Cancer Statistics 2009

A Presentation From the American Cancer Society

2009, American Cancer Society, Inc.

2009 Estimated US Cancer Deaths*

Men 292,540 Women 269,800

Lung & bronchus

30%

26%

Lung & bronchus

Prostate
Colon & rectum Pancreas Leukemia Liver & intrahepatic bile duct Esophagus Urinary bladder Non-Hodgkin lymphoma Kidney & renal pelvis All other sites

9%
9% 6% 4% 4% 4% 3% 3% 3% 25%

15%
9% 6% 5% 4% 3% 3% 2% 2% 25%

Breast
Colon & rectum Pancreas Ovary Non-Hodgkin lymphoma Leukemia Uterine corpus Liver & intrahepatic bile duct Brain/ONS All other sites

ONS=Other nervous system. Source: American Cancer Society, 2009.

US Mortality, 2006
Rank Cause of Death 1. 2. 3. 4. Heart Diseases Cancer Cerebrovascular diseases Chronic lower respiratory diseases No. of deaths 631,636 559,888 137,119 124,583 % of all deaths 26.0 23.1 5.7 5.1

5.
6. 7.

Accidents (unintentional injuries)

Diabetes mellitus Alzheimer disease

121,599
72,449 72,432

5.0
3.0 3.0

8.
9. 10.

Influenza & pneumonia

Nephritis* Septicemia

56,326
45,344 34,234

2.3
1.9 1.4

*Includes nephrotic syndrome and nephrosis. Source: US Mortality Data 2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.

Change in US Death Rates* from 1991 to 2006

Rate Per 100,000
400

1991
313.0 300

2006
200.2 215.1 180.7

200

100

63.3 43.6 34.8 17.8

Heart diseases

Cerebrovascular diseases

Influenza & pneumonia

Cancer

* Age-adjusted to 2000 US standard population. Sources: US Mortality Data, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.

Trends in the Number of Cancer Deaths Among Men and Women, US, 1930-2006
300,000
295,000

Men
250,000
Number of Cancer Deaths

290,000 285,000 280,000

Men

Women
200,000

275,000 270,000 265,000

20 00 20 01 20 02 20 03 20 04 20 05 20 06

Women

150,000

100,000

50,000

0 1930

1940

1950

1960

1970

1980

1990

2000

Source: US Mortality Data, 1930-2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.

Cancer Death Rates* by Sex, US, 1975-2005

300

Rate Per 100,000

Men

250

Both Sexes
200

Women
150

100

50

0
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 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.

Cancer Death Rates* Among Men, US,1930-2005

100

Rate Per 100,000

Lung & bronchus

80

60
Stomach

40

Prostate Colon & rectum

20

Pancreas

Leukemia
1930 1935 1940 1945 1950 1955 1960 1965 1970 1975

Liver
1980 1985 1990 1995 2000 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.

Cancer Death Rates* Among Women, US,1930-2005

100

Rate Per 100,000

80

60
Lung & bronchus

40

Uterus Breast Colon & rectum

20

Stomach Ovary

1930

1935

1940

1945

1950

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

*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.

2005

Pancreas

Cancer Death Rates* by Race and Ethnicity, US, 2001-2005

400 350 300 250 200 159.2 150 100 50 0 White African American Asian/Pacific Islander 138.8 95.6 230.7 186.7 313.0

Men

Women

190.0 142.0 159.0 105.2

American Indian/ Alaskan Native

Hispanic

*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 and Population Sciences, National Cancer Institute, 2008.

Cancer Sites in Men for Which African American Death Rates* Exceed White Death Rates*, US, 2001-2005 Site
All sites Prostate Larynx Stomach Myeloma Oral cavity and pharynx Small intestine Liver and intrahepatic bile duct Colon and rectum
African American White Ratio of African American/White

313.0 59.4 4.8 11.5 8.3 6.7 0.7 10.3 31.8

230.7 24.6 2.1 5.0 4.3 3.8 0.4 6.7 22.1

1.4 2.4 2.3 2.3 1.9 1.8 1.8 1.5 1.4

Esophagus
Lung and bronchus Pancreas

9.8
93.1 15.4

7.8
71.3 12.1

1.3
1.3 1.3

*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.

Cancer Sites in Women for Which African American Death Rates* Exceed White Death Rates*, US, 2001-2005 Site
All sites African American 186.7 White 159.2 Ratio of African American/White 1.2

Stomach
Myeloma Uterine cervix Esophagus Uterine corpus Small intestine Larynx Colon and rectum Pancreas Breast Gallbladder Urinary bladder Liver and intrahepatic bile duct

5.5
6.0 4.7 2.8 7.1 0.5 0.8 22.4 12.4 33.5 1.0 2.8 3.9

2.5
2.8 2.3 1.6 3.9 0.3 0.5 15.3 9.0 24.4 0.8 2.2 2.9

2.2
2.1 2.0 1.8 1.8 1.7 1.6 1.5 1.4 1.4 1.3 1.3 1.3

*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.

Cancer Death Rates* by Sex and Race, US, 1975-2005

500 Rate Per 100,000 450 400 350 300 250
African American women White men African American men

200 150 100 50 0

1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
*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.

White women

2009 Estimated US Cancer Cases*

Men 766,130
Prostate Lung & bronchus Colon & rectum Urinary bladder Melanoma of skin Non-Hodgkin lymphoma Kidney & renal pelvis Leukemia Oral cavity Pancreas All Other Sites 25% 15% 10% 7% 5% 5% 4% 5% 3% 3% 3% 19%

Women 713,220
27% 14% 10% 6% 4% Breast Lung & bronchus Colon & rectum Uterine corpus Non-Hodgkin lymphoma Melanoma of skin

4%
3% 3% 3% 22%

Thyroid
Ovary Pancreas All Other Sites

Kidney & renal pelvis

*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. Source: American Cancer Society, 2009.

Cancer Incidence Rates* by Sex, US, 1975-2005

700 600 500 400 300 200 100

Rate Per 100,000

Men

Both Sexes

Women

0 1975

1978

1981

1984

1987

1990

1993

1996

1999

2002

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.

Cancer Incidence Rates* Among Men, US, 1975-2005

Rate Per 100,000
250
Prostate

200

150

100
Colon and rectum

Lung & bronchus

50
Non-Hodgkin lymphoma

Urinary bladder

Melanoma of the skin

0 1975

1978

1981

1984

1987

1990

1993

1996

1999

2002

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.

Cancer Incidence Rates* Among Women, US, 1975-2005

Rate Per 100,000
250

200

150

Breast

100
Colon and rectum Lung & bronchus Uterine Corpus

50
Ovary

0 1975

Non-Hodgkin lymphoma

1978

1981

1984

1987

1990

1993

1996

1999

2002

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.

Cancer Incidence Rates* by Race and Ethnicity, 2001-2005

Rate Per 100,000
800 700 600 500 423.6 400 300 200 100 0
White African American Asian/Pacific Islander American Indian/ Alaska Native Hispanic

Men
651.5 551.4

Women

398.9 354.0 287.8 336.6 296.4

419.4 317.8

*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 and Population Sciences, National Cancer Institute, 2008.

Cancer Incidence Rates* by Sex and Race, US,1975-2005

Rate Per 100,000
900 800
African American men

700 600 500 400

African American women White women White men

300 200 100 0 1975

1978

1981

1984

1987

1990

1993

1996

1999

2002

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.

Lifetime Probability of Developing Cancer, Men, 2003-2005* Site

All sites Prostate
Lung and bronchus Colon and rectum

Risk
1 in 2 1 in 6
1 in 13 1 in 18

Urinary bladder
Melanoma Non-Hodgkin lymphoma Kidney

1 in 27
1 in 39 1 in 45 1 in 57

Leukemia
Oral Cavity Stomach

1 in 67
1 in 72 1 in 90

* 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 men. 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, Women, US, 2003-2005* Site

All sites Breast
Lung & bronchus Colon & rectum

Risk
1 in 3 1 in 8
1 in 16 1 in 20

Uterine corpus
Non-Hodgkin lymphoma Urinary bladder Melanoma

1 in 40
1 in 53 1 in 84 1 in 58

Ovary
Pancreas Uterine cervix

1 in 72
1 in 75 1 in 145

* 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. 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

Cancer Survival*(%) by Race,1996-2004

African American Absolute Difference

Site All Sites

White

68

58

10

Breast (female)
Colon Esophagus Leukemia

91
66 18 52

78
55 11 42

13
11 7 10

Non-Hodgkin lymphoma
Oral cavity Prostate Rectum

66
62 99 67

58
42 96 59

8
20 3 8

Urinary bladder
Uterine cervix Uterine corpus

82
74 86

66
65 61

16
9 25

*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 and Population Sciences, National Cancer Institute, 2008.

Trends in Five-year Relative Survival (%)* Rates, US, 1975-2004

Site All sites Breast (female) Colon Leukemia Lung and bronchus Melanoma Non-Hodgkin lymphoma Ovary Pancreas Prostate Rectum Urinary bladder 1975-1977 50 75 52 35 13 82 48 37 3 69 49 74 1984-1986 54 79 59 42 13 87 53 40 3 76 57 78 1996-2004 66 89 65 51 16 92 65 46 5 99 67 81

*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 and Population Sciences, National Cancer Institute, 2008.

Cancer Incidence & Death Rates* in Children 0-14 Years, 1975-2005

18 16 14 12 10 8 6 4 2

Rate Per 100,000

Incidence

Mortality

0 1975

1978

1981

1984

1987

1990

1993

1996

1999

2002

2005

*Age-adjusted to the 2000 Standard population. Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control and Population Sciences, National Cancer Institute, 2008.

Cancer Incidence Rates* in Children 0-14 Years by Sex, 2001-2005

Site All sites Leukemia Acute Lymphocytic

Male 16.1 5.4 4.3

Female 14.1 4.5 3.6

Total 15.1 5.0 3.9

Brain/ONS
Soft tissue Non-Hodgkin lymphoma Kidney and renal pelvis Bone and Joint Hodgkin lymphoma

3.4
1.1 1.2 0.8 0.7 0.7

3.1
1.0 0.6 0.8 0.7 0.4

3.2
1.1 0.9 0.8 0.7 0.5

*Per 100,000, age-adjusted to the 2000 US standard population. ONS = Other nervous system Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control and Population Sciences, National Cancer Institute, 2008.

Cancer Death Rates* in Children 0-14 Years by Sex, US, 2001-2005

Site All sites Leukemia Acute Lymphocytic Male 2.7 0.8 0.4 Female Total 2.3 0.7 0.3 2.5 0.8 0.4

Brain/ONS
Non-Hodgkin lymphoma Soft tissue Bone and Joint Kidney and Renal pelvis

0.8
0.1 0.1 0.1 0.1

0.7
0.1 0.1 0.1 0.1

0.7
0.1 0.1 0.1 0.1

*Per 100,000, age-adjusted to the 2000 US standard population. ONS = Other nervous system Source: Surveillance, Epidemiology, and End Results Program, 1975-2005, Division of Cancer Control and Population Sciences, National Cancer Institute, 2008.

Trends in Cancer Survival by Age Group, Children 0-14 Years,1975-2004

Age

Year of Diagnosis

5 - Year Relative Survival Rates *

0 - 4 Years

1975 - 1977 1996 - 2004

57.3 80.8

5 - 9 Years

1975 - 1977
1996 - 2004

58.5 78.8

10 - 14 Years

1975 - 1977 1996 - 2004

58.9 80.0

*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 and Population Sciences, National Cancer Institute, 2008.

Tobacco Use in the US, 1900-2005

5000 100 90 80
Per capita cigarette consumption

Per Capita Cigarette Consumption

4500 4000 3500 3000 2500 2000 1500 1000 500 0

Female lung cancer death rate Male lung cancer death rate

70 60 50 40 30 20 10 0

1900

1905 1910

1915 1920

1925 1930

1935

1940 1945

1950 1955

1960 1965

1970

1975 1980

1985 1990

1995

Year

*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.

2000 2005

Age-Adjusted Lung Cancer Death Rates*

Trends in Cigarette Smoking Prevalence* (%), by Sex, Adults 18 and Older, US, 1965-2007
60 50
Prevalence (%)

40 30 20 10 0
1965 1974 1979 1983 1985 1990 1992 1994 1995 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Men Women

Year

*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.

Current* Cigarette Smoking Prevalence (%) Among High School Students by Sex and Race/Ethnicity, US, 1991-2007
50 1991 2005 40
40 40 39 40 37 32 31 27 27 23 25 23 24 18 17 1112 13 12 11 8 14 38 33 30 2828 22 19 16 1415 23 19 18 15 19 19 26 3536 34 33 32 32 28 27 25

1995 2007

1997

1999

2001

2003

Prevalence (%)

30

20

10

0 White, nonHispanic Female White, nonHispanic Male African African American, non- American, nonHispanic Hispanic Male Female Hispanic Female Hispanic Male

*Smoked cigarettes on one or more of the 30 days preceding the survey. Source: Youth Risk Behavior Surveillance System, 1991, 1995, 1997, 1999, 2001, 2003, 2005, 2007 National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2008.

Trends in Consumption of Five or More Recommended Vegetable and Fruit Servings for Cancer Prevention, Adults 18 and Older, US, 1994-2007
35 30
Prevalence (%)

25 20 15 10 5 0

24.2

24.4

24.1

24.4

23.6

24.3

24.7

1994

1996

1998

2000 Year

2003

2005

2007

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 (1984-1995, 1996, 1998) and Public Use Data Tape (2000, 2003, 2005, 2007), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001, 2004, 2006, 2008.

Trends in Prevalence (%) of No Leisure-Time Physical Activity, by Educational Attainment, Adults 18 and Older, US, 1992-2007

60 55 50 45 40 35 30 25 20 15 10 5 0
1992 1994 1996

Adults with less than a high school education

Prevalence (%)

All adults

1998

2000

2002

2003

2004

2005

2006

Year
Note: Data from participating states and the District of Columbia were aggregated to represent the United States. Educational attainment is for adults 25 and older. Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape (2000, 2002, 2004, 2005, 2006, 2007), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001, 2003, 2005, 2006, 2007, 2008.

2007

Trends in Prevalence (%) of High School Students Attending PE Class Daily, by Grade, US, 1991-2007
70 60 50

Prevalence (%)

9th
40

10th
30 20 10 0 1991

11th 12th

1993

1995

1997

1999 Year

2001

2003

2005

2007

Source: Source: Youth Risk Behavior Surveillance System, 1991, 1995, 1997, 1999, 2001, 2003, 2005, 2007 National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2008.

Trends in Obesity* Prevalence (%), Children and Adolescents, by Age Group, US, 1971-2006
20 18 17 16 15 16

Prevalence (%)

12 10 10 7 5 5 5 4 7

11

11

6 5

0 2 to 5 years NHANES I (1971-74) NHANES 1999-2002 6 to 11 years NHANES II (1976-80) NHANES 2003-2006 12 to 19 years NHANES III (1988-94)

*Body mass index (BMI) at or above the sex-and age-specific 95th percentile BMI cutoff points from the 2000 sexspecific 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.

Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2006
45 40 35 35
Prevalence (%)

33 31 28

34 32 26

34 35

36

30 25 20 15 10 5 0 Both sexes 13 15 15 11 12 13 23 21

16 17

17

Men NHANES II (1976-80) NHANES 2005-2006

Women NHANES III (1988-94)

NHES I (1960-62) NHANES 1999-2002

NHANES I (1971-74) NHANES 2003-2004

*Obesity is defined as a body mass index of 30 kg/m2 or greater. Age adjusted to the 2000 US standard population. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002, 2004. 20032004, 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.

Trends in Overweight* Prevalence (%), Adults 18 and Older, US, 1992-2007

1992 1995

1998

2007

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.

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
70 60 50

All women 40 and older

Prevalence (%)

Women with less than a high school education

40

30 20 10 0
1991 1992 1993 1994 1995

Women with no health insurance

1996

1997

1998

1999

2000

2002

2004

2006

Year
*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.

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
100

All women 18 and older

80

Women with no health insurance Women with less than a high school education

Prevalence (%)

60

40

20

0 1992

1993

1994

1995

1996

1997 1998 Year

1999

2000

2002

2004

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.

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

Trends in Recent* Fecal Occult Blood Test Prevalence (%), by Educational Attainment and Health Insurance Status, Adults 50 Years and Older, US, 1997-2006
30 25
Prevalence (%)
24 20 21 22 19 16 16 16 18 16 14 12 8 9 12 9 9 8

1997 2004

1999 2006

2001

2002

20 15 10 5 0

Total

Less than a high school education

No health insurance

*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.

Trends in Recent* Flexible Sigmoidoscopy or Colonoscopy Prevalence (%), by Educational Attainment and Health Insurance Status, Adults 50 Years and Older, US, 1997-2006

60
50

56 45 44 44

1999

2001 43

2002

2004

2006

50
Prevalence (% )

41

40 30

37

36 36

22 21 21 22

25

20 10 0
Total Less than a high school education No health insurance

*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 clinicians assistance.

Recent* Prostate-Specific Antigen (PSA) Test Prevalence (%), by Educational Attainment and Health Insurance Status, Men 50 Years and Older, US, 2001-2006

70 60
Prevalence (%)
58 55 2001 2004 52 54 46 42 39 40 30 28 25 2002 2006

50 40 30 20 10 0
Total

27

Less than a high school education

No health insurance

*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.

Recent* Digital Rectal Examination (DRE) Prevalence (%), by Educational Attainment and Health Insurance Status, Men 50 Years and Older, US, 2001-2006

60 50
Prevalence (%)

57 53 50 50 44 42 37 35 29 26 22 23 2001 2004 2002 2006

40 30 20 10 0
Total

Less than a high school education

No health insurance

*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.

Sunburn* Prevalence (%) in the Past Year, Adults 18 and Older, US, 2004
50 45 40 36.3 46.4

White nonHispanic

Age-Adjusted Prevalence (%)

35 30 25 20 15 10 5.7 5 0 Male Female 5.8

Other
26.3 24.0 22.5 18.4

Hispanic

Black nonHispanic

*Reddening of any part of the skin for more than 12 hours. Note: The overall prevalence of sunburn among adult males is 46.4% and among females is 36.3%. Source: Behavioral Risk Factor Surveillance System Public Use Data Tape , 2004. National Center for Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2005.

Ultraviolet Radiation Exposure Behaviors* Prevalence (%), Adults 18 and Older, US, 2005
Total
45 40 35 30 30 26 25 20 15 10 5 0 Apply sunscreen Seek the shade Wear a hat Wear longsleeved shirt Wear long pants Used indoor tanning device 19 17 12 13 12 14 10 11 10 11 24 40 40 37 33 30

Male

Female

Prevalence (%)

*Proportion of respondents reporting always or often practicing the particular sun protection behavior on any warm sunny day. Used an indoor tanning device, including a sunbed, sunlamp, or tanning booth at least once, in the past 12 months. Source: National Health Interview Survey Public Use Data File 2005, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.

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