Jemal Ahmedin, Clegg Limin X, Ward Elizabeth, Ries Lynn A G, Wu Xiaocheng, Jamison Patricia M, Wingo Phyllis A, Howe Holly L, Anderson Robert N, Edwards Brenda K
Epidemiology and Surveillance Research Department, American Cancer Society, 1599 Clifton Road, Atlanta, GA 30329, USA.
Cancer. 2004 Jul 1;101(1):3-27. doi: 10.1002/cncr.20288.
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 regarding cancer occurrence and trends in the U.S. This year's report features a special section on cancer survival.
Information concerning cancer cases was obtained from the NCI, CDC, and NAACCR and information concerning recorded cancer deaths was obtained from the CDC. The authors evaluated trends in age-adjusted cancer incidence and death rates by regression models and described and compared survival rates over time and across racial/ethnic populations.
Incidence rates for all cancers combined decreased from 1991 through 2001, but stabilized from 1995 through 2001 when adjusted for delay in reporting. The incidence rates for female lung cancer decreased (although not statistically significant for delay adjusted) and mortality leveled off for the first time after increasing for many decades. Colorectal cancer incidence rates also decreased. Death rates decreased for all cancers combined (1.1% per year since 1993) and for many of the top 15 cancers occurring in men and women. The 5-year relative survival rates improved for all cancers combined and for most, but not all, cancers over 2 diagnostic periods (1975-1979 and 1995-2000). However, cancer-specific survival rates were lower and the risk of dying from cancer, once diagnosed, was higher in most minority populations compared with the white population. The relative risk of death from all cancers combined in each racial and ethnic population compared with non-Hispanic white men and women ranged from 1.16 in Hispanic white men to 1.69 in American Indian/Alaska Native men, with the exception of Asian/Pacific Islander women, whose risk of 1.01 was similar to that of non-Hispanic white women.
The continued measurable declines for overall cancer death rates and for many of the top 15 cancers, along with improved survival rates, reflect progress in the prevention, early detection, and treatment of cancer. However, racial and ethnic disparities in survival and the risk of death from cancer, and geographic variation in stage distributions suggest that not all segments of the U.S. population have benefited equally from such advances.
美国癌症协会（ACS）、疾病控制与预防中心（CDC）、国家癌症研究所（NCI）以及北美中央癌症登记协会（NAACCR）每年都会合作，提供有关美国癌症发病情况和趋势的最新信息。今年的报告特别设有一个关于癌症生存率的章节。
有关癌症病例的信息来自NCI、CDC和NAACCR，有关记录的癌症死亡信息来自CDC。作者通过回归模型评估了年龄调整后的癌症发病率和死亡率趋势，并描述和比较了不同时间以及不同种族/族裔人群的生存率。
从1991年到2001年，所有癌症的综合发病率有所下降，但在对报告延迟进行调整后，从1995年到2001年趋于稳定。女性肺癌的发病率有所下降（尽管经延迟调整后无统计学显著差异），且在数十年上升后死亡率首次趋于平稳。结直肠癌的发病率也有所下降。所有癌症的综合死亡率下降（自1993年以来每年下降1.1%），男性和女性中15种最常见癌症中的许多种死亡率也下降。在两个诊断时期（1975 - 1979年和1995 - 2000年）内，所有癌症的综合5年相对生存率有所提高，大多数（但并非所有）癌症也是如此。然而，与白人相比，大多数少数族裔人群的癌症特异性生存率较低，一旦确诊，死于癌症的风险更高。与非西班牙裔白人男性和女性相比，各种族和族裔人群中所有癌症综合死亡的相对风险范围从西班牙裔白人男性的1.16到美国印第安人/阿拉斯加原住民男性的1.69不等，但亚太岛民女性除外，其风险为1.01，与非西班牙裔白人女性相似。
总体癌症死亡率以及15种最常见癌症中的许多种死亡率持续显著下降，同时生存率提高，这反映了癌症预防、早期检测和治疗方面的进展。然而，在生存率和癌症死亡风险方面的种族和族裔差异，以及癌症分期分布的地理差异表明，美国并非所有人群都能平等地从这些进展中受益。
