Engler Announces Cancer Incidence and Deaths Continue to Decline

Governor John Engler today announced continued decreases in both the frequency of cancer and in the number of deaths caused by cancer in Michigan. Engler announced the Internet availability of the Cancer Incidence and Mortality Report, compiled by the Division for Vital Records and Health Statistics in the Michigan Department of Community Health.

"I am pleased to announce this continued decrease in the frequency of cancer and deaths caused by cancer," said Engler. "The fact that cancer rates are dropping for both males and females is outstanding news. While there are probably several reasons for these declines, we are particularly encouraged by the evidence that cases of breast cancer are being diagnosed earlier, when they are more easily and successfully treated."

"The information in this report serves as a valuable resource for use in epidemiological studies and for planning and evaluating cancer prevention and control programs," said James K. Haveman, Jr., Director of the Michigan Department of Community Health. "We will continue our efforts to make sure these numbers continue to move in the right direction."

There were 42,629 cases of invasive cancer diagnosed among Michigan residents in 1996. The age-adjusted rate of cancer incidence declined in 1996 to 38.4 cases per 10,000 individuals, compared to the rate of 40.0 observed in 1995. The number of deaths caused by cancer in 1996 was 19,563, with 19,504 cancer deaths occurring in 1997. The overall age-adjusted cancer mortality rate declined from 17.0 in 1995 to 16.6 deaths per 10,000 individuals in 1997.

• Cancer Incidence and Mortality Rates Continue to Decline

The rates for both cancer incidence and cancer mortality have been declining during the 1990s in Michigan and nationally. The age-adjusted cancer incidence rate for Michigan was 38.4 per 10,000 persons in 1996, marking the fourth year that it has declined. The age-adjusted cancer mortality rate for Michigan declined from 17.0 per 10,000 in 1995 to 16.6 per 10,000 in 1997. The overall mortality rate has started to decline during the 1990s after a long history of rising rates.

• Frequency of Cancer is Stable or Declining for All Major Primary Organ Sites

Breast cancer incidence rates have held relatively stable from 1992 through 1996, while modest declines in breast cancer mortality continue through 1997. Declines in incidence for lung and prostate cancer are in evidence for a third straight year. The rates for colorectal cancer indicate a steady lowering of both incidence and mortality.

• Cancer Rates are Dropping for Both Males and Females

Declines in rate are evident for all cancers and for the leading cancer sites for both sexes. The drop in incidence has been much faster for males than for females, with the most marked declines for men being prostate cancer and lung cancer. A noticeable decline in lung cancer mortality among males is paralleled by a stable rate for females. Despite these declines for males, cancer remains more common among males than among females.

• The Trend Toward Earlier Diagnosis is Continuing

The pattern of progressively earlier stage at diagnosis continued into 1996. Increasingly, cancer cases are being identified with localized disease, particularly for colon, breast, cervical and prostate cancers.

• Detailed Primary Site/Type Data

Cancer incidence and mortality increases progressively with age for all cancer sites, except for the incidence of Hodgkin’s lymphoma. Relative to cancer mortality, lung cancer is the dominant cancer primary site across all age. Cancer incidence by site is more varied relative to the age of the patient. Breast cancer and cancers of the genitourinary tract are the most common cancers in patients under 50. Cancers of the prostate and the lung are the most frequent for ages over 50. At ages 50 through 74 breast cancer is next most frequent followed by colon cancer. Over 75 years of age, the four leading cancer sites remain the same with colon cancer surpassing breast cancer in frequency.

Prostate cancer was the most common cancer diagnosed in 1996 with 6,632 new cases identified and has been the most frequently diagnosed cancer since 1991. The incidence rate for prostate cancer has declined for the fourth straight year, falling from a rate of 14.6 cases per 10,000 men in 1995 to 13.9 per 10,000 in 1996, a decrease of 4.8%. Many prostate cancers were discovered in the late 1980s and early 1990s with the introduction and widespread use of prostate specific antigen (PSA) tests. Fewer cancers are being detected with the ongoing use of PSA tests; since 1992 prostate cancer incidence in Michigan has declined by 34.3%.

The age-adjusted mortality rate for prostate cancer declined in 1996 and held steady in 1997 with a rate of 2.4 per 10,000. This compares to 2.5 per 10,000 in 1995 and 2.9 per 10,000 back in 1992.

Lung cancer was the second leading type of cancer diagnosed in 1996. Lung cancer incidence rates declined for the third year, continuing the general decline in the rate since it peaked in 1991. There were 6,376 new lung cancer cases diagnosed in Michigan residents during 1996, compared to 6,787 new cases identified during 1995. The incidence rate decreased 8.0% from 6.3 cases per 10,000 in 1995 to 5.8 cases per 10,000 in 1996.

Lung cancer is the leading cause of death among cancer victims. In 1996 there were 5,653 deaths caused by lung cancer. The number declined slightly in 1997 to 5,543 lung cancer deaths. There were 2.7 times more lung cancer than colorectal cancer deaths, the second leading cancer killer, in 1997. This reflects the severity and difficultly in treating lung cancer cases. The age-adjusted lung cancer mortality rate declined to 4.9 per 10,000 by 1997. This rate had been between 5.0 and 5.1 per 10,000 from 1991 through 1996.

Breast cancer was the third leading type of cancer diagnosed in 1996 and the leading cancer among women. There were 6,236 new breast cancer cases identified in Michigan during 1996. The age-adjusted breast cancer incidence rates declined by 6.5 % from 11.1 per 10,000 women in 1995 to 10.4 per 10,000 women in 1996. This is the sharpest decline in the rate of new breast cancer cases since the incidence rates for this disease began falling in 1993. Between 1991 and 1996, the age-adjusted breast cancer incidence rates declined by 11.1%.

Deaths due to breast cancer are also declining. The number of breast cancer deaths in 1996 was 1,593 with 1,538 breast cancer deaths in 1997. The age-adjusted mortality rate for breast cancer among Michigan females declined from 2.7 per 10,000 in 1995 to 2.5 in 1996 and then decreased to 2.4 in 1997. Since 1989, breast cancer mortality in Michigan has decreased 17.2% from the peak rate of 2.9 per 10,000.

Colorectal cancer was the fourth leading type of cancer diagnosed in 1996 with 4,977 new colorectal cancer cases diagnosed. The age-adjusted incidence rate for colorectal cancer held steady in 1996 at 4.3 cases per 10,000 after declining rates for four consecutive years through 1995. Colorectal cancer was the second most frequent cause of cancer related death in 1996 and again in 1997. As with the incidence rate for colorectal cancer, the age-adjusted mortality rate for this cancer site remained stable at 1.7 cases per 10,000 in 1995 through 1997.

Selected state and local cancer incidence and mortality tables and graphics can be found on the Department of Community Health’s web site at www.mdch.state.mi.us and then by clicking on "Health Statistics" and then clicking the "Cancer" button.