Atlas of Cancer Mortality
Results -- National Mortality Rates
During the 25-year study period 1970-94, more than 9.5 million
whites and 1.1 million blacks died from cancer
(Table 1a). The
national annual age-adjusted mortality rates per 100,000
person-years for all cancers combined ranged from 136 among white
females to 294 among black males. Although counts and rates for more
than 40 specific categories of cancer are presented, almost 60
percent of all cancer deaths among males were due to 4 primary sites
of cancer: lung, prostate, colon, and pancreas. Among females,
nearly 60 percent of all cancer deaths were due to cancers of the
breast, lung, colon, ovary, and pancreas. During the 20-year study
period 1950-69, more than 4.8 million whites died from cancer; the
numbers and rates are presented in
Table 1b.
The 1970-94 national mortality rates for all cancers combined were
54 percent higher among white males than females and 84 percent
higher among black males than females
(Table 2 and
Figures 1a-b).
Most forms of cancer were more common among males than females,
except for cancers of the breast, gallbladder, and thyroid. Among
whites, the male/female rate ratio was highest for lip cancer,
surpassing 10-fold, while ratios were also notably high for cancers
of the larynx, esophagus, and bladder, each exceeding three-fold.
Among blacks, the male/female ratio was highest for cancer of the
larynx (6.5), followed by cancers of the oral cavity and pharynx,
and the esophagus, each ratio being four-fold or greater. The
male/female ratio for lung cancer was nearly three-fold among whites
and nearly four-fold among blacks. Due to the large numbers of
deaths, all male/female rate ratios were significantly different
from unity.
The U.S. rates for all cancers combined were 40 percent higher among
black than white males and 17 percent higher among black than white
females
(Table 2 and
Figures 2a-b).
For most specific forms of
cancer, rates were higher among blacks than whites. The excess among
blacks was most pronounced for esophageal cancer, with a black/white
ratio exceeding three-fold in both males and females. Black/white
ratios ranged between two- and three-fold for cancer of the cervix
uteri among females; for cancers of the penis, prostate, oral
cavity, and stomach among males; and for multiple myeloma in both
sexes. On the other hand, rates for about one-third of all the
cancers were higher among whites than blacks, most notably for
cancers of the lip (males only), testis, eye, and brain, and for
melanoma and non-Hodgkin's lymphoma. Most of the black/white rate
ratios were significantly different from unity, except for rectal
cancer among males, lung cancer among females, and nonmelanoma skin
cancer in both sexes. The sex and race ratios varied somewhat with
age. For all cancers combined, the higher rates among black than
white males were limited to those aged 40 years and older
(Figure 3),
while the higher rates
among males than females were primarily among those aged 60 and older.
Cancer mortality rates increased logarithmically with age, at least
up to about age 40 for melanoma of the skin and cervical cancer, age
50 for breast cancer, and age 60 for many other sites
(Figure 3).
At older ages, the rates for certain cancers, such as cancers of the
nasopharynx, oral cavity and pharynx, esophagus, larynx, lung, and
brain, and Hodgkin's disease, did not continue to rise. Age-specific
rates were bimodal for cancers of the bones and joints, testis,
brain, and other endocrine glands, and for Hodgkin's disease and leukemia.
Suggested Citation
Devesa SS, Grauman DG, Blot WJ, Pennello G, Hoover RN, Fraumeni JF Jr. Atlas of cancer
mortality in the United States, 1950-94. Washington, DC: US Govt Print Off; 1999 [NIH Publ No.
(NIH) 99-4564].
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