Introduction

The Nation's investment in cancer research is making a difference:

• Many people are adopting good health habits that reduce the chances of getting cancer.
• The rates of new cancers are going down.
• Overall, cancer death rates have dropped.
• Many people who have had cancer live longer, with the opportunity to enjoy a better quality of life than was possible years ago.

Yet cancer remains a major public health problem-one that profoundly affects the more than 1 million people diagnosed each year, as well as their families and friends:

• Not all cancer rates are going down. For example, the rates of new lung cancers in females have continued to rise. The rates of new cases and deaths from non-Hodgkin's lymphoma also continued to rise, as have the rates of new cases of melanoma.
• The burden of some types of cancer weighs more heavily on some groups than others. The rates of both new cases and deaths from cancer vary by cancer site, socioeconomic status, sex, and racial and ethnic group.
• The economic burden of cancer also is taking its toll. As our Nation's population grows and ages, more people will get cancer. Meanwhile, the costs of cancer diagnosis and treatment are on the rise. The combination of these trends will accelerate the overall national costs of cancer treatment.

Why a Progress Report Is Needed

For the past 30 years, our country has vigorously fought the devastating effects of cancer. Now it is time to see how far we have come. Cancer Progress Report 2001 is the first in a new series of reports to describe the Nation's progress against cancer through research and related efforts. The report is based on the most recent data from the National Cancer Institute, the Centers for Disease Control and Prevention, other Federal agencies, professional groups, and cancer researchers.

The Cancer Progress Report was designed to help policymakers review past efforts and plan future ones. The public can use the report to better understand the nature and results of strategies to fight cancer. Researchers, clinicians, and public health providers can focus on the gaps and opportunities identified in the report, paving the way to future progress against cancer.

What's in the Report

Cancer Progress Report 2001 includes key measures of progress along the cancer continuum:

• Prevention. The measures in this section cover behaviors that can help people prevent cancer—the most important of which is not using tobacco. This section also covers exposures to chemicals in the environment.
• Early Detection. Screening tests are ways to find cancers early, when there is the best chance for cure. This section describes the proportion of people using recommended screening tests and who they are.
• Diagnosis. We can learn much about progress against cancer by looking at the rates of new cancer cases (incidence) and of cancers diagnosed at late stages. This section describes both.
• Treatment. Few treatment measures have been tracked at a national level. This section explains the current status of treatment measures and describes the kinds of measures that are emerging from ongoing research and monitoring activities.
• Life After Cancer. Trends in the proportion of cancer patients alive 5 years after their diagnosis and the costs of cancer care are addressed in this section
• End of Life. This section includes the rate of deaths (mortality) from cancer and the estimated number of years of life lost (person-years of life lost) due to cancer.

Where possible, the Cancer Progress Report shows changes in these data over time (trends). Most of the trend graphs were made using a new statistical method that illustrates real changes in direction instead of merely connecting one dot to another. This report also shows whether the trends are "rising" or "falling" using standard definitions, and it explains why changes might have occurred (Appendix D). For some measures, differences in the cancer burden between some U.S. racial and ethnic groups also are presented. We were not able to present information on all demographic groups for all measures because of space limitations.

Most of the measures in this report are identical to those in Healthy People 2010—a comprehensive set of 10-year health objectives for the Nation-sponsored by the U.S. Department of Health and Human Services. This enabled us to show the Nation's progress relative to Healthy People cancer-related targets for 2010.

How Data Were Selected

In selecting measures that would be meaningful to readers of this report, we relied on those that are based on scientific evidence and long-term national, rather than State or local, data collection efforts. The report includes more measures for prevention, because more data on trends are available in that area. Some measures such as "quality of life" were not included in this report, even though they are important in assessing the cancer burden, because there simply is no consensus on how best to track these measures at this time.

The data in Cancer Progress Report 2001 come from a variety of systems and surveys with different collection techniques and reporting times, so time periods may vary. Where possible, 1990 was used as the starting point or baseline against which to measure how well the Nation is progressing toward the Healthy People 2010 targets.