1. Healthy People 2010 Focus Area 3: Cancer Progress Review August 17, 2006

2. Developmental Little or no change Status of Cancer Objectives Infrastructure Statewide cancer registries Overall cancer deaths Cervical cancer deaths Prostate cancer deaths Lung cancer deaths Colorectal cancer deaths Melanoma cancer deaths Breast cancer deaths Oropharyngeal cancer deaths Cancer survival Mortality Sun exposure and skin cancer (adolescents) Sun exposure and skin cancer (adults) Provider counseling about cancer prevention Provider counseling about physical activity Provider counseling about mammograms Cancer Prevention Pap tests ever Colorectal cancer screening (FOBT) Pap tests in past 3 years Colorectal cancer screening Mammograms sigmoidoscopy Cancer Detection/Treatment ImprovingGetting worse Baseline data only Target met

3. Improving Overall cancer deaths Lung cancer deaths Breast cancer deaths Colorectal cancer deaths Sun exposure and skin cancer - adults Pap smear - ever Cancer survival Highlighted Objectives Getting worse/Little or no change Pap smear within past three years Colorectal cancer screening - FOBT Developmental Sun exposure and skin cancer - adolescents ImprovingGetting worseLittle or no change Baseline data only Target met Developmental Colorectal cancer screening - sigmoidoscopy Mammograms Target met

4. Mortality and associated health behaviors Note: The Black and white groups exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Vital Statistics System- Mortality, NCHS, CDC. SOURCES: National Vital Statistics System- Mortality, NCHS, CDC; National Health Interview Survey, NCHS, CDC; Youth Risk Behavior Survey, YRBS, CDC. ImprovingGetting worseLittle or no changeBaseline data onlyTarget met Developmental MortalityPrevention/Detection 3-2. Lung cancer deaths27-1. Cigarette smoking (adults) 27-2. Cigarette smoking (students) 3-3. Breast cancer deaths3-13. Mammograms 3-4. Cervical cancer deaths3-11a. Pap test (ever) 3-11b. Pap test (past 3 years) 3-5. Colorectal cancer deaths3-12a. Fecal occult blood test (past 2 years) 3-12b. Sigmoidoscopy (ever) 3-6. Oropharyngeal deathsTobacco and Alcohol 3-8. Melanoma deaths3-9a. Sun safety behavior (students) 3-9b. Sun safety behavior (adults)

5. Overall cancer mortality, by race and ethnicity Age-adjusted rate per 100,000 1960 0 100 150 200 250 300 White Black Obj. 3-1 1950 1970 1980 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. Asian Hispanic American Indian 2010 Target 2003 1990 2000

6. Overall cancer mortality, by race and ethnicity Age-adjusted rate per 100,000 White Black Obj. 3-1 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. Asian Hispanic American Indian 1960195019701980 2003 1990 2000 1000 10 2010 Target 100

7. Leading causes of cancer mortality, by gender, 2003 Number of deaths Men Total = 287,990 Women Total = 268,912 Lung 68,122 Breast 41,620 Colon/Rectum 27,951 Lymph/blood 25,603 Pancreas 15,717 Ovary 14,657 Other 75,242 Lung 89,964 Lymph/ blood 30,076 Colon/Rectum 28,007 Prostate 29,554 Pancreas 15,060 Esophagus 9,921 Other 85,408 SOURCE: National Vital Statistics System--Mortality, NCHS, CDC.

8. Asian Lung cancer mortality, by race and ethnicity Age-adjusted rate per 100,000 0 10 20 30 White Black Hispanic American Indian Obj. 3-2 40 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. 50 60 70 80 2010 Target 19601950 1970 1980 2003 1990 2000

9. Asian Lung cancer mortality, by race and ethnicity Age-adjusted rate per 100,000(log scale) White Black Hispanic American Indian Obj. 3-2 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. 1960 1950 1970 1980 2003 1990 2000 1 10 100 2010 Target

10. Note: Data are age adjusted to the 2000 standard population. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. Lung cancer mortality, by gender Age-adjusted rate per 100,000 Total 0 10 20 Obj. 3-2 Males Females 30 40 50 60 70 80 90 100 2010 Target 19601950 1970 1980 2003 1990 2000

11. Note: Data are age adjusted to the 2000 standard population. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. Lung cancer mortality, by gender Age-adjusted rate per 100,000(log scale) Total 10 Obj. 3-2 Males Females 100 1960195019701980 2003 1990 2000 1 2010 Target

12. Asian Female breast cancer mortality, by race and ethnicity Age-adjusted rate per 100,000 0 5 10 20 25 30 35 White Black Hispanic American Indian Obj. 3-3 15 40 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. 45 2010 Target 19601950 1970 1980 2003 1990 2000 1995

13. Asian Female breast cancer mortality, by race and ethnicity Age-adjusted rate per 100,000(log scale) 10 White Black Hispanic American Indian Obj. 3-3 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. 100 1 1960 1950 19701980 2003 1990 2000 1995 2010 Target

14. Asian Colorectal cancer mortality, by race and ethnicity Age-adjusted rate per 100,000 White Black Hispanic American Indian Obj. 3-5 35 0 5 10 20 25 30 15 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. 2010 Target 1960 1970 1980 2003 1990 2000

15. Asian Colorectal cancer mortality, by race and ethnicity White Black Hispanic American Indian Obj. 3-5 10 Note: Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Persons of Hispanic origin may be any race. Only one race category could be recorded. Recording more than one race was not an option. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. 100 1 1960 19701980 2003 1990 2000 Age-adjusted rate per 100,000(log scale) 2010 Target

16. Note: Data are age adjusted to the 2000 standard population. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. Obj. 3-1 2010 target: 13.7 Colorectal cancer mortality, by Health Service Area, 1999-2003

17. Sun safety behavior in adults and adolescents Age-adjusted percent Adults (18+) 2010 Target Note: The Black and white groups exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. SOURCE: National Vital Statistics System- Mortality, NCHS, CDC. Note: Sun safety behavior includes sunscreen use, wearing a hat, and wearing long-sleeved clothing. Data are age adjusted to the 2000 standard population. I = 95% confidence interval. SOURCES: National Health Interview Survey, NCHS, CDC; Youth Risk Behavior Survey, YRBS, CDC. Objs. 3-9a, 3-9b 2000 2005 Students, grades 9-12 ** **Developmental objective, target to be determined.

18. Asian Age-adjusted percent 2000 2003 0 10 20 30 40 50 60 White Black Hispanic 70 Note: American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. Data for Native Hawaiian and other Pacific Islanders are statistically unreliable. SOURCE: National Health Interview Survey, NCHS, CDC. 2005 Adults who ever received a colorectal endoscopy or FOBT in the past 2 years, aged 50 years and older American Indian 2 or more races

19. Age-adjusted percent 2000 2003 2010 Target- endoscopy FOBT 0 20 30 50 Objs. 3-12a, 3-12b Note: Data are age adjusted to the 2000 standard population. SOURCE: National Health Interview Survey, NCHS, CDC. Colorectal cancer screening, aged 50 years and older 2005 10 40 60 Endoscopy 2010 Target- FOBT

20. Asian Women receiving a mammogram within past 2 years, aged 40 years and older Percent 19872000 2003 0 10 20 30 40 50 60 White Black Hispanic Obj. 3-13 1990 70 80 Note: The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one race prior to 1999. For 1999 and later years, persons were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. Data for American Indian/Alaska Native, Native Hawaiian and other Pacific Islanders, and 2 or more races are statistically unreliable. SOURCE: National Health Interview Survey, NCHS, CDC. 19941998 2005 2010 Target

21. Asian Women receiving Pap test in past 3 years, aged 18 years and older Percent White Black Hispanic American Indian Obj. 3-11b 0 10 20 30 40 50 60 70 80 90 100 1987 2000 2003 1990 19941998 2005 Note: American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one race prior to 1999. For 1999 and later years, persons were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. Data for Native Hawaiian and other Pacific Islanders, and 2 or more races are statistically unreliable. SOURCE: National Health Interview Survey, NCHS, CDC. 2010 Target Tota l Cervical cancer mortality Age-adjusted rate per 100,000 Note: Data are age adjusted to the 2000 standard population. SOURCE: National Vital Statistics System--Mortality, NCHS, CDC. 2010 Target

22. Early cancer detection procedures, by family income level, 2005 Age-adjusted percent Mammogram (past 2 years): Females 40+ Pap test (past 3 years): Females 18+ Fecal occult blood test (past 2 years): Adults 50+ Colorectal endoscopy exam* (ever): Adults 50+ Poor Near poor Middle/High 2010 Target *Includes sigmoidoscopy, colonoscopy, and proctoscopy Note: Data are age adjusted to the 2000 standard population. Poor includes those below the Federal poverty level, Near poor includes those 100-199% of the Federal poverty level, and Middle/high income includes those 200% or more of the Federal poverty level. SOURCE: National Health Interview Survey, CDC, NCHS. Objs. 3-13, 3-11b, 3-12a, 3-12b

23. Progress review data and slides are available on the web at: http://www.cdc.gov/nchs/hphome.htm