In the U.S., the median age at diagnosis of cancer is 68 years. As the U.S. population grows and ages, the number of newly diagnosed cancer patients can be expected to rise from 1.3 million persons to 2.6 million, the authors report. This increase, especially in the number of older cancer patients, will spur demand for supportive, palliative, and medical services. It will also create new challenges for health care providers because older patients are more likely to have significant comorbidity or take medicines that might interact with cancer treatment. Older people are under-represented in clinical trials, which are the most valuable resource for identifying new treatments.

Although cancer death rates decreased and incidence rates stabilized from 1995 through 1999, according to the report, there were many differences in the data due to age, race, and sex of patients, as well as type of cancer.

Cancer incidence and death rates increased rapidly with age and were generally higher for men than for women in 1995 through 1999, except for persons below the age of 50 years, where women had higher cancer incidence and death rates.

Overall, men had stable cancer incidence rates whereas women had increasing incidence rates. For women, overall cancer incidence rates increased from 1987 to 1999 due to increased breast cancer rates among women aged 50-64 years and increased lung cancer rates among women 65-74 years old.

The U.S. death rate from cancer decreased an average of more than 1 percent per year from 1993 to 1999. During the 1990s, the decline accelerated for most age groups in men and women, with the notable exception of lung cancer death rates in older women. Lung cancer was the leading cause of cancer deaths, accounting for almost one third of deaths in men and about one fourth of deaths in women. Colorectal cancer was the second leading cause of cancer death overall, accounting for about 10 percent of deaths, with breast and prostate cancer deaths together representing another 14 percent.

The decline in cancer death rates during the 1990s reflects longer-term mortality trends and can be traced to both reductions in tobacco use and to better screening methods for earlier detection. More effective treatments also contributed to the decline. Routine screening also influenced cancer incidence trends and improved the prognosis for many cancer patients.

Progress against cancer can be measured by the reductions in the rate of cancer deaths at each age, as well as shifts in detecting cancer at earlier and more treatable stages of disease at diagnosis. But despite the progress noted in this annual report, the authors warn, "the future aging of the population will dramatically increase the number of cancers and the age of most cancer patients." Barring no major breakthroughs in cancer prevention, the U.S. will face a substantial cancer burden increase in the decades to come.

The report was compiled by The American Cancer Society (ACS), the National Cancer Institute (NCI), the North American Association of Central Cancer Registries (NAACCR), the National Institute on Aging, and the Centers for Disease Control and Prevention (CDC), including the National Center for Health Statistics (NCHS) and the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).