Reduced cancer reporting by the US Department of Veterans Affairs (VA) hospitals in 2007 (for patients diagnosed through 2005) impacted the most recent US cancer surveillance data. To quantify the impact of the reduced VA reporting on cancer incidence and trends produced by the Surveillance, Epidemiology, and End Results Program, we estimated numbers of missing VA patients in 2005 by sex, age, race, selected cancer sites, and registry and calculated adjustment factors to correct for the 2005 incidence rates and trends. Based on our adjustment factors, we estimated that as a result of the underreporting, the overall cancer burden was underestimated by 1.6% for males and 0.05% for females. For males, the percentage of patients missing ranged from 2.5% for liver cancer to 0.4% for melanoma of the skin. For age-adjusted male overall cancer incidence rates, the adjustment factors were 1.015, 1.012, and 1.035 for all races, white males, and black males, respectively. Modest changes in long-term incidence trends were observed, particularly in black males.

American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation.

Background The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information about cancer occurrence and trends in the United States (U.S.). This year’s report includes trends in colorectal cancer (CRC) incidence and death rates and highlights use of microsimulation modeling as a tool for interpreting past trends and projecting future trends to assist in cancer control planning and policy decisions. Methods Information on invasive cancers was obtained from the NCI, CDC, and NAACCR, and information on deaths from the CDC’s National Center for Health Statistics. Annual percentage changes in the age-standardized incidence and death rates (2000 U.S. population standard) for all cancers combined and for the top 15 cancers were estimated by joinpoint analysis of long-term (1975–2006) trends and short-term fixed interval (1997–2006) trends. All statistical tests were two-sided. Results Both incidence and death rates from all cancers combined significantly declined (P < .05) in the most recent time period for men and women overall and for most racial and ethnic populations. These decreases were driven largely by declines in both incidence and death rates for the 3 most common cancers in men (i.e., lung and prostate cancers and CRC) and for two of the 3 leading cancers in women (i.e., breast cancer and CRC). The long-term trends for lung cancer mortality in women showed smaller and smaller increases until 2003 when there was a change to a non-significant decline. Microsimulation modeling shows that declines in CRC death rates are consistent with a relatively large contribution from screening and with a smaller but demonstrable impact of risk factor reductions and improved treatments. These declines are projected to continue if risk factor modification, screening, and treatment remain at current rates, but could be further accelerated with favorable trends in risk factors and higher utilization of screening and optimal treatment. Conclusions Although the decrease in overall cancer incidence and death rates is encouraging, rising incidence and mortality for some cancers are of concern.

Background The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the U.S. This year’s report includes the prevalence of comorbidity at time of first cancer diagnosis among patients with lung, colorectal, breast or prostate cancer and the survival among cancer patients based on comorbidity level. Methods Data on cancer incidence were obtained from NCI, CDC, and NAACCR, and on mortality from CDC. Long- (1975/92-2010) and short- (2001-2010) term trends in age-standardized incidence and death rates for all cancers combined and for the leading cancers among men and among women were examined by joinpoint analysis. Through linkage with Medicare claims, the prevalence of comorbidity among cancer patients diagnosed between 1992 through 2005 residing in 11 Surveillance, Epidemiology, and End Results (SEER) areas were estimated and compared to those among a 5% random sample of cancer-free Medicare beneficiaries. Among cancer patients, survival and the probabilities of dying of their cancer and of other causes by comorbidity level, age, and stage were calculated. Results Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2001 through 2010. Overall incidence rates decreased in men and stabilized in women. The prevalence of comorbidity was similar among cancer-free Medicare beneficiaries (31.8%), breast cancer patients (32.2%), and prostate cancer patients (30.5%), highest among lung cancer patients (52.8%), and intermediate among colorectal cancer patients (40.7%). Among all cancer patients and especially for patients diagnosed with local and regional disease, age and comorbidity level were important influences on the probability of dying of other causes and consequently on overall survival. For patients diagnosed with distant disease, the probability of dying of cancer was much higher than the probability of dying of other causes, and age and comorbidity had a smaller effect on overall survival. Conclusions Cancer death rates in the U.S. continue to decline. Estimates of survival that include the probability of dying of cancer and other causes stratified by comorbidity level, age and stage can provide important information to facilitate treatment decisions.