Delaware Cancer Incidence and Mortality, 2000-2004 Summary Statistics Incidence: During 2000-2004, a total of 21,379 cancers were diagnosed among Delaware residents. Of these, 11,253 (52.6%) occurred among men; 10,126 (47.4%) occurred among women. The large majority of cases (17,489, 81.8%) were diagnosed among Caucasians; 3,176 cases (14.9%) were diagnosed among African Americans. The remaining cases (714, 3.3%) were diagnosed among Delawareans of other races. The four most commonly occurring cancers among Delawareans (lung/bronchus, colorectal, breast and prostate) accounted for over half (55.3%) of all cancers diagnosed during 2000-2004. As depicted below in Table 1, of cancers occurring among both men and women, lung/bronchus cancer was the most commonly diagnosed, accounting for 3,307 (15.5%) of all cancer cases. It was the second most commonly diagnosed cancer among both men and women, accounting for 1,815 (16.1% of) cases among men and 1,492 (14.7% of) cases among women. Prostate cancer was the most commonly diagnosed cancer overall and among men, with 3,328 cases accounting for 15.6% of all cancer cases and 29.6% of cases diagnosed among men. Among women, breast cancer was the most commonly diagnosed, with 2,882 cases accounting for 28.5% of all cancers diagnosed among women, and 13.5% of all cancer cases. Colorectal cancer was the fourth most commonly diagnosed cancer overall (2,308 cases; 10.8%), and the third most commonly diagnosed for both men and women, accounting for 1,206 cases (10.7%) among men, and 1,102 cases (10.9%) among women. Table 1. Ranking, most frequently diagnosed cancers among Delawarean men and women, 2000-2004 Cancer Rank # (%) Men # (%) Men Women # (%) Women Prostate 1 3,328 (15.6) 1 3,328 (29.6) --- --- Lung/bronchus 2 3,307 (15.5) 2 1,815 (16.1) 2 1,492 (14.7) Breast 3 2,882 (13.5) --- --- 1 2,882 (28.5) Colorectal 4 2,308 (10.8) 3 1,206 (10.7) 3 1,102 (10.9) Data source: Delaware Division of Public Health; Cancer Incidence and Mortality in Delaware, 2007 Comparing Caucasian and African-American Delawareans (see Table 2, below), prostate cancer was the most commonly diagnosed cancer among African Americans, accounting for 642 (38.0% of) cases diagnosed among African-American men, and 20.2% of cancers diagnosed among African Americans overall. Prostate cancer accounted for 2,549 (27.8% of) cases diagnosed among Caucasian men, and 14.6% of cancers diagnosed among Caucasians overall. Lung/bronchus cancer was the most commonly diagnosed cancer of those cancers occurring among both men and women. Lung/bronchus cancer accounted for 483 (15.2% of) cases diagnosed among African Americans, and 2,772 (15.8% of) cancer cases diagnosed among Caucasians. Breast cancer was the most commonly diagnosed cancer among women, accounting for 434 (29.2% of) cases diagnosed among African-American women (and 13.7% of cancers diagnosed among all African Americans), and 2,371 (28.5% of) cases diagnosed among Caucasian women (and 13.6% of all cancers diagnosed among Caucasians). A total of 333 colorectal cancer cases was diagnosed among African Americans, accounting for 10.5% of all cancer cases diagnosed within this racial group; 1,896 colorectal cancer cases were diagnosed among Caucasians, accounting for 10.8% of all cases diagnosed among Caucasians. Age-adjusted 2000-2004 incidence rates for Delaware, for selected cancers, appear in the next table. The 1999-2003 rates for Delaware and 2000-2004 rates for the U.S. also are provided, for comparison purposes. Excepting for cervical cancer, the incidence rates for these selected cancers declined in Delaware between the 1999-2003 and 2000-2004 time periods; for cervical cancer, the rates stayed the same. Delaware’s rates continue to exceed those of the U.S., except for cervical cancer, where Delaware’s rate is slightly (but not significantly) lower than that of the U.S. Table 3. Delaware cancer incidence, 2000-2004 and 1999-2003; U.S. cancer incidence 2000-2004 Cancer DE Rate* 2000-2004 DE Rate* 1999-2003 US Rate* 2000-2004 All sites 501.3 503.5 473.6 Breast (female) 125.3 129.2 131.0 Cervical 8.6 8.6 7.4 Colorectal 54.3 56.7 51.5 Lung/bronchus 76.9 77.8 63.0 Prostate 173.0 176.2 147.9 Data sources: Delaware Division of Public Health; Cancer Incidence and Mortality in Delaware, 2007 (2000-2004 rates; US rates per SEER 9) Delaware Division of Public Health; Cancer Incidence and Mortality in Delaware, 2006 (1999-2003 rates) *Rates are per 100,000 and are age-adjusted to the 2000 US standard population. The incidence rates for five specific cancers and for all cancer sites combined were compared across two time periods: 1990-1994 v. 1995-1999, and 1995-1999 v. 2000-2004; the percent change between the two time periods was calculated for each comparison. In only one comparison did a rate increase between the earlier and current time period: Prostate cancer showed a minor (0.01%, not significant) increase in incidence between 1995-1999 and 2000-2004; in all other cases, the current rate is lower than the one occurring in an earlier time period. The percent change between the later comparison time periods (1995-1999 v. 2000-2004) typically is larger than is the change between the earlier comparison time periods (1990-1994 v. 1995- 1999); for example, colorectal cancer incidence declined 11.3% between 1995-1999 and 2000-2004; the rate declined by less than half that percentage (4.5%) between 1990- 1994 and 1995-1999. Mortality: During 2000-2004, 8,553 Delawareans died of cancer. Of these cancer-related deaths, 4,465 (52.2%) occurred among men, and 4,088 (47.8%) occurred among women. The large majority of deaths (7,116, 83.2%) occurred among Caucasians; 1,295 (15.1%) occurred among African Americans. The remaining deaths (142, 1.7%) occurred among Delawareans of other races. Over half of all cancer-related deaths (52.4%) were due to the four cancers most commonly occurring among Delawareans: lung/bronchus, colorectal, breast and prostate. As depicted in the table below, lung/bronchus cancer was the most commonly occurring among cancer deaths, accounting for 2,588 (30.3%) of all cancer-related deaths. It also was the leading cause of cancer-related deaths among both men and women, accounting for 1,458 (32.7% of) deaths among men, and 1,130 (27.6% of) deaths among women. Breast cancer and prostate cancer were the second most commonly occurring among cancer-related deaths for women and men, respectively. Breast cancer accounted for 623 (15.2% of) deaths among women (and 7.3% of cancer- related deaths overall); prostate cancer accounted for 442 (9.9% of) deaths among men (and 5.2% of deaths overall). Colorectal cancer was the second most common cause of cancer-related deaths overall, accounting for 828 (9.7% of) deaths; it was the third most commonly occurring cause of cancer-related death among both men and women, accounting for 424 (9.5% of) deaths among men, and 404 (9.9% of) deaths among women. Table 5. Leading causes of cancer-related deaths among Delawarean men and women, 2000-2004 Cancer Rank # (%) Overall Men # (%) Men Women # (%) Women Lung/bronchus 1 2,588 (30.3) 1 1,458 (32.7) 1 1,130 (27.6) Prostate 4 442 (5.2) 2 442 (9.9) --- --- Breast 3 623 (7.3) --- --- 2 623 (15.2) Colorectal 2 828 (9.7) 3 424 (9.5) 3 404 (9.9) Data source: Delaware Division of Public Health; Cancer Incidence and Mortality in Delaware, 2007 Lung/bronchus cancer was the leading cause of cancer-related death among both African-American and Caucasian Delawareans (see Table 6, below), accounting for 359 (27.7% of) deaths among African Americans, and 2,195 (30.8% of) deaths among Caucasians. Breast cancer was the third leading cause of death among both African- Americans and Caucasians, accounting for 115 (8.9% of) all cancer-related deaths occurring among African Americans, and for 495 (7.0% of) all cancer-related deaths occurring among Caucasians. Prostate cancer was the second leading cause of cancer- related death among men, accounting for 88 (13.3%) of 663 deaths among African- American men (and 6.8% of all cancer-related deaths occurring among African Americans), and for 344 (9.2%) of 3,730 deaths among Caucasian men (4.8% of cancer- related deaths occurring among Caucasians). Colorectal cancer was the second leading cause of cancer-related deaths among both African Americans and Caucasians, accounting for 145 (11.2% of) these deaths among African Americans, and 675 (9.5% of) cancer deaths among Caucasians. Lung/bronchus cancer also was the leading cause of death among both African- American and Caucasian men and women, accounting for 211 (31.8%) and 148 (23.4%) of all cancer-related deaths among African-American men and women, respectively, and for 1,227 (32.9%) and 968 (28.6%) of all cancer-related deaths among Caucasian men and women, respectively. Breast cancer was the second leading cause of cancer-related death among both African-American and Caucasian women, accounting for 115 (18.2% of) deaths occurring among African-American women and for 495 (14.6% of) deaths occurring among Caucasian women. Prostate cancer was the second leading cause of cancer-related death among African-American men, accounting for 88 (13.3% of) deaths among these men, and the third leading cause of cancer-related death among Caucasian men, accounting for 344 (9.2% of) deaths among these men. Colorectal cancer was the second leading cause of cancer-related death among Caucasian men, accounting for 348 (9.3% of) deaths among that population. It was the third leading cause of cancer-related death among African- American men and among both African-American and Caucasian women, accounting for 71 (10.7%), 74 (11.7%) and 327 (9.7%) of deaths within these populations, respectively. Age-adjusted 2000-2004 mortality rates for Delaware, for selected cancers, appear in the table below. The 1999-2003 rates for Delaware and 2000-2004 rates for the U.S. also are provided, for comparison purposes. Although Delaware’s rates continue to exceed those of the U.S., the mortality rates for all of these cancers did decline in Delaware between the 1999-2003 and 2000-2004 time periods. Table 8. Delaware cancer mortality, 2000-2004 and 1999-2003; U.S. cancer mortality 2000-2004 Cancer DE Rate* 2000-2004 DE Rate* 1999-2003 US Rate* 2000-2004 All sites 201.7 206.9 192.7 Breast (female) 26.2 26.7 25.5 Cervical 2.9 3.5 2.6 Colorectal 19.7 21.0 19.4 Lung/bronchus 60.4 61.5 54.7 Prostate 28.1 28.5 27.9 Data source: Delaware Division of Public Health; Cancer Incidence and Mortality in Delaware, 2007 (2000-2004 rates) Delaware Division of Public Health; Cancer Incidence and Mortality in Delaware, 2006 (1999-2003 rates) *Rates are per 100,000 and are age-adjusted to the 2000 US standard population. Percentage decline and rate of decline in mortality: Because Delaware’s population is relatively small, minor fluctuations in the number of cancer cases or deaths for a given year may result in large changes to rates based on a single year’s experience. To smooth rates that otherwise could appear erratic, rates for small populations – such as Delaware’s – commonly are calculated for five-year periods v. individual years. These five-year rates, v. individual, annual rates, are also more appropriate for use in examining rate changes over time, as they are more stable and reliable than would be those for single years. For these reasons, for Delaware, we calculated and compared five-year annual average rates to examine changes in mortality rates, v. using specific, annual rates such as those appearing in Espey et al’s recently published article, Overall Cancer Incidence and Mortality Rates in the U.S. The mortality rates for five specific cancers and for all cancer sites combined were compared across two time periods: 1990-1994 v. 1995-1999, and 1995- 1999 v. 2000-2004; the percent change between the two time periods was calculated for each comparison. In only one case did the rate increase between the earlier and later time period compared: Mortality for cervical cancer increased 0.1% (not significantly) between the 1990-1994 and 1995-1999 time period. The percent change between the later comparison time periods (1995-1999 v. 2000-2004) typically is larger than is the change between the earlier time periods (1990-1994 v. 1995-1999); for example, prostate cancer mortality declined 10.1% between 1990-1994 and 1995-1999; it declined by nearly three times that (28.4%) between 1995-1999 and 2000-2004.. The annual average percent change between two sets of five-year rates is presented. These figures were calculated be comparing the rates for 1990-1994 to those for 1995-1999, and the rates for 1995-1999 to those for 2000-2004; an overall percent change was calculated for each comparison. That percentage was then divided by the number of years between the first year of the earlier time period and the last year of the later time period, inclusive, (i.e., by 10) to produce an average annual percent change. The rate of reduction between the later time periods (1995-1999 v. 2000-2004) was always more rapid than between the earlier two time periods (1990-1994 v. 1995-1999). For example, for prostate cancer, the average annual percent decline in mortality between 1990 and 1999 was 1.0%; between 1995 and 2004, the average annual percent decline was 2.8%. For the United States, the mortality rate always declined between the time periods compared, and the rate of reduction was usually more rapid between the later time periods than between the earlier time periods. The average annual percent decline in Delaware typically exceeded that of the United States. Printed copies of tables, graphs, and charts can by obtained by contacting: Delaware Cancer Control Program Division of Public Health Thomas Collins Bldg. 540 S. DuPont Hwy. Dover, Delaware 19901-4523 (302) 744-1020