`CA CANCER] CLlN 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 accountfor
`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.)
`
`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-
`cific cancer incidence rates collected by
`the National Cancer Institute’s Surveil-
`
`lance, Epidemiology, and End Results
`(SEER) prograrn.1 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).2
`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
`
`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
`prostate cancer cases would approxi-
`their assistance in preparation of this manuscript.
`mate the rates observed prior to wide-
`This article is also available online at http://www.
`ca-journal.org.
`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
`
`III 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},6 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-
`
`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
`tional Classification of Diseases; 2) popu-
`colon and rectum cancer incidence rates
`lations of 500,000 or more; 3) death
`
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`CA CANCER] CLIN 2000;50:7»33
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`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
`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
`
`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 w0men, 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 c0mbined
`
`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.
`
`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.
`
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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-
`
`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.3
`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
`
`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
`currently available cancer mortality and
`prostate cancers.3
`
`10
`
`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
`
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`CA CANCER] CLIN 2000;50:7e33
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`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
`Institute: SEER Cancer
`1. National Cancer
`Incidence Public-Use Database, 1973-1996, August
`1998 Submission. US Department of Health and
`Human Services, Public Health Selvice. Bethesda,
`MD, 1999.
`2. Wingo PA. Landis S. Parker S. 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.
`J Reg
`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.
`4. Wingo PA, Landis S, Ries LAG: An adjustment
`to the 1997 estimate for new prostate cancer cases.
`CA Cancer J Cljn 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.cdcgov/nchswww/about/major/dvs/mcd/1996
`mcdhtm 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: WHO 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 a1.
`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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`
`When ?
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`Starting March/April 2000!
`
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`CANCER STATISTICS, 2000
`
`Table 1
`Estimated New Cancer Cases by Gender. US, 2000*
`
`Total
`Male
`Female
`
`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
`
`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
`
`
`
`1,220,100
`All Sites
`30,200
`Oral cavity & pharynx
`6,900
`Tongue
`10,900
`Mouth
`8,200
`Pharynx
`4,200
`Other oral cavity
`226,600
`Digestive system
`12,300
`Esophagus
`21,500
`Stomach
`4,700
`Small intestine
`93,800
`Colon
`36,400
`Rectum
`3,400
`Anus, anal canal, & anorectum
`15,300
`Liver & intrahepatic bile duct
`6,900
`Gallbladder & other biliary
`28,300
`Pancreas
`4,000
`Other digestive organs
`179,400
`Respiratory system
`10,100
`Larynx
`164,100
`Lung & bronchus
`5,200
`Other respiratory organs
`2,500
`Bones & joints
`8,100
`Soft tissue (including heart)
`56,900
`Skin (excluding basal & squamous)
`47,700
`Melanomas—skin
`9,200
`Other non—epithelial skin
`184,200
`Breast
`265,900
`Genital system
`12,800
`Uterine cervix
`36,100
`Uterine corpus
`23,100
`Ovary
`3,400
`Vulva
`2,100
`Vagina & other genital, female
`180,400
`180,400
`Prostate
`6,900
`6,900
`Testis
`1,100
`1,100
`Penis & other genital, male
`28,100
`58,600
`86,700
`Urinary system
`14,900
`38,300
`53,200
`Urinary bladder
`12,400
`18,800
`31,200
`Kidney & renal pelvis
`800
`1,500
`2,300
`Ureter & other urinary organs
`1,000
`1,200
`2,200
`Eye & orbit
`7,000
`9,500
`16,500
`Brain & other nervous system
`14,600
`5,600
`20,200
`Endocrine system
`13,700
`4,700
`18,400
`Thyroid
`900
`900
`1,800
`Other endocrine
`26,400
`35,900
`62,300
`Lymphoma
`3,200
`4,200
`7,400
`Hodgkin‘s disease
`23,200
`31,700
`54,900
`Non—Hodgkin’s lymphoma
`6,300
`7,300
`13,600
`Multiple myeloma
`13,900
`16,900
`30,800
`Leukemia
`1,400
`1,800
`3,200
`Acute lymphocytic leukemia
`3,500
`4,600
`8,100
`Chronic lymphocytic leukemia
`4,900
`4,800
`9,700
`Acute myeloid leukemia
`1,800
`2,600
`4,400
`Chronic myeloid leukemia
`Other leukemia
`5,400
`3,100
`2,300
`
`Other & unspecified primary sites
`34,000
`15,700
`18,300
`*Exoludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.
`
`
`
`12
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`CA CANCER] CLIN 2000;50:7»33
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`Table 2
`Estimated Cancer Deaths by Gender. US. 2000*
`Total
`Male
`Female
`
`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
`
`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
`
`
`
`
`All Sites
`Oral cavity & pharynx
`Tongue
`lVouth
`Pharynx
`0 her oral cavity
`Digestive system
`Esophagus
`8 omach
`Snail intestine
`Colon
`Rectum
`ATUS, anal canal, & anorectum
`Liver & intrahepatic bile duct
`Gallbladder & other biliary
`Pancreas
`0 her digestive organs
`Respiratory system
`Larynx
`Lung & bronchus
`0 her respiratory organs
`Bones & joints
`Soft tissue (including heart)
`Skin (excluding basal & squamous)
`lVelanomas-skin
`0 her non—epithelial skin
`Breast
`Genital system
`U erine cervix
`U erine 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
`*Excludes in situ carcinomas except urinary bladder.
`
`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
`
`VOL. 50 NO. 1 JANUARY/FEBRUARY 2000
`
`13
`
`AstraZeneca Exhibit 2008 p. 7
`
`
`
`
`
`CANCER STATISTICS, 2000
`
`
`
`Table 3
`Estimated New Cancer Cases by Site and State, US. 2000*
`Non-
`Hodgkin’s
`Lung&
`Uterine
`Uterine Colon&
`Female
`All
`Corpus Bronchus Melanoma Lymphoma
`Cervix
`Rectum
`Breast
`Sites
`500
`3,000
`900
`900
`200
`1,800
`2,700
`21,500
`—
`200
`100
`100
`—
`200
`200
`1,500
`600
`2,800
`1,000
`900
`200
`2,000
`2,800
`20,300
`400
`2,200
`400
`500
`100
`1,300
`1,900
`13,700
`3,200
`14,000
`5,000
`5,300
`1,300
`11,400
`17,900
`113,200
`400
`1,500
`700
`700
`100
`1,400
`2,000
`13,400
`500
`1,900
`600
`700
`100
`1,500
`2,300
`15,400
`100
`600
`100
`200
`100
`400
`500
`3,900
`100
`300
`—
`100
`—
`300
`500
`2,700
`2,500
`12,600
`3,500
`4,000
`900
`9,100
`12,000
`88,100
`900
`4,200
`1,000
`1,000
`400
`2,800
`4,600
`29,400
`100
`500
`100
`200
`—
`400
`500
`4,300
`100
`600
`200
`200
`—
`500
`700
`4,700
`1,600
`7,300
`1,900
`2,500
`600
`6,000
`8,900
`55,100
`800
`4,000
`1,000
`1,200
`300
`3,100
`4,200
`27,900
`600
`1,900
`500
`700
`100
`1,900
`2,100
`14,200
`300
`1,600
`500
`500
`100
`1,200
`1,600
`11,900
`500
`3,400
`900
`800
`300
`2,200
`2,700
`20,500
`500
`2,900
`700
`800
`300
`2,200
`3,200
`20,800
`100
`1,000
`200
`300
`100
`700
`900
`6,800
`700
`3,100
`800
`900
`300
`2,600
`3,700
`22,600
`800
`3,900
`1,300
`1,400
`200
`3,500
`4,400
`30,100
`1,400
`6,100
`1,400
`2,100
`400
`4,800
`6,700
`44,100
`500
`2,300
`700
`1,100
`200
`2,000
`2,800
`19,900
`200
`1,900
`400
`500
`200
`1,300
`2,000
`13,200
`800
`4,000
`1,100
`1,100
`300
`2,900
`3,700
`27,000
`100
`500
`100
`200
`—
`400
`600
`4,100
`200
`900
`200
`300
`100
`1,000
`1 ,100
`7,300
`200
`1,200
`400
`300
`100
`900
`1,000
`8,300
`100
`700
`200
`300
`—
`600
`700
`5,500
`1,500
`4,800
`1,700
`1,900
`400
`4,600
`6,400
`40,000
`200
`700
`300
`300
`100
`700
`1,000
`6,600
`3,200
`9,800
`2, 600
`3,800
`1,000
`9,200
`13,700
`81,500
`1,100
`5,200
`1,300
`1,400
`400
`3,700
`5,200
`35,700
`100
`300
`100
`100
`—
`400
`500
`3,000
`2,000
`7,800
`1,900
`2,700
`600
`6,200
`8,600
`56,100
`300
`2,500
`700
`700
`200
`1,700
`2,400
`16,100
`400
`2,200
`700
`700
`100
`1,600
`2,200
`15,800
`2,200
`8,600
`2, 400
`3,000
`600
`7,800
`10,500
`66,600
`100
`800
`200
`300
`100
`600
`800
`5,400
`500
`2,500
`500
`700
`200
`1,900
`2,600
`18,000
`100
`400
`200
`200
`—
`400
`400
`3,500
`600
`4,200
`1,300
`1,200
`400
`2,900
`3,800
`27,300
`2,100
`10,700
`3,400
`3,600
`1,000
`8,300
`11,500
`76,100
`200
`400
`400
`300
`100
`600
`900
`5,100
`Jtah
`100
`400
`200
`100
`100
`400
`400
`2,700
`Vermont
`1,000
`4,000
`1,200
`1,200
`300
`2,900
`4,500
`29,300
`Virginia
`600
`3,100
`1,100
`1,100
`200
`2,300
`3,500
`23,600
`Washington
`300
`1,600
`400
`400
`100
`1 ,100
`1,400
`10,500
`West Virginia
`700
`2, 800
`1,000
`1,200
`200
`2,500
`3,300
`23,600
`Wisconsin
`100
`200
`100
`100
`300
`300
`2,000
`Wyoming
`36,100
`164,100
`47,700
`54,900
`130,200
`12,800
`182,800
`1,220,100
`Unitedstatest
`— Estimate is 50 or fewer cases. State case estimates between 51 and 99 were rounded to 100.
`* Excludes basa and squamous cell skin cancers and in situ carcinomas except urinary bladder.
`1 State estimates may not add up to United States total due to rounding.
`
`
`
`Urinary
`lfldney Prostate Bladder
`400
`3,500
`800
`—
`100
`100
`500
`3,300
`900
`400
`2,200
`500
`2,900
`16,400
`5,200
`400
`1,800
`600
`400
`2,300
`800
`100
`600
`200
`—
`600
`100
`2,000
`13,700
`4,300
`700
`4,400
`1,000
`100
`700
`100
`200
`800
`200
`1,400
`7,800
`2,400
`800
`3,900
`1,200
`400
`2,200
`600
`300
`1,800
`500
`600
`2,600
`600
`600
`3,200
`700
`200
`900
`400
`500
`3,300
`1,000
`700
`4,200
`1,700
`1,200
`6,600
`2,100
`600
`3,300
`1,000
`300
`2,200
`300
`700
`3,600
`1 ,100
`100
`700
`200
`200
`1,000
`300
`200
`1,200
`400
`100
`700
`300
`1,000
`5,600
`2,100
`200
`1,200
`200
`1,900
`11,800
`4,100
`900
`5,300
`1,400
`100
`500
`100
`1,500
`7,800
`2,500
`500
`2,100
`700
`400
`2,700
`700
`1,700
`10,000
`3,100
`100
`700
`300
`500
`2,900
`800
`100
`600
`100
`700
`3,600
`900
`2,200
`11,300
`2,800
`100
`1,200
`200
`100
`300
`100
`700
`4,400
`1 ,100
`600
`3,200
`1,000
`300
`1,300
`400
`700
`3,800
`1,200
`100
`400
`31,200
`180,400
`
`53,200
`
`State
`Alabama
`Alaska
`Arizona
`Arkansas
`California
`Colorado
`Connecticut
`Delaware
`Dist. of Col.
`:Iorida
`Georgia
`-lawaii
`daho
`||in0is
`ndiana
`owa
`Kansas
`Kentucky
`.0uisiana
`aine
`aryland
`assachusetls
`ichigan
`innesota
`Mississippi
`issouri
`ontana
`ebraska
`evada
`ew Hampshire
`eW Jersey
`New Mexico
`eW York
`North Carolina
`orth Dakota
`Ohio
`Oklahoma
`Oregon
`Jen nsyivania
`Rhode Island
`South Carolina
`South Dakota
`ennessee
`
`
`
` eXas
`
`
`
`
`
`
`14
`
`CAiA CANCER ]OURNAL FOR CLINICIANS
`
`AstraZeneca Exhibit 2008 p. 8
`
`
`
`
`CA CANCER] CLIN 2000;50:7»33
`
`
`
`Table 4
`Estimated Cancer Mortality by Site and State, US. 2000*
`Estimated Number of Deaths
`Non-
`Reported
`Lung & Hodgkin‘s
`All Female Colon &
`Death Rate
`Sites Breast Rectum Liver Leukemia Bronchus Lymphoma Ovary Pancreas Prostate Stomach
`per100,000t
`State
`9,700
`600
`800
`300
`300
`2,800
`400
`200
`500
`600
`200
`179
`Alabama
`700
`100
`100
`—
`—
`200
`— —
`—
`—
`—
`167
`Alaska
`9,200
`600
`900
`200
`300
`2,600
`400
`200
`500
`600
`200
`155
`Arizona
`6,200
`400
`600
`200
`200
`2,100
`300
`200
`300
`400
`100
`181
`Arkansas
`51,200
`4,000
`4,900
`1,700
`2,100
`13,400
`2,500 1,400
`2,700
`2,900
`1,500
`156
`Calitornia
`6,100
`400
`600
`100
`300
`1,400
`300
`100
`300
`300
`100
`142
`Colorado
`7,000
`500
`600
`200
`300
`1,900
`300
`200
`400
`400
`200
`163
`Connecticut
`1,800
`100
`200
`—
`100
`500
`100
`—
`100
`100
`—
`195
`Delaware
`1,200
`100
`100
`—
`—
`300
`— —
`100
`100
`100
`212
`Dist. of Col.
`39,900
`2,700
`3,900
`1,000
`1,500
`12,000
`1,900
`900
`2,100
`2,400
`900
`166
`Florida
`13,300
`1,000
`1,200
`300
`500
`4,000
`500
`400
`600
`800
`300
`175
`Georgia
`2,000
`100
`200
`100
`100
`500
`100
`—
`100
`100
`100
`133
`Hawaii
`2,100
`200
`200
`—
`100
`500
`100
`100
`100
`100
`—
`148
`Idaho
`24,900
`2,000
`2,600
`700
`1,000
`6,900
`1,200
`700
`1,300
`1,400
`600
`178
`Illinois
`12,600
`900
`1,300
`300
`500
`3,900
`600
`300
`600
`700
`200
`178
`Indiana
`6,400
`500
`800
`100
`300
`1,800
`300
`200
`300
`400
`100
`160
`Iowa
`5,400
`400
`500
`100
`200
`1,600
`200
`100
`300
`300
`100
`159
`Kansas
`9,300
`600
`900
`200
`300
`3,200
`400
`200
`400
`500
`200
`192
`Kentucky
`9,400
`700
`1,000
`300
`400
`2,700
`400
`200
`500
`600
`300
`193
`Louisiana
`3,100
`200
`300
`—
`100
`900
`200
`100
`200
`200
`100
`185
`Maine
`10,200
`800
`1,100
`200
`400
`2,900
`400
`200
`500
`600
`300
`184
`Maryland
`13,600
`1,000
`1,500
`300
`500
`3,700
`700
`300
`700
`700
`300
`178
`Massachusetts
`20,000
`1,500
`2,100
`500
`700
`5,800
`1,000
`500
`1,000
`1,200
`400
`173
`Michigan
`9,000
`600
`900
`200
`400
`2,200
`500
`200
`500
`600
`200
`156
`Minnesota
`6,000
`400
`600
`200
`200
`1,800
`200
`100
`300
`400
`100
`182
`Mississippi
`12,200
`800
`1,300
`300
`500
`3,800
`500
`300
`500
`600
`300
`176
`Missouri
`1,900
`100
`200
`100
`100
`500
`100
`100
`100
`100
`—
`159
`Montana
`3,300
`300
`400
`100
`200
`900
`200
`100
`100
`200
`100
`155
`Nebraska
`3,800
`200
`400
`100
`100
`1,200
`200
`100
`200
`200
`100
`184
`Nevada
`2,500
`200
`300
`100
`100
`700
`100
`100
`100
`100
`—
`181
`New Hampshire
`18,100
`1,400
`2,000
`500
`800
`4,600
`900
`500
`1,000
`1,000
`500
`179
`New Jersey
`3,000
`200
`300
`100
`100
`700
`100
`100
`100
`200
`100
`146
`New Mexico
`36,900
`3,100
`4,000
`900
`1,400
`9,400
`1,800 1,000
`2,200
`2,100
`1,100
`169
`NewYork
`16,200
`1,200
`1,600
`300
`600
`5,000
`700
`400
`800
`900
`300
`175
`North Carolina
`1,300
`100
`200
`—
`100
`300
`100
`—
`100
`100
`—
`155
`North Dakota
`25,400
`1,900
`2,700
`500
`1,000
`7,400
`1,300
`600
`1,300
`1,400
`500
`180
`Ohio
`7,300
`500
`700
`200
`300
`2,400
`300
`200
`300
`400
`100
`170
`Oklahoma
`7,100
`500
`700
`100
`300
`2,100
`300
`200
`400
`500
`100
`166
`Oregon
`30,100
`2,300
`3,400
`700
`1,200
`8,200
`1,400
`800
`1,500
`1,800
`600
`177
`Pennsylvania
`2,400
`200
`300
`100
`100
`800
`100
`100
`100
`100
`100
`178
`Rhode Island
`8,200
`600
`800
`200
`300
`2,400
`300
`200
`400
`500
`200
`178
`South Carolina
`1,600
`100
`200
`—
`100
`400
`100
`—
`100
`100
`—
`155
`South Dakota
`12,400
`900
`1,200
`300
`400
`4,000
`600
`300
`600
`600
`300
`181
`Tennessee
`34,400
`2,600
`3,600
`1 ,100
`1,400
`10,300
`1,700
`900
`1,700
`2,000
`900
`168
`Texas
`2,300
`200
`200
`100
`100
`400
`100
`100
`100
`200
`40
`122
`Utah
`1,200
`100
`200
`—
`—
`400
`100
`—
`—
`100
`—
`172
`Vermont
`13,300
`1,000
`1,300
`300
`500
`3,800
`600
`300
`600
`800
`300
`177
`Virginia
`10,700
`800
`1,000
`300
`500
`3,000
`500
`300
`500
`600
`200
`162
`Washington
`4,800
`300
`500
`100
`200
`1,500
`200
`100
`200
`200
`100
`184
`West Virginia
`10,700
`700
`1,100
`200
`500
`2,700
`600
`300
`600
`700
`200
`163
`Wisconsin
`900
`100
`100
`—
`—
`200
`— —
`—
`100
`—
`157
`Wyoming
`170 552,200
`40,800
`56,300 13,800
`21,700
`156,900
`26,100 14,000
`28,200
`31,900
`13,000
`United Statest
`— Estimate is 50 or fewer deaths. State death estimates between 51 and 99 were rounded to 100.
`* Excludes in situ carcinomas except urinary bladder.
`T 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, Centers for Disease Control and Prevention 1999,
`Institute.
`Surveillance, Epidemiology, and End Results Program, Division of Cancer Control and Population Sciences, National Cancer
`3; State estimates may not add up to United States total due to rounding.
`
`
`
`
`
`
`
`VOL. 50 NO. 1 JANUARY/FEBRUARY 2000
`
`15
`
`AstraZeneca Exhibit 2008 p. 9
`
`
`
`
`
`CANCER STATISTICS, 2000
`
`
`
`Figure 1
`Estimated New Cancer Cases”
`1 0 Leading Sites by Gender. US. 2000
`
`Prostate
`
`29%
`
`30%
`
`Breast
`
`14%
`Lung & Bronchus
`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%
`
`12%
`11%
`
`Lung & Bronchus
`Colon & Rectum
`
`~
`
`6%
`
`4%
`
`4%
`
`3%
`
`2%,
`2%
`
`Uterine Corpus
`
`Ovary
`
`Non—Hodgkin’s Lymphoma
`
`Melanoma of Skin
`
`Urinary Bladder
`Pancreas
`
`Thyroid
`2%
`2%
`Pancreas
`All Other Sites
`19%
`22%
`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%
`
`L
`
`Pancreas
`
`Non—Hodgkin’s Lymphoma
`
`Leukemia
`
`Esophagus
`
`Liver & Intrahepatic 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
`
`Brain & Other Nervous System
`2%,
`2% Stomach’r
`
`2% Multiple Myeloma’r
`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.
`
`6
`
`CAiA CANCER ]OURNAL FOR CLINICIANS
`
`AstraZeneca Exhibit 2008 p. 10
`
`
`
`
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`CA CANCER]
`
`CLIN 2000;SO:7»33
`
`
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