Cancer Incidence and Mortality in New Jersey, 1994 -1998
Summary of Cancer Incidence Data
Overall age-adjusted cancer incidence rates have increased for both males and females, particularly for black females. Lung cancer incidence rates have decreased slightly for males and have increased for females. Prostate cancer rates increased slightly at least through 1997, possibly reflecting the last phase of the typical pattern seen following the introduction of a widespread screening program. Breast cancer incidence rates also appear to be rising at least through 1997 in a manner consistent with continued improvements in screening, since the rise in rates were primarily among the in situ and local stages during these years. Incidence rates for colon cancer have been fairly stable for both males and females.
The rise in non-Hodgkin's lymphoma incidence can still be seen during these years particularly among females while malignant melanoma increases are apparent among males. Incidence of these cancers has been increasing for the country as a whole. Overall patterns in New Jersey continued to approximate those for the entire nation during 1993-1997, as published in Cancer in North America, 1993-1997.
Summary of Cancer Incidence Rates in New Jersey, 1994-1998 (Tables 1-6)
A total of 43,303 cases of invasive cancer diagnosed in 1998 among New Jersey residents had been reported to the NJSCR. During the period 1994-1998, a total of 212,116 cases of cancer were diagnosed among New Jersey residents, 51% among males and 49% among females. Tables 1 through 6 display the total counts of newly diagnosed cases of cancer in New Jersey and the age-adjusted incidence rates by race and gender for the period 1994 through 1998.
In the paragraphs below, we note the most striking patterns indicated in Tables 1 through 6 according to gender and the largest racial subgroups also taking into account fluctuations and trends in incidence data for years prior to 1994. Incidence data for years prior to 1994 can be viewed on the NJDHSS website, www.state.nj.us/health and can also be found in our previous cancer incidence reports.
Males (Tables 1, 3, and 5): During the years 1994-1998, the overall cancer incidence rate increased. Lung cancer incidence rates decreased slightly among all males combined and among white males during this period. Prostate cancer rates rose among both whites and blacks through 1997. Rates for non-Hodgkin's lymphoma among all males and malignant melanoma of the skin among white males continued to increase, a trend also seen in the U.S. as a whole. Incidence rates for kidney and liver/intrahepatic bile duct cancers have increased slightly.
Females (Tables 2, 4, 6, and 7): The overall cancer incidence rate for females increased (Table 2). Incidence rates of lung cancer rose during the 1994-1998 period, in contrast to the decline of lung cancer rates in males. Declines continued to be seen for invasive cervical cancer. In situ breast cancer rates rose markedly during these years, indicating increased rates of screening. Invasive breast cancer incidence rates also rose slightly, and the increases were primarily among cancers diagnosed at the most treatable (local) stage (Table 7) again suggesting that screening is becoming more widespread (see our in-depth report of September 1998 on breast cancer regarding breast cancer trends during 1979-1995). The incidence of cancers of the uterine corpus also increased during these years. Non-Hodgkin's lymphoma incidence increased as well. For white females (Table 4), the incidence of malignant melanoma of the skin and thyroid cancer increased and for black females (Table 6), there was an increase in bladder cancers.
Comparison of Cancer Incidence Data for New Jersey with the United States, 1993-1997
Tables 8 and 9 show the comparable incidence rates for the three most common sites of cancer for males and for females, as well as the comparable rates for melanoma, non-Hodgkin's lymphoma, and for all cancer sites combined. Historically, New Jersey rates have been representative of the Northeast region, which tends to have higher cancer incidence rates than the U.S. as a whole.
When comparing rates between areas or over time, it is important to use rates that are adjusted or weighted to a common standard. In this report, as is general practice in this country, we have presented rates adjusted to the 1970 U.S. population. Using this standard, along with the Surveillance, Epidemiology, and End Results (SEER) multiple primary rules, makes it possible to compare New Jersey age-adjusted rates to rates published by NAACCR in Cancer in North America. The most recent detailed data available from NAACCR are for the time period 1993-1997. Therefore, we have prepared comparison tables for major sites for this time period.
For males (Table 8), all races combined, total cancer incidence rates were higher in New Jersey than the U.S. during the period 1993-1997. The incidence rates for colorectal and prostate cancer and non-Hodgkin's lymphoma were higher than those for the total U.S. Lung cancer rates were the same for whites but lower for blacks in New Jersey compared to the nation. Melanoma incidence rates for the U.S. and New Jersey were similar.
For females (Table 9), New Jersey had higher incidence rates than the U.S. during the period 1993-1997 for total cancers, lung, colorectal, and non-Hodgkin's lymphoma for all races combined, for blacks and for whites. Black females had slightly lower breast cancer rates in New Jersey, while white females in New Jersey had higher rates. Melanoma incidence rates were slightly lower in New Jersey for white females, but for black females the New Jersey rates were similar to the U.S.
Summary of Cancer Mortality Data
The New Jersey cancer mortality data through 1998 reflect many trends observed throughout the nation. Cancer mortality rates of the U.S. have been on the decline since 1991 and the decline has been more rapid since 1995. This decline is more apparent among New Jersey men than women. Research suggests that advances in treatment and increased screening have helped reduce mortality from cancer. Declines in smoking rates are also believed to have contributed to the decreases in males.
Cancer Mortality Rates in New Jersey, 1994-1998 (Tables 10-15)
There were 17,583 deaths in 1998 for which cancer was designated on the death certificates as the underlying cause. During the period 1994-1998, 90,706 deaths from cancer occurred among New Jersey residents, 50% among males and 50% among females. Tables 10-15 display the total counts of deaths from cancer in New Jersey and age-adjusted mortality rates by race and gender for the period 1994 through 1998.
In the paragraphs below, we note the most striking patterns indicated in Tables 10 through 15 according to gender and the largest racial subgroups. Mortality trends are also compared to the incidence data described above and shown in Tables 1 through 6.
Males (Tables 10, 12, 14): During the years 1994-1998, the overall cancer mortality rate decreased (Table 10) despite a slight increase in incidence rates over the past few years. In particular, lung cancer mortality rates decreased, consistent with trends in incidence. Decreases were also seen in prostate cancer and colorectal cancer rates. In addition, pancreatic cancer, also one of the top five sites of cancer mortality in New Jersey, decreased slightly since 1995.
Bladder cancer mortality rates declined, as did oral and pharyngeal cancer deaths. Mortality rates for non-Hodgkin's lymphoma remained constant, despite a slight increase in incidence.
For white males (Table 12), the trends for the most common cancers were similar to those for all males. Colorectal cancer rates decreased for white men.
Although cancer mortality rates for black males (Table 14) have been significantly higher than for white males, they also show an overall decreasing trend. Mortality rates for esophageal cancer, one of the top causes of cancer death among blacks, has decreased.
Females (Tables 11, 13, and 15): During the years 1994-1998, the overall cancer mortality rate decreased (Table 11) despite increases in incidence rates. Breast cancer mortality rates decreased in contrast to the increase in incidence rates, an observation is consistent with the trend toward earlier diagnoses for breast cancers. A downward trend was also seen for colorectal cancer deaths even though incidence did not decrease. However, mortality rates among females for lung cancer increased, similar to the incidence rates. Cervical cancer mortality rates decreased, again reflecting the trend toward diagnosis at an earlier stage. There was a slight downward trend in ovarian cancer mortality. Uterine corpus mortality rates remained stable. There were no clear trends for melanoma or non-Hodgkin's lymphoma mortality, despite the increase in incidence rates.
For white females (Table 13), the cancer mortality trends for most common cancers were similar to those for all females combined. Ovarian cancer decreased more consistently for white women.
For black females (Table 15), cancer mortality rates were higher than those for white females but not as high as for black males. Rates for most common cancers fluctuated during the 5-year period. Over these years cervical cancer mortality rates have declined more dramatically for black females than for white females.
Comparison of Cancer Mortality Data for New Jersey with the United States, 1993-1997
For all cancer sites combined, New Jersey cancer mortality rates were higher among males than the corresponding rates for the U.S. However, mortality rates for black males were somewhat lower in New Jersey than the comparable rate for the U.S. Lung cancer mortality rates in males were lower in N.J. than for the nation. Mortality rates for colorectal cancer and prostate cancer were higher in New Jersey than the U.S.
Among females, the mortality rates for all sites combined, lung, colorectal, and breast cancers were higher in New Jersey than the U.S. as a whole during this five-year period.