Delaware Cancer Incidence and Mortality Rates February 2004 Delaware Division of Public Health Department of Health and Social Services Dover, Delaware Delaware Cancer Incidence and Mortality Rates Contents Delaware Division of Public Health Delaware Health and Social Services February 2004 Summary Page 3 Table I-1 Delaware Incidence of All Cancer Table I-2 Delaware Incidence of Lung Cancer Table I-3 Delaware Incidence of Colorectal Cancer Table I-4 Delaware Incidence of Female Breast Cancer Table I-5 Delaware Incidence of Cervical Cancer Table I-6 Delaware Incidence of Prostate Cancer Table M-1 Delaware Mortality of All Cancer Table M-2 Delaware Mortality of Lung Cancer Table M-3 Delaware Mortality of Colorectal Cancer Table M-4 Delaware Mortality of Female Breast Cancer Table M-5 Delaware Mortality of Cervical Cancer Table M-6 Delaware Mortality of Prostate Cancer Table UI-1 SEER Incidence of All Cancer Table UI-2 SEER Incidence of Lung Cancer Table UI-3 SEER Incidence of Colorectal Cancer Table UI-4 SEER Incidence of Female Breast Cancer Table UI-5 SEER Incidence of Cervical Cancer Table UI-6 SEER Incidence of Prostate Cancer Table UM-1 U.S. Mortality of All Cancer Table UM-2 U.S. Mortality of Lung Cancer Table UM-3 U.S. Mortality of Colorectal Cancer Table UM-4 U.S. Mortality of Female Breast Cancer Table UM-5 U.S. Mortality of Cervical Cancer Table UM-6 U.S. Mortality of Prostate Cancer Technical Notes Page 29 Delaware Cancer Incidence and Mortality Rates Summary Delaware Division of Public Health Delaware Health and Social Services February 2004 This report updates Delaware's cancer incidence and mortality rates to the year 2001. Its purpose is to provide researchers and other interested people with a core set of statistics for further analysis of the major cancer sites. All 2001 incidence rates are provisional, and may be adjusted for late reports in the future. The numbers in this report are age-adjusted five-year average annual rates per 100,000 population. Incidence Using the U.S. 2000 population as the standard, Delaware's five-year average annual age-adjusted incidence rate was 504.2 per 100,000 during 1997-2001. After falling for five consecutive time periods, the rate increased in 1997-2001, although the increase is not statistically significant. In the 1996-2000 time period, Delaware's cancer incidence rate was 4.8 percent higher than the estimated U.S. rate. In this same time period, the rate among Delaware Blacks was 3.6 percent higher than the estimated U.S. rate. U.S. rates are estimated by Surveillance Epidemiology and End Results - SEER, a program of the National Cancer Institute. Between the 1990-1994 time period and 1996-2000, the Delaware cancer incidence rate decreased 4.2 percent, compared to a 2.9 percent decrease in the estimated U.S. rate. Among Blacks, the rate decreased 11.0 percent in Delaware, compared to 4.8 percent in the estimated U.S. rate. The average annual rate from 1997-2001 was higher for men (591.5 compared to 445.1 for women), Blacks (535.4 compared to 503.6 for Whites) and in New Castle County (510.0 compared to 471.1 in Sussex and 468.4 in Kent). For men, prostate (28.7 percent), lung (17.7 percent), and colorectal (11.4 percent) were the most commonly diagnosed cancers. For women, breast (29.9 percent), lung (14.1 percent), and colorectal (12.1 percent) were most common. Mortality Using the U.S. 2000 population as the standard, Delaware's five-year average annual age-adjusted mortality rate was 218.7 per 100,000 during 1997-2001. The rates have fallen for the seventh consecutive time period. In the 1996-2000 time period, Delaware's cancer mortality rate was 9.6 percent higher than the U.S. rate. Between the 1990-1994 time period and 1996-2000, the Delaware cancer mortality rate decreased 8.9 percent, compared to a 5.3 percent decrease in the U.S. rate. Among Blacks, the rate decreased 14.9 percent in Delaware, compared to 6.9 percent in the nation. The average annual rate from 1997-2001 was higher for men (268.3 compared to 187.6 for women), Blacks (267.4 compared to 215.9 for Whites) and in Kent County (221.7 compared to 220.9 in New Castle and 213.5 in Sussex ). For men, lung (33.6 percent), prostate (10.6 percent), and Colorectal (9.4 percent) were the most common cause of cancer deaths. For women, lung (25.7 percent), breast (15.8 percent), and colorectal (10.6 percent) were the most common cause of cancer deaths. Delaware Cancer Incidence and Mortality Rates Technical Notes Delaware Population Populations used for rate calculations come from the Delaware Population Consortium (DPC), in their September 23, 2003 (Version 2003.0) estimate. More information about DPC can be found at the following web site: http://www.cadsr.udel.edu/demography/consortium.htm Estimated U.S. Incidence Rates The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute is an authoritative source of information on cancer incidence and survival in the United States. Case ascertainment for SEER began on January 1, 1973. The SEER Program currently collects and publishes cancer incidence and survival data from 11 population-based cancer registries and three supplemental registries covering approximately 26 percent of the US population. Because no complete registry of cancer incidence exists for the nation, as it does for mortality data, SEER incidence rates are usually used to estimate U.S. cancer incidence rates. U.S. Mortality Rates The SEER Program annually obtains from the National Center for Health Statistics a public-use file containing information on all deaths occurring in the US by calendar year. Information on each death includes age at death, sex, geographic area of residence, and underlying and contributing causes of death. For this publication, only the underlying cause of death is used in the calculation of mortality rates. International Classification of Disease Coding From 1980 to 2000, the International Classification of Diseases for Oncology second edition (ICD-O-2) was used by hospitals and cancer registries as the standard for classifying cancers by site. Beginning in 2001, ICD-O-3 became the new standard. To assure that cancer incidence rates could be fairly compared throughout the years in this report, all rates are based on ICD-O-3). All SEER incidence rates are also based on ICD-O-3. Similarly, ICD-9 was the standard to assign cause of death prior to 1999, and ICD-10 was the standard from 1999 to present. Rates in this report from 1999-2001 were converted to ICD-9 to allow a fair comparison over all years reported. This is the same procedure used by SEER for U.S. mortality rates included in this report. See http://seer.cancer.gov/tools/conversion/ for further information. Age-Adjustment Age-adjustment is a statistical procedure used to compare incidence and mortality rates over time, or in geographic areas or populations that have different age distributions. Since an older population would be expected to have a higher cancer rate than a younger population, age-adjustment is used to make comparisons of rates without the influence of age. Beginning in 1999, the 2000 projected U.S. population became the new standard for adjusting incidence and mortality rates. The 2000 U.S. population standard replaced the 1970 U.S. population standard used in previous years. In this publication, all rates and time periods are adjusted to the Year 2000 population estimates. To order a print copy of this report, contact: State Epidemiologist Division of Public Health PO Box 637 Dover, DE 19903-0637