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TB A ID S M alaria A ll 3 C an cer
WHO (2003)
CANCER – WORLDWIDE BURDEN (2005)
7 million Deaths
25 million Living with Cancer
CANCER – WORLDWIDE BURDEN (2030)
17 million Deaths
75 million Living with Cancer
Outline
$2.53 TRILLION
on Health Care
U.S. Health Care Spending
200
6
* Excludes alcoholic beverages ($150 billion) and tobacco products ($92 billion)
Source: Bureau of Economic Analysis; National Bureau of Statistics of China, MGI analysis
Spending: US vs. Other
Countries
Per capita health care
spending, 2006
$ at PPP*
Virchow’s node
Prostate Cancer
Breast Cancer
Cervical Disease
Renal Cancer
Melanoma
Colon Cancer
Overdiagnosis
Cure is Possible but not Necessary
Prostate
200
150
100
Lung & bronchus
50
Colon and rectum
Urinary bladder
0 Non-Hodgkin lymphoma
1975 1978 1981 1984 1987 1990 1993 1996of the
Melanoma 1999
skin 2002 2005
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.
Source: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database:
SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2006, National Cancer Institute, 2009.
Cancer Death Rates* Among Men, US,1930-2006
100
Rate Per 100,000
Lung & bronchus
80
60
40 Stomach
Prostate
Colon & rectum
20
Pancreas
0
1930
1940
1950
1955
1965
1975
1985
1990
2000
1935
1945
1960
1970
1980
1995
2005
Leukemia Liver
100
Uterine corpus
0 Non-Hodgkin lymphoma
1975 1978 1981 1984 1987 1990 1993 1996 Melanoma
1999 2002 2005
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.
Source: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database:
SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2006, National Cancer Institute, 2009.
Cancer Death Rates* Among Women, US,1930-2006
100
Rate Per 100,000
80
60
0 Ovary
1930
1940
1950
1955
1965
1975
1985
1990
2000
1935
1945
1960
1970
1980
1995
2005
Pancreas
250
Both Sexes
200
Women
150
100
50
0
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
500
Rate Per 100,000
450
350
300
White men
250
200
African American women
150
White women
100
50
0
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
12
10
4
Mortality
2
0
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
3 0 0 ,0 0 0 295,000
290,000 Men
Men
285,000
2 5 0 ,0 0 0
280,000
Number of Cancer Deaths
275,000
2 0 0 ,0 0 0 Women
270,000
Women
265,000
1 5 0 ,0 0 0
00
03
04
01
02
05
06
07
20
20
20
20
20
20
20
20
1 0 0 ,0 0 0
5 0 ,0 0 0
0
1930 1940 1950 1960 1970 1980 1990 2000
Source: US Mortality Data, 1930-2007, National Center for Health Statistics, Centers for Disease
Control and Prevention, 2010.
Deaths averted from 1991-2020 in males and
1992-2020 in females based on current rate of
decline
The blue line represents the actual number of cancer deaths recorded (solid) and projected
(dashed) based on decreasing trends during 2003-2007. The red line represents the expected
number of cancer deaths if cancer mortality rates had remained the same since 1990 (males)
and 1991(females).
Trends in Cigarette Smoking Prevalence* (%), by Sex, Adults 18
and Older, US, 1965-2008
60
50
40
Prevalence (%)
30
Men
20
Women
10
0
1965
1979
1983
1985
1990
1992
1994
1995
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
1974
1997
Ye ar
*Redesign of survey in 1997 may affect trends. Estimates are age adjusted to the 2000 US standard population using five
age groups: 18-24, 25-34 years, 35-44 years, 45-64 years, and 65 years and over.
Source: National Health Interview Survey, 1965-2008, National Center for Health Statistics, Centers for Disease Control and
Prevention, 2009.
Current* Cigarette Smoking Prevalence (%) Among High School
Students by Sex and Race/Ethnicity, US, 1991-2007
50
1991 1995 1997 1999 2001 2003
2005 2007
40
40 40
40 39 38
37
3536 34
33 33 32
32 31 32
30
Prevalence (%)
30 2727 2828 28
27
26
25 25
23 23 24 23
22
19 1819 19 19
20 18
17 16
1415 15
13 14
12
1112 11
10 8
0
White, non- White, non- African African Hispanic Hispanic Male
Hispanic Hispanic Male American, non- American, non- Female
Female Hispanic Hispanic Male
Female
We must realize:
What we know.
What we do not know.
What we believe.
American Urological Association
We need:
Then we can actually figure out how good our current treatments are!!!
Mammogram Prevalence (%), by Educational Attainment and
Health Insurance Status, Women 40 and Older, US, 1991-2008
70
62
60 All women 40 and older
54
50
Prevalence (%)
30
10
0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2002 2004 2006 2008
Year
*A mammogram within the past year. Note: Data from participating states and the District of Columbia were
aggregated to represent the United States.
Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use
Data Tape (2000 to 2008), National Centers for Chronic Disease Prevention and Health Promotion, Centers for
Disease Control and Prevention, 1997, 1999, 2000, 2001-2009.
Breast Cancer as of 2008
53% (NHIS),
62.1% (BRFSS)
Breast Cancer
Odds that Mammography will save a
woman’s
life over a ten year period
7800 deaths
32,000 diagnosed
24,200 survive
7800 deaths
32,000 diagnosed
7000 deaths
32,000 diagnosed
•63.1% by BRFSS
Trends in Recent* Fecal Occult Blood Test Prevalence (%), by
Educational Attainment and Health Insurance Status, Adults 50
Years and Older, US, 1997-2008
30
1997 1999 2001 2002
2004 2006 2008
25 24
22
21
20
20 19 18
Prevalence (%)
16 16 16 16
15 14
15
12 13 12
9 9 9
10 8 8 7
0
Total Less than a high school No health insurance
education
*A fecal occult blood test within the past year. Note: Data from participating states and the District of Columbia were
aggregated to represent the United States.
Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use Data
Tape (2000 to 2008), National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease
Control and Prevention, 1997, 1999, 2000, 2001-2009.
Trends in Recent* Flexible Sigmoidoscopy or Colonoscopy
Prevalence (%), by Educational Attainment and Health Insurance
Status, Adults 50 Years and Older, US, 1997-2008
41
40 37 36 36
30 25 26
22 21 21 22
20
10
0
Total Less than a high school No health insurance
education
*A flexible sigmoidoscopy or colonoscopy within the past ten years. Note: Data from participating states and the
District of Columbia were aggregated to represent the United States.
Source: Behavior Risk Factor Surveillance System CD-ROM (1984-1995, 1996-1997, 1998, 1999) and Public Use Data
Tape (2000 to 2008), National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease
Control and Prevention, 1997, 1999, 2000, 2001-2009.
Nutrition and Physical Activity
35
30
2 4 .2 2 4 .4 2 4 .1 2 4 .4 2 3 .6 2 4 .3 2 4 .7
25
Prevalence (%)
20
15
10
0
1994 1996 1998 2000 2003 2005 2007
Year
Note: Data from participating states and the District of Columbia were aggregated to represent the United
States.
Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape
(2000, 2003, 2005, 2007), National Center for Chronic Disease Prevention and Health Promotion, Centers for
Disease Control and Prevention, 1997, 1999, 2000, 2001, 2004, 2006, 2008.
Trends in Prevalence (%) of No Leisure-Time Physical Activity, by
Educational Attainment, Adults 18 and Older, US, 1992-2008
60
Adults with less than a high school education
55
50
45
40
Prevalence (%)
35
30
25
20
15 All adults
10
5
0
2007
1992
1994
1996
1998
2000
2002
2003
2004
2005
2006
2008
Year
Note: Data from participating states and the District of Columbia were aggregated to represent the United
States. Educational attainment is for adults 25 and older.
Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape
(2000 to 2008), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease
Control and Prevention, 1997-2009.
Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20
to 74, US, 1960-2008†
45
40
35 35 36
33 33 33 34
35
31
30 28
26
Prevalence (%)
25 23
21
20 17
16 17
15 15
13
15 12 13
11
10
0
Both sexes Men Women
*Obesity is defined as a body mass index of 30 kg/m2 or greater. † Age adjusted to the 2000 US standard population.
Source: 1976-2006: National Health and Nutrition Examination Survey, Hispanic Health and Nutrition Examination Survey
(1982–84). Centers for Disease Control and Prevention, National Center for Health Statistics, Health, United States, 2008,
With Special Feature on the Health of Young Adults. Hyattsville, Maryland: 2009. 2007-2008: National Health and Nutrition
Examination Survey Public Use Data File, 2007-2008 National Center for Health Statistics, Centers for Disease Control and
Prevention, 2009.
Trends in Obesity* Prevalence (%), Children and Adolescents, by
Age Group, US, 1971-2008
25
20
20
18 18
17
16 16
Prevalence (%)
15
12
11 11
10 10
10
7
7 6
5 5 5
5 4
0
2 to 5 years 6 to 11 years 12 to 19 years
*Body mass index (BMI) at or above the sex-and age-specific 95th percentile BMI cutoff points from the 2000 sex-specific BMI-
for-age CDC Growth Charts. Note: Previous editions of Cancer Statistics used the term “overweight” to describe youth in this
BMI category.
Source: National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2002, National Center for
Health Statistics, Centers for Disease Control and Prevention, 2002, 2004. 2003-06: Ogden CL, et al. High Body Mass Index for
Age among US Children and Adolescents, 2003-2006. JAMA 2008; 299 (20): 2401-05. 2007-08: Ogden CL, et al. Prevalence of
High Body Mass Index in US Children and Adolescents, 2007-2008. JAMA 2010; 303 (3): 242-249.
Sunburn* Prevalence (%) in the Past Year, Adults 18 and
Older, US, 2005
50
44
45
41 Total
40 38
36
34
Age-Adjusted Prevalence (%)
35 32 White non-
Hispanic
30
25 Other
22 22 22 22
20
20 19
Hispanic
15
10
10 8
6 Black non-
5 Hispanic
0
Total Male Female