to die
`of breast (see article by Dignam in this is-
`sue of CA, page 50) and colon and rectum
`cancers than are women of any other
`racial or ethnic group, and they have ap-
`proximately the same lung and bronchus
`cancer death rate as white women. As
`
`was seen with incidence rates, black men
`have the highest mortality rates of colon
`and rectum,
`lung and bronchus, and
`prostate cancers.3
`
`CANCER IN CHILDREN
`
`Cancer is the second leading cause of
`death among children between one and 14
`years of age in the US; accidents are the
`most frequent cause of death in this age
`group (Table 12). The most commonly
`occurring cancers in children are leu-
`kemias (in particular, acute lymphocytic
`leukemia), tumors of the central and sym-
`pathetic nervous systems,
`lymphomas,
`soft—tissue sarcomas, and renal tumors?
`Over the past 20 years, there have been
`significant improvements in the five—year
`relative survival rate for many childhood
`cancers, especially acute lymphocytic and
`acute myeloid leukemia, non—Hodgkin’s
`lymphoma, and Wilms’ Tumor (Table 13).
`Between 1974/1976 and 1989/1995, five-
`
`year relative survival rates for childhood
`cancers at all sites combined improved
`from 56% to 75%.
`
`Limitations and Future Challenges
`
`Our estimates of the expected numbers of
`new cancer cases and cancer deaths
`
`should be interpreted with caution when
`tracking trends over time. These estimates
`may vary considerably from year to year,
`particularly for rare cancers and for states
`with smaller populations. We therefore
`discourage the use of these estimates to
`track year-to-year changes in cancer oc-
`currence and death. The recorded num-
`ber of cancer deaths and cancer death
`rates from the National Center for Health
`
`Statistics, and SEER cancer incidence
`rates are generally more informative sta-
`tistics for the purpose of tracking cancer
`trends. For example, breast cancer inci-
`dence rates increased about 1% per year
`between 1979 and 1982, increased 4% per
`year between 1982 and 1987, and were ap-
`proximately constant between 1987 and
`1996. Despite the stabilization of inci-
`dence rates during the latter time period,
`the estimates of new breast cancer cases
`increased between 1988 and 1996.
`Our estimates are based on the most
`
`currently available cancer mortality and
`
`10
`
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`
`CA CANCER] CLIN 2000;S0:7-33
`
`incidence data; however, these data are
`three and four years old, respectively, at
`the time that the estimates are calculated.
`
`As such, the effects of large changes oc-
`curring in the three— or four—year interval
`between 1996 or 1997 and 2000 cannot be
`
`captured by our modeling efforts. Finally,
`our estimates of new cancer cases are
`
`based on incidence rates for the geo-
`graphic locations that participate in the
`SEER program and, therefore, may not
`be representative of the total US.
`Despite these limitations, our esti-
`mates do describe current patterns of
`cancer incidence and mortality in the
`US. Such estimates will assist our con-
`
`tinuing efforts to reduce the public
`health burden of cancer as we enter the
`
`21st century.
`
`References
`1. National Cancer
`
`Institute: SEER Cancer
`
`Incidence Public-Use Database, 1973-1996, August
`1998 Submission. US Department of Health and
`Human Services, Public Health Service. Bethesda,
`MD, 1999.
`
`2. Wingo PA, Landis S, Parker 3, et al: Using can-
`
`cer registry and Vital statistics data to estimate the
`number of new cancer cases and deaths in the
`
`United States for the upcoming year.
`Management 1998;25:43-51.
`3. Ries LAG, Kosary CL, Hankey BF, Miller BA,
`Edwards BK (eds). SEER Cancer Statistics
`Review, 1973-1996. National Cancer Institute,
`Bethesda, MD, 1997.
`
`J Reg
`
`4. Wingo PA, Landis S, Ries LAG: An adjustment
`to the 1997 estimate for new prostate cancer cases.
`CA Cancer J Clin 1997;47:239-242.
`5. National Center for Health Statistics, Division of
`Vital Statistics. Multiple Cause—of—Death for ICD9,
`1996 Data Public-Use Documentation. (Web site)
`www.cdc.gov/nchswww/about/major/dvs/mcd/1996
`mcd.htm 1999.
`
`6. DEVCAN: Probability of Developing or Dying
`of Cancer (Software), version 4. Feuer EJ, Wun
`LM. National Cancer Institute, Bethesda, MD,
`1999.
`
`7. World Health Organization: WIIO Mortality
`Database.
`(Web site) www.who/int/whosis/mort
`1999.
`
`8. World Health Organization: World Health
`Statistics Annual, 1996. Geneva, Switzerland, 1997.
`
`9. Wingo PA, Ries LAG, Giovino GA, et al.
`Annual report to the nation on the status of cancer
`1973-1996, with a special section on lung cancer and
`tobacco smoking. J Natl Cancer Inst 1999,91:
`675-690.
`
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`
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`Education activity will be included in each upcoming issue of CA—A Cancer Journal for
`Clinicians.
`
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`
`When?
`
`What?
`
`Starting March/April 2000!
`
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`include management of cancer pain; malignant melanoma; new treatments for
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`
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`
`for physicians.
`
`VOL. 50 NO. 1 JANUARY/FEBRUARY 2000
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`AstraZeneca Ex. 2008 p. 5
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`

`
`CANCER STATISTICS. 2000
`
` Table 1
`
`Estimated New Cancer Cases by Gender. US, 2000*
`
`All Sites
`Oral cavity & pharynx
`Tongue
`Mouth
`Pharynx
`Other oral cavity
`Digestive system
`Esophagus
`Stomach
`Small intestine
`Colon
`Rectum
`Anus, anal canal, & anorectum
`Liver & intrahepatic bile duct
`Gallbladder & other biliary
`Pancreas
`Other digestive organs
`Respiratory system
`Larynx
`Lung & bronchus
`Other respiratory organs
`Bones & joints
`Soft tissue (including heart)
`Skin (excluding basal & squamous)
`Melanomas-skin
`Other non-epithelial skin
`Breast
`Genital system
`Uterine cervix
`Uterine corpus
`Ovary
`Vulva
`Vagina & other genital, female
`Prostate
`Testis
`Penis & other genital, male
`Urinary system
`Urinary bladder
`Kidney & renal pelvis
`Ureter & other urinary organs
`Eye & orbit
`Brain & other nenrous system
`Endocrine system
`Thyroid
`Other endocrine
`Lymphoma
`Hodgkin's disease
`Non—Hodgkin’s lymphoma
`Multiple myeloma
`Leukemia
`Acute lymphocytic leukemia
`Chronic lymphocytic leukemia
`Acute myeloid leukemia
`Chronic myeloid leukemia
`Other leukemia
`Other 8: unspecified primary sites
`
`Total
`
`1,220,100
`30,200
`6,900
`10,900
`8,200
`4,200
`226,600
`12,300
`21,500
`4,700
`93,800
`36,400
`3,400
`15,300
`6,900
`28,300
`4,000
`179,400
`10,100
`164,100
`5,200
`2,500
`8,100
`56,900
`47,700
`9,200
`184,200
`265,900
`12,800
`36,100
`23,100
`3,400
`2,100
`180,400
`6,900
`1,100
`86,700
`53,200
`31,200
`2,300
`2,200
`16,500
`20,200
`18,400
`1,800
`62,300
`7,400
`54,900
`13,600
`30,800
`3,200
`8,100
`9,700
`4,400
`5,400
`34,000
`
`Male
`
`619,700
`20,200
`4,500
`6,500
`5,900
`3,300
`117,600
`9,200
`13,400
`2,300
`43,400
`20,200
`1,400
`10,000
`2,900
`13,700
`1,100
`101,500
`8,100
`89,500
`3,900
`1,500
`4,300
`34,100
`27,300
`6,800
`1,400
`188,400
`
`180,400
`6,900
`1,100
`58,600
`38,300
`18,800
`1,500
`1,200
`9,500
`5,600
`4,700
`900
`35,900
`4,200
`31,700
`7,300
`16,900
`1,800
`4,600
`4,800
`2,600
`3,100
`15,700
`
`Female
`
`600,400
`10,000
`2,400
`4,400
`2,300
`900
`109,000
`3,100
`8,100
`2,400
`50,400
`16,200
`2,000
`5,300
`4,000
`14,600
`2,900
`77,900
`2,000
`74,600
`1,300
`1,000
`3,800
`22,800
`20,400
`2,400
`182,800
`77,500
`12,800
`36,100
`23,100
`3,400
`2,100
`
`28,100
`14,900
`12,400
`800
`1,000
`7,000
`14,600
`13,700
`900
`26,400
`3,200
`23,200
`6,300
`13,900
`1,400
`3,500
`4,900
`1,800
`2,300
`18,300
`
`*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.
`
`12
`
`CA’A CANCERJOURNAL FOR CLINICIANS
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`Astrazeneca Ex. 2008 p. 6
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`CA CANCER] CLIN 2000;S0:7—33
`
`Estimated Cancer Deaths by Gender. US, 2000*
`
`Table 2
`
`All Sites
`Oral cavity & pharynx
`Tongue
`Mouth
`Pharynx
`Other oral cavity
`Digestive system
`Esophagus
`Stomach
`Small intestine
`Colon
`Rectum
`Anus, anal canal, & anorectum
`Liver & intrahepatic bile duct
`Gallbladder & other biliary
`Pancreas
`Other digestive organs
`Respiratory system
`Larynx
`Lung & bronchus
`Other respiratory organs
`Bones & joints
`Soft tissue (including heart)
`Skin (excluding basal & squamous)
`Melanomas—skin
`Other non-epithelial skin
`Breast
`Genital system
`Uterine cervix
`Uterine corpus
`Ovary
`Vulva
`Vagina & other genital, female
`Prostate
`Testis
`Penis & other genital, male
`Urinary system
`Urinary bladder
`Kidney & renal pelvis
`Ureter & other urinary organs
`Eye & orbit
`Brain & other nervous system
`Endocrine system
`Thyroid
`Other endocrine
`Lymphoma
`Hodgkin's disease
`Non—Hodgkin’s lymphoma
`Multiple myeloma
`Leukemia
`Acute lymphocytic leukemia
`Chronic lymphocytic leukemia
`Acute myeloid leukemia
`Chronic myeloid leukemia
`Other leukemia
`Other & unspecified primary sites
`
`Total
`
`552,200
`7,800
`1,700
`2,300
`2,100
`1,700
`129,800
`12,100
`13,000
`1,200
`47,700
`8,600
`500
`13,800
`3,400
`28,200
`1,300
`161,900
`3,900
`156,900
`1,100
`1,400
`4,600
`9,600
`7,700
`1,900
`41,200
`59,000
`4,600
`6,500
`14,000
`800
`600
`31,900
`300
`300
`24,600
`12,200
`11,900
`500
`200
`13,000
`2,100
`1,200
`900
`27,500
`1,400
`26,100
`11,200
`21,700
`1,300
`4,800
`7,100
`2,300
`6,200
`36,600
`
`Male
`
`284,100
`5,100
`1 ,100
`1,300
`1,500
`1,200
`69,300
`9,200
`7,600
`600
`23,100
`4,700
`200
`8,500
`1,200
`13,700
`500
`93,100
`3,100
`89,300
`700
`800
`2,200
`6,000
`4,800
`1,200
`400
`32,500
`
`31,900
`300
`300
`15,700
`8,100
`7,300
`300
`100
`7,100
`1,000
`500
`500
`14,400
`700
`13,700
`5,800
`12,100
`700
`2,800
`3,900
`1,300
`3,400
`18,500
`
`Female
`
`268,100
`2,700
`600
`1,000
`600
`500
`60,500
`2,900
`5,400
`600
`24,600
`3,900
`300
`5,300
`2,200
`14,500
`800
`68,800
`800
`67,600
`400
`600
`2,400
`3,600
`2,900
`700
`40,800
`26,500
`4,600
`6,500
`14,000
`800
`600
`
`8,900
`4,100
`4,600
`200
`100
`5,900
`1,100
`700
`400
`13,100
`700
`12,400
`5,400
`9,600
`600
`2,000
`3,200
`1,000
`2,800
`18,100
`
`*Excludes in situ carcinomas except urinary bladder.
`
`VOL. 50 NO. 1 JANUARY/FEBRUARY 2000
`
`13
`
`Astrazeneca Ex. 2008 p. 7
`
`

`
`CANCER STATISTICS. 2000
`
` Table 3
`
`Estimated New Cancer Cases by Site and State, US, 2000*
`Non-
`Hodgkin’s
`Lung 81
`Uterine
`Corpus Bronchus Melanoma Lymphoma
`500
`3,000
`900
`900
`—
`200
`100
`100
`666
`2,833
`1,020
`922
`466
`2,200
`460
`566
`3,200
`14,000
`5,000
`5,300
`466
`‘ ,533
`720
`722
`566
`,933
`620
`722
`100
`600
`100
`200
`100
`333
`—
`133
`2,566
`12,633
`3,520
`4,022
`966
`1,200
`1,060
`1,066
`100
`500
`100
`200
`166
`633
`223
`222
`1,666
`7,333
`1,923
`2,522
`866
`4,033
`1,023
`1,223
`600
`‘,933
`533
`733
`366
`,633
`523
`522
`500
`3,400
`900
`800
`500
`2,900
`700
`800
`166
`‘ ,033
`223
`362
`766
`3,100
`860
`960
`866
`3,933
`1,323
`1,422
`1,400
`6,133
`1,403
`2,133
`566
`2,300
`760
`1,166
`200
`1,900
`400
`500
`800
`4,000
`1,100
`1,100
`166
`533
`123
`222
`266
`900
`260
`366
`266
`1,233
`423
`322
`166
`733
`223
`322
`1,566
`4,800
`1,760
`1,966
`200
`700
`300
`300
`3,200
`9,833
`2,633
`3,833
`1,166
`5,233
`1,323
`1,422
`166
`300
`160
`166
`2,000
`7,833
`1,933
`2,733
`366
`2,533
`723
`722
`466
`2,203
`760
`766
`2,200
`8,600
`2,400
`3,000
`100
`833
`233
`333
`566
`2,533
`523
`722
`166
`433
`223
`223
`600
`4,233
`1,333
`1,233
`2,160
`10,733
`3,420
`3,622
`200
`400
`400
`300
`100
`400
`200
`100
`1,000
`4,033
`1,233
`1,233
`660
`3,100
`1,160
`1,166
`360
`1,633
`423
`422
`700
`2,833
`1,033
`1,233
`160
`233
`123
`122
`36,100
`164,163
`47,700
`54,930
`
`State
`Alabama
`Alaska
`Arizona
`Arkansas
`California
`Colorado
`Connecticut
`Delaware
`Dist. of Col.
`Florida
`Georgia
`Hawaii
`Idaho
`Illinois
`Indiana
`Iowa
`Kansas
`Kentucky
`Louisiana
`Maine
`Maryland
`Massachusetts
`Michigan
`Minnesota
`Mississippi
`Missouri
`Montana
`Nebraska
`Nevada
`New Hampshire
`New Jersey
`New Mexico
`New York
`North Carolina
`North Dakota
`Ohio
`Oklahoma
`Oregon
`Pennsylvania
`Rhode Island
`South Carolina
`South Dakota
`Tennessee
`Texas
`Utah
`Vermont
`Virginia
`Washington
`West Virginia
`Wisconsin
`Wyoming
`United Statest
`
`All
`Sites
`21,500
`1,500
`20,322
`13,766
`113,200
`13,422
`15,422
`3,900
`2,733
`88,122
`29,466
`4,300
`4,722
`55,122
`27,922
`14,233
`11,922
`20,500
`20,800
`6,822
`22,666
`30,122
`44,133
`19,966
`13,200
`27,000
`4,122
`7,366
`8,322
`5,522
`40,026
`6,600
`81,533
`35,723
`3,066
`56,133
`16,122
`15,866
`66,600
`5,433
`18,022
`3,523
`27,333
`76,122
`5,100
`2,700
`29,333
`23,666
`10,522
`23,633
`2,022
`1,220,130
`
`Female
`Breast
`2,700
`200
`2,826
`1,966
`17,900
`2,026
`2,326
`500
`530
`12,026
`4,666
`500
`726
`8,936
`4,226
`2,130
`1,626
`2,700
`3,200
`926
`3,766
`4,426
`6,730
`2,866
`2,000
`3,700
`626
`1 ,166
`1,026
`726
`6,466
`1,000
`13,730
`5,226
`560
`8,630
`2,426
`2,266
`10,500
`830
`2,626
`426
`3,830
`11,526
`900
`400
`4,530
`3,566
`1,426
`3,330
`326
`182,800
`
`Colon &
`Uterine
`Cervix Rectum
`200
`1,800
`—
`200
`222
`2,030
`166
`1,300
`1,300
`11,400
`122
`1,430
`122
`1,530
`100
`400
`—
`330
`922
`9,130
`466
`2,800
`—
`400
`—
`530
`622
`6,030
`322
`3,130
`133
`1,930
`122
`1,230
`300
`2,200
`300
`2,200
`122
`730
`360
`2,600
`222
`3,530
`433
`4,830
`266
`2,000
`200
`1,300
`300
`2,900
`—
`430
`166
`1,000
`22
`930
`—
`630
`466
`4,600
`100
`700
`1,033
`9,230
`422
`3,730
`—
`400
`633
`6,230
`222
`1,730
`166
`1,600
`600
`7,800
`133
`630
`222
`1,930
`—
`430
`433
`2,930
`1,022
`8,330
`100
`600
`100
`400
`333
`2,930
`266
`2,300
`122
`1,130
`233
`2,530
`—
`330
`12,830
`130,200
`
`Urinary
`lfidney Prostate Bladder
`400
`3,500
`800
`—
`100
`100
`566
`3,366
`933
`466
`2,266
`500
`2,900
`16,400
`5,200
`466
`1,866
`633
`466
`2,366
`833
`100
`600
`200
`—
`600
`133
`2,666
`13,766
`4,333
`766
`4,466
`1,000
`100
`700
`100
`266
`866
`233
`1,4 26
`7,866
`2,433
`826
`3,966
`1,233
`430
`2,200
`633
`326
`1,866
`533
`600
`2,600
`600
`600
`3,200
`700
`226
`966
`433
`566
`3,366
`1,000
`726
`4,266
`1,733
`1,230
`6,600
`2,‘ 33
`666
`3,366
`1,000
`300
`2,200
`300
`700
`3,600
`1,‘ 00
`126
`766
`233
`266
`1,066
`300
`226
`1,266
`433
`126
`766
`333
`1,060
`5,666
`2,‘ 00
`200
`1,200
`200
`1,930
`11,800
`,‘ 33
`926
`5,366
`1,433
`166
`506
`‘00
`1,530
`7,800
`2,533
`526
`2,166
`733
`466
`2,766
`700
`1,700
`10,000
`3,‘ 00
`130
`700
`333
`526
`2,966
`833
`126
`666
`‘ 33
`730
`3,600
`933
`2,266
`11,366
`2,833
`100
`1 ,200
`200
`100
`300
`‘ 00
`730
`4,400
`1,‘ 33
`666
`3,266
`,000
`326
`1,366
`433
`730
`3,800
`1,233
`126
`466
`—
`31,200
`180,400
`53,260
`
`— Estimate is 50 or fewer cases. State case es imates between 51 atd 99 were ounded to 100.
`* Excludes basal and squamous cel skin cancers and in s‘ u carcinomas except Lr'nary bladder.
`T State estimates may 101 add up to United States total due to rounding.
`
`CA’A CANCERJOURNAL FOR CLINICIANS
`
`Astrazeneca Ex. 2008 p. 8
`
`

`
`CA CANCER] CLIN 2000;S0:7-33
`
` Table 4
`
`Estimated Cancer Mortality by Site and State. US, 2000*
`
`Estimated Number of Deaths
`Non-
`Reported
`Lung& Hodgkin’s
`All Female Co|on&
`Death Rate
`Liver Leukemia Bronchus Lymphoma Ovary Pancreas Prostate Stomach
`Sites Breast Rectum
`per1oo,ooor
`State
`300
`300
`2,800
`400
`200
`530
`600
`200
`9,700
`600
`800
`‘79
`Alabama
`—
`—
`230
`—
`—
`—
`—
`—
`700
`10C
`100
`67
`Alaska
`200
`300
`2,600
`403
`233
`530
`603
`200
`9,200
`6E0
`900
`55
`Arizona
`200
`200
`2,100
`300
`200
`330
`400
`100
`6,200
`400
`600
`81
`Arkansas
`1,700
`2,100
`13,430
`2,503 1,433
`2,730
`2,903
`1,500
`51,200
`4,000
`4,900
`56
`California
`100
`300
`1,430
`303
`133
`300
`303
`100
`6,100
`40C
`600
`42
`Colorado
`200
`300
`1,900
`300
`200
`430
`400
`200
`7,000
`500
`600
`‘ 63
`Jon necticul
`—
`100
`500
`100
`—
`130
`100
`—
`1,800
`10C
`200
`‘ 95
`Delaware
`—
`—
`330
`—
`—
`100
`103
`100
`1,200
`10C
`100
`212
`Dist. of Col.
`1,000
`1,500
`12,030
`1,903
`933
`2,130
`2,403
`900
`39,900
`2,700
`3,900
`‘ 66
`‘lorida
`300
`500
`4,030
`503
`433
`630
`803
`300
`13,300
`1,000
`‘,200
`75
`Georgia
`100
`100
`530
`103
`—
`130
`103
`100
`2,000
`10C
`200
`‘33
`Hawaii
`—
`100
`530
`103
`133
`100
`103
`—
`2,100
`20C
`200
`‘48
`daho
`700
`1,000
`6,930
`1,203
`733
`1,300
`1,403
`600
`24,900
`2,000
`2,600
`‘ 78
`llinois
`300
`500
`3,900
`600
`300
`630
`700
`200
`12,600
`900
`‘ ,300
`‘ 78
`ndiana
`100
`300
`1,800
`300
`200
`330
`400
`100
`6,400
`500
`800
`‘60
`owa
`100
`200
`1,630
`203
`133
`300
`303
`100
`5,400
`400
`500
`‘ 59
`Kansas
`200
`300
`3,230
`403
`233
`400
`503
`200
`9,300
`600
`900
`‘92
`Kentucky
`300
`400
`2,730
`403
`233
`530
`603
`300
`9,400
`70C
`‘,000
`‘93
`_ouisiana
`—
`100
`930
`203
`133
`230
`203
`100
`3,100
`20C
`300
`‘85
`lrlaine
`200
`400
`2,930
`403
`233
`500
`603
`300
`10,200
`80C
`‘,100
`‘84
`lrlaryland
`300
`500
`3,730
`703
`333
`700
`703
`300
`13,600
`1,000
`‘,500
`‘78
`lrlassachusetts
`500
`700
`5,800
`1,000
`500
`1,030
`1,200
`400
`20,000
`1,500
`2,100
`‘73
`lrlichigan
`200
`400
`2,200
`500
`200
`530
`600
`200
`9,000
`600
`900
`‘56
`Vlinnesota
`200
`200
`1,830
`203
`133
`300
`403
`100
`6,000
`400
`600
`‘ 82
`lrlississippi
`300
`500
`3,830
`503
`333
`530
`603
`300
`12,200
`800
`‘,300
`‘76
`lrlissouri
`100
`100
`500
`100
`100
`130
`100
`—
`1,900
`100
`200
`‘ 59
`lrlontana
`100
`200
`930
`203
`133
`130
`203
`100
`3,300
`30C
`400
`‘ 55
`ebraska
`100
`100
`1,230
`203
`133
`230
`203
`100
`3,800
`20C
`400
`‘ 84
`evada
`100
`100
`700
`100
`100
`130
`100
`—
`2,500
`200
`300
`‘81
`ew Hampshire
`500
`800
`4,600
`900
`500
`1,030
`1,000
`500
`18,100
`1,400
`2,000
`‘ 79
`\lew Jersey
`100
`100
`700
`100
`100
`130
`200
`100
`3,000
`200
`300
`‘46
`ew Mexico
`900
`1,400
`9,430
`1,803 1,033
`2,230
`2,103
`1,100
`36,900
`3,100
`4,000
`‘69
`ewYork
`300
`600
`5,030
`703
`433
`830
`903
`300
`16,200
`1,200
`1,600
`‘75
`orth Carolina
`—
`100
`300
`100
`—
`130
`100
`—
`1,300
`100
`200
`‘55
`orth Dakota
`500
`1,000
`7,430
`1,303
`633
`1,300
`1,403
`500
`25,400
`1,900
`2,700
`‘80
`3hio
`200
`300
`2,430
`303
`233
`300
`403
`100
`7,300
`50C
`700
`‘70
`3klahoma
`100
`300
`2,100
`300
`200
`430
`500
`100
`7,100
`500
`700
`‘66
`3regon
`700
`1,200
`8,200
`1,400
`800
`1,530
`1,800
`600
`30,100
`2,300
`3,400
`‘77
`°ennsylvania
`100
`100
`830
`103
`133
`100
`103
`100
`2,400
`200
`300
`‘78
`3hode Island
`200
`300
`2,430
`303
`233
`430
`503
`200
`8,200
`600
`800
`‘78
`South Carolina
`—
`100
`430
`103
`—
`130
`103
`—
`1,600
`10C
`200
`‘55
`South Dakota
`300
`400
`4,030
`603
`333
`630
`603
`300
`12,400
`9CC
`1,200
`‘81
`Tennessee
`1,100
`1,400
`10,330
`1,703
`933
`1,700
`2,003
`900
`34,400
`2,600
`3,600
`‘ 68
`Texas
`100
`100
`430
`103
`133
`100
`203
`40
`2,300
`20C
`200
`‘ 22
`Utah
`—
`—
`400
`100
`—
`—
`100
`—
`1,200
`100
`200
`‘72
`Vermont
`300
`500
`3,800
`600
`300
`630
`800
`300
`13,300
`1,000
`1,300
`‘77
`Virginia
`300
`500
`3,030
`503
`333
`500
`603
`200
`10,700
`800
`1,000
`‘62
`Washington
`100
`200
`1,530
`203
`133
`200
`203
`100
`4,800
`300
`500
`‘84
`West Virginia
`200
`500
`2,730
`603
`333
`630
`703
`200
`10,700
`7CC
`1,100
`‘63
`Wisconsin
`—
`—
`230
`—
`—
`—
`103
`—
`900
`10C
`100
`‘57
`Wyoming
`‘70 552,200
`40,800
`56,300 13,800
`21,700
`156,930
`26,103 14,000
`28,200
`31,903
`13,000
`United Statest
`— Estimate is 50 orfewer deaths. State death estimates between 51 and 99 were rounded to 100.
`* Excludes in situ ca cinomas except ur'nary bladder.
`1' Average annual morta ity rate between 1992 and 1996, age—adjusted to the 1970 US standard population.
`Source: US Mortality 1992-1996, National Center for Health Statistics, Cente s for Disease Control and Prevention 1999,
`Institute.
`Surveillance, Epiderriology, and End Results Program, Division of Cancer Control and Population Sciences, National Cancer
`¢ State estimates may not add up to United States total due to rounding.
`
`VOL. 50 NO.1]A UARY/FEBRUARY 2000
`
`15
`
`Astrazeneca Ex. 2008 p. 9
`
`

`
`CANCER STATISTICS. 2000
`
` Figure 1
`
`1 0 Leading Sites by Gender. US. 2000
`
`Estimated New Cancer Cases*
`
`Prostate
`
`29%
`
`30%
`
`Breast
`
`Lung & Bronchus
`
`14%
`
`Colon & Rectum 10%
`
`Urinary Bladder
`
`Non-Hodgkin’s Lymphoma
`
`Melanoma of Skin
`
`Oral Cavity & Pharynx
`
`Kidney & Renal Pelvis
`
`Leukemia
`
`6%
`
`5%
`
`4%
`
`3%
`
`3%
`
`3%
`
`Pancreas
`
`2%
`
`All Other Sites
`
`19%
`
`12%
`
`11%
`
`Lung & Bronchus
`
`Colon & Rectum
`
`6%
`
`4%
`
`4%
`
`3%
`
`2%
`
`2%
`
`2%
`
`22%
`
`Uterine Corpus
`
`Ovary
`
`Non-Hodgkin's Lymphoma
`
`Melanoma of Skin
`
`Urinary Bladder
`
`Pancreas
`
`Thyroid
`
`All Other Sites
`
`*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.
`Percentages may not total 100% due to rounding.
`
`10 Leading Sites by Gender, US. 2000
`
`Figure 2
`Estimated Cancer Deaths*
`
`Lung & Bronchus
`Prostate
`
`31%
`1 1 %
`
`Colon & Rectum
`
`10%
`
`Pancreas
`
`Non—Hodgkin‘s Lymphoma
`
`Leukemia
`
`Esophagus
`
`Liver & lntrahepatic Bile Duct
`
`Urinary Bladder
`
`Stomach
`
`5%
`
`5%
`
`4%
`
`3%
`
`3%
`
`3%
`
`3%
`
`All Other Sites
`
`22%
`
`25% Lung & Bronchus
`1 5% Breast
`
`11% Colon & Rectum
`
`5% Pancreas
`
`5% Ovary
`
`5% Non—Hodgkin’s Lymphoma
`
`4% Leukemia
`
`2% Uterine Corpus
`
`2% Brain & Other Nervous System
`
`2% Stomacht
`
`2% Multiple Myelomat
`
`21% All Other Sites
`
`*Excludes in situ carcinomas except urinary bladder.
`TThese two cancers both received a ranking of 10; they have the same projected number of deaths and contribute the
`same percentage. Percentages may not total 100% due to rounding.
`
`16
`
`CA”A CANCERJOURNAL FOR CLINICIANS
`
`Astrazeneca Ex. 2008 p. 10
`
`

`
`0
`
`A
`
`N
`
`0O
`
`0000020:00020000000000000:0
`
`0.003.0.0000.00
`
`
`
`c00_:00.00A05:00.00.00___::0A00:_25.00.0:.5000__<
`
`0.0.000W0000_:00.00000_:00.00000_:00.00000.00_:00.00_0_>_E2000.00200M000_:00.000000_:00.00000_:00.00000_:00.0000$00020M00_::00A05:00.00E___500.0000___500..
`
`
`
`
`
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`
`2A000_:00.00000_:00.000:0_:5.050.00_:00.0000$
`
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`
`0,A000_::0A000_000.00000_:00.000