Significant Recent Declines In Adult Leukemia Incidence Rates In the United States

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 873-873
Author(s):  
Julie A Ross ◽  
Kimberly J Johnson ◽  
James R Cerhan ◽  
Cindy K Blair ◽  
John T Soler ◽  
...  
Keyword(s):  
United States ◽  
Race And Ethnicity ◽  
Conflicts Of Interest ◽  
Statistical Significance ◽  
The United States ◽  
Incidence Rates ◽  
Years Of Life Lost ◽  
Newly Diagnosed ◽  
Incidence Trends ◽  
Time Period

Abstract Abstract 873 Each year in the United States, approximately 45,000 individuals are newly diagnosed with leukemia and 22,000 will die of the disease. Due to this poor survival, leukemia ranks fifth in person years of life lost among specific cancers. Little is known about causes, although exposure to solvents, radiation, pesticides and, to a modest extent, cigarette smoke has been implicated for some subtypes. The last comprehensive report of leukemia trends covered the period 1973–1998 [Xie Y et al, Cancer 2003]. Evaluation of recent leukemia incidence trends could provide important new etiologic insights. Using Surveillance, Epidemiology and End Results (SEER) Program data, we analyzed leukemia incidence trends in U.S. adults (≥ 20 years of age) by age, leukemia subtype (acute myeloid (AML), acute lymphoid (ALL), chronic myeloid (CML), chronic lymphoid (CLL)) sex, race, and ethnicity for the period 1987–2007. Frequencies, age-adjusted incidence rates (IR, per million), and trends were calculated along with annual percent change (APC) and corresponding 95% confidence intervals (CI). Joinpoint analyses were used to detect any significant directional changes in IRs over the period. Of 43,970 newly diagnosed cases identified, IRs increased with age and were consistently higher in males than females for all four subtypes. The highest IRs occurred for CLL (54.4), followed by AML (38.3), CML (20.6) and ALL (7.0). With regard to trends, IRs for CLL (APC -0.5; CI: -0.9, -0.1) and CML (APC -1.2; CI: -1.6, -0.8) declined over the time period; declines were observed in males and females, and by race and ethnicity. Male(M):Female(F) IR ratios remained relatively constant at approximately 2.0 and 1.7, respectively. For ALL, IRs decreased in males (APC -0.9; CI: -1.9, 0.2) but slightly increased in females (APC 0.4; CI: -1.0, 1.7), which was most notable in Hispanics (APC 4.0; CI: 1.2, 6.8). In contrast to CML and CLL, the overall M:F rate ratio for ALL decreased, although it did not reach statistical significance (p=0.08). For AML, IRs increased significantly for males (APC 1.0; CI: 0.3,1.6) and females (APC 1.7; CI: 0.7, 2.7) from 1987–2000 and 1987–2001, respectively. However, since then, AML IRs for males have been significantly decreasing by 4.2% per year (CI: -6.4, -2.1), while IRs for females have been decreasing by 1.6% per year (CI: -4.1, 0.9). Across the entire time period 1987–2007, there was a statistically significant negative trend (p=0.002) in the M:F IR ratio for AML. Decreasing IRs across many leukemias since 1987 are unlikely to reflect changes in screening or diagnostic coding practices. Instead, these observations may reflect temporal changes in etiologically relevant environmental exposures. Of note, the prevalence of cigarette smoking in the population has decreased and occupational safety practices (e.g., reducing solvent/radiation/pesticide exposure) have improved over the last several decades, which could contribute to the gradual decreases in some IRs observed. In contrast, the rapid and significant decrease noted for AML since 2000, especially following a significant increase, was striking and deserved additional scrutiny. We further consulted with our cancer registry colleagues to determine whether the introduction of myelodysplastic syndrome (MDS) as a new malignancy in SEER in 2001 could be influencing recent AML trends given the (apparently) coincidental overlap in time periods. Of note, approximately one third of MDS patients subsequently develop AML. We learned that AML following an MDS diagnosis from 2001–2009 was not reportable to SEER and therefore not counted. We are not aware that this has been documented in the literature. However, beginning for 2010 diagnoses, SEER changed this practice such that AML following MDS will be captured as a second malignancy. Based on these changes in AML surveillance, it will especially be important to monitor future trends for this malignancy. Overall, this study demonstrates the value of in-depth analyses of SEER cancer IRs and trends; analyses may reveal patterns of clinical and/or etiological importance, or, in the instance of AML, unpublished coding rule changes. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Trends in the Incidence of Pancreatic Adenocarcinoma in All 50 United States Examined Through an Age-Period-Cohort Analysis

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Wilson L da Costa ◽  
Abiodun O Oluyomi ◽  
Aaron P Thrift
Keyword(s):  
United States ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Cohort Analysis ◽  
The United States ◽  
Incidence Rates ◽  
Ductal Adenocarcinoma ◽  
Birth Cohorts ◽  
Men And Women ◽  
Cancer Statistics ◽  
Incidence Trends

Abstract Background Pancreatic ductal adenocarcinoma is a major contributor to cancer-related mortality in the United States. We aimed to investigate trends in incidence rates from all 50 states from 2001 to 2016, overall and by race, sex, and state and using age-period-cohort analyses. Methods Age-adjusted incidence rates and trends in adults aged 35 years and older were calculated using data from the US Cancer Statistics registry. We used joinpoint regression to compute annual percent changes (APC) and average annual percent changes. We also analyzed incidence trends by age groups and birth cohorts through age-period-cohort modeling. Results Age-standardized incidence rates increased by 1.23% (95% confidence interval [CI] = 0.92% to 1.54%) annually between 2001 and 2008 but were stable between 2008 and 2016 (APC = 0.11%, 95% CI = -0.13% to 0.35%). APCs and inflection points were no different for men and women. Rates increased statistically significantly among non-Hispanic whites (NHW) and non-Hispanic blacks between 2001 and 2007 and between 2001 and 2008, respectively, but, in later years, rates increased slowly among NHWs (APC = 0.36%, 95% CI = 0.12% to 0.60%), and were stable among non-Hispanic blacks (APC = -0.40%, 95% CI = -0.89% to 0.10%). The number of states with age-standardized incidence rates no less than 20.4 per 100 000 increased from 16 in 2001–2003 to 40 by 2015–2016. We found a strong birth cohort effect in both men and women and increasing rates among successive birth cohorts of NHWs. Conclusions The incidence of pancreatic ductal adenocarcinoma has consistently increased in the United States, albeit at slower rates recently. We observed notable increases among NHWs and in some states in the central and southern part of the country.

Ethnic and Racial Difference In H.Pylori Infection In Patients With ITP Treated At A MAJOR Tertiary Medical Center In LOS Angeles

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3548-3548
Author(s):  
Caitlin M O'Neill ◽  
Ulysses Gomez ◽  
Ilene C Weitz ◽  
Casey O'Connell ◽  
Howard Liebman
Keyword(s):  
United States ◽  
Los Angeles ◽  
Racial Differences ◽  
Conflicts Of Interest ◽  
Medical Center ◽  
The United States ◽  
Response To Therapy ◽  
Additional Patient ◽  
Newly Diagnosed ◽  
H Pylori

Abstract Background Infection with Helicobacter pylori has been implicated as an etiologic agent for the development of immune thrombocytopenia (ITP). In a systematic review of the medical literature Stasi and colleagues reported wide regional variation in the prevalence of H. pylori infection in ITP patients with significant differences in improvement in platelet count with infection eradication. The largest report on H.pylori infection in ITP patients diagnosed in the United States found a lower prevalence of infection (21.6%) than the reported seroprevalence (32.5%) for the general United States population.1 Only 1 of 15 treated patients responded eradication of their infection.1 Based upon this report the American Society of Hematology ITP guidelines do not recommend routine H. pylori testing during the evaluation of newly diagnosed patients. Los Angeles County-University of Southern California Medical Center is the largest healthcare provider in the metropolitan Los Angeles region. It services a large and ethically diverse patient population. Screening for H.pylori infection in newly diagnosed and previously diagnosed ITP patients was begun as a routine part of the diagnostic algorithm in 2008. We initiated a retrospective review of H.pylori infection in patients screened during this period. Results At the time of this report the medical records of 80 ITP patients (M/F: 22/58) have been reviewed. 68 (F/M: 52/16) patients, 51 with 1o ITP and 17 with 2ry ITP, were screened for H.pylori. The median age of the screened patients was 50 yrs (23 to 85 yrs). Patients were screened with either the H. pylori stool antigen (46 pts; 65%) or H. pylori Breath test (10 pts; 16%). 12 patients (19%) were only screened for H.pylori antibodies. Of the screened patients, 29/68 (42.6%) tested positive for H. pylori. However, there were significant ethnic and racial differences in the prevalence of infection (Table ). 27 of the 29 positive patients were treated for their infection. H. Pylori eradication was documented in 20 of 22 (91%). An additional patient was successfully treated with a second course of antibiotics. Response to therapy could not be assessed in 14 of the 27 treated patients due to treatment with concomitant ITP medications. Of the 13 patients who could be evaluated for response using IWG criteria, there were 4 (30.8%) complete responses, 1 (7.7%) partial response and no response in 8 (61.5%). All complete responders were treated within 2 months of initial presentation. At the time of this report only 3 of the 29 patients remain on ITP treatment. Conclusion There are significant ethnic and racial differences in the prevalence of H. pylori infection in ITP patients diagnosed in the greater Los Angeles metropolitan region. Despite earlier reports from New York and Miami, early identification and treatment of H. pylori infected may result in remissions up to a third of patients. 1. Michel M et al. Blood 2004; 103: 890-896. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Incidence trends, rates, and ethnic variations of primary CNS tumors in Texas from 1995 to 2013

2017 ◽  
Vol 5 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Solomon N Ambe ◽  
Kristopher A Lyon ◽  
Damir Nizamutdinov ◽  
Ekokobe Fonkem
Keyword(s):  
United States ◽  
American Indians ◽  
Large Population ◽  
Ethnic Disparities ◽  
The United States ◽  
Incidence Rates ◽  
Cns Tumors ◽  
Annual Percent Change ◽  
Incidence Trends ◽  
Percent Change

Abstract Background Although rare, primary central nervous system (CNS) tumors are associated with significant morbidity and mortality. Texas is a representative sample of the United States population given its large population, ethnic disparities, geographic variations, and socio-economic differences. This study used Texas data to determine if variations in incidence trends and rates exist among different ethnicities in Texas. Methods Data from the Texas Cancer Registry from 1995 to 2013 were examined. Joinpoint Regression Program software was used to obtain the incidence trends and SEER*Stat software was used to produce average annual age-adjusted incidence rates for both nonmalignant and malignant tumors in Texas from 2009 to 2013. Results The incidence trend of malignant primary CNS tumors in whites was stable from 1995 to 2002, after which the annual percent change decreased by 0.99% through 2013 (95% CI, -1.4, -0.5; P = .04). Blacks and Asian/Pacific Islanders showed unchanged incidence trends from 1995 to 2013. Hispanics had an annual percent change of -0.83 (95% CI, -1.4, -0.2; P = .009) per year from 1995 through 2013. From 2009 to 2013, the incidence rates of nonmalignant and malignant primary CNS tumors were highest among blacks, followed by whites, Hispanics, Asians, and American Indians/Alaskan Natives. Conclusions Consistent with the 2016 Central Brain Tumor Registry of the United States report, the black population in Texas showed the highest total incidence of CNS tumors of any other race studied. Many factors have been proposed to account for the observed differences in incidence rate including geography, socioeconomic factors, and poverty factors, although the evidence for these external factors is lacking.

scholarly journals Spatio-temporal analysis of influenza-like illness and prediction of incidence in high-risk regions, in the United States from 2011 to 2020

2021 ◽  
Author(s):  
Zhijuan Song ◽  
Xiaocan Jia ◽  
Junzhe Bao ◽  
Yongli Yang ◽  
Huili Zhu ◽  
...  
Keyword(s):  
United States ◽  
Statistical Significance ◽  
Temporal Analysis ◽  
The United States ◽  
Incidence Rates ◽  
Influenza Like Illness ◽  
Temporal Cluster ◽  
Control And Prevention ◽  
Spatio Temporal ◽  
And Control

Abstract Introduction: About 8% of Americans get influenza during an average season from the Centers for Disease Control and Prevention in the United States. It is necessary to strengthen the early warning of influenza and the prediction of public health. Methods In this study, we analyzed the characteristics of Influenza-like Illness (ILI) by Geographic Information System and SARIMA model, respectively. Spatio-temporal cluster analysis detected 23 clusters of ILI during the study period. Results The highest incidence of ILI was mainly concentrated in the states of Louisiana, District of Columbia and Virginia. The Local spatial autocorrelation analysis revealed the High-High cluster was mainly located in Louisiana and Mississippi. This means that if the influenza incidence is high in Louisiana and Mississippi, the neighboring states will also have higher influenza incidence rates. The regression model SARIMA(1, 0, 0)(1, 1, 0)52 with statistical significance was obtained to forecast the ILI incidence of Mississippi. Conclusions The study showed, the ILI incidence will begin to increase in the 45th week 2020 and peak in the 6th week 2021. To conclude, notable epidemiological differences were observed across states, indicating that some states should pay more attention to prevent and control respiratory infectious diseases.

scholarly journals Ovarian Cancer Incidence Trends in Relation to Changing Patterns of Menopausal Hormone Therapy Use in the United States

2013 ◽  
Vol 31 (17) ◽  
pp. 2146-2151 ◽  
Author(s):  
Hannah P. Yang ◽  
William F. Anderson ◽  
Philip S. Rosenberg ◽  
Britton Trabert ◽  
Gretchen L. Gierach ◽  
...  
Keyword(s):  
United States ◽  
Ovarian Cancer ◽  
Cancer Incidence ◽  
The United States ◽  
Incidence Rates ◽  
Ovarian Cancer Risk ◽  
Histologic Subtype ◽  
Incidence Trends ◽  
Cancer Incidence Rates

Purpose After a report from the Women's Health Initiative (WHI) in 2002, a precipitous decline in menopausal hormonal therapy (MHT) use in the United States was linked to a decline in breast cancer incidence rates. Given that MHT use is also associated with increased ovarian cancer risk, we tested whether ovarian cancer incidence rates changed after 2002. Methods Using the North American Association of Central Cancer Registries database (1995 to 2008; N = 171,142 incident ovarian cancers), we applied standard analytic approaches and age-period-cohort (APC) models to estimate ovarian cancer incidence rate changes before (1995 to 2002) and after (2003 to 2008) the WHI report. Results Among women age ≥ 50 years, age-standardized ovarian cancer incidence declined by 0.8% per year (95% CI, −1.8% to −0.5% per year) before the WHI announcement; after the WHI report, the rate declined by 2.4% per year (95% CI, −2.5% to −2.2% per year). APC models confirmed an accelerated decline in ovarian cancer incidence after the WHI report, adjusted for age and birth cohort effects. This sudden change was notable among women most likely to have used MHT (ie, women age 50 to 69 years, white women, and residents of regions with highest MHT prescription frequency). The largest changes were found for the endometrioid histologic subtype. Conclusion After a marked reduction in MHT use around 2002, ovarian cancer incidence rates demonstrated an accelerated decline, with the largest changes for endometrioid carcinomas. This strong temporal association, although not proving a causal role of hormones in ovarian carcinogenesis, suggests that future analytic research supporting cancer control efforts should clarify the role of hormonal exposures on the development and behavior of subtypes of ovarian cancer.

Incidence Rates of the Leukemias in the United States Are Significantly Associated with Birth Cohort,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4203-4203
Author(s):  
Philip S Rosenberg ◽  
William F. Anderson
Keyword(s):  
United States ◽  
Birth Cohort ◽  
Conflicts Of Interest ◽  
Pediatric Population ◽  
The United States ◽  
Incidence Rates ◽  
Cohort Effects ◽  
Major Type ◽  
Nationally Representative ◽  
Pediatric Aml

Abstract 4203 BACKGROUND: Leukemia (all types) is a common cancer in the United States (US) with 44,600 new cases expected in 2011. There are currently only a few established risk factors for any major type. If leukemia risks are substantially modulated by known or unknown environmental and lifestyle exposures, then incidence rates in the population should vary significantly by birth cohort. However, prior studies have not examined birth cohort effects using contemporary data and methods. METHODS: We used nationally representative data from the National Cancer Institute's Surveillance, Epidemiology and End Results Program for 1992 – 2008 (68,481 leukemias and 6.6×108 person-years of follow-up). For each major type in male and female pediatric (ages 0 – 17) and adult (ages 18 – 85) populations, we estimated the average annual percentage change in incidence attributable to calendar period and/or birth cohort (net drift), and the significance of unique (non-linear) birth cohort effects, using age-period-cohort statistical models and Poisson regression. RESULTS: In adults, birth cohort effects for AML were significant in men (P = 0.002) and borderline significant in women (P = 0.053). Compared to men born during 1947 – 1951, men born in the 1920s–1930s were 1.4-fold more likely to develop AML; AML rates were stable in men born after 1951. Birth cohort patterns for AML were qualitatively similar in women compared to men. For CLL, birth cohort effects were highly significant in men (P=5.7×10−6), peaking among men born circa 1939 and falling by 38% among men born circa 1963. In contrast, birth cohort effects for CLL were almost completely absent in women. For CML, incidence declined steadily by 1.3%/year among men (P = 0.0003) and by 1.5%/year among women (P = 0.0008). For ALL, incidence increased steadily by 2.0%/year among women (P = 0.001); birth cohort patterns were similar in men but not statistically significant (P = 0.36). In the pediatric population, AML rates were stable over time. In contrast, ALL rates increased by 1.4%/year among males (P = 0.001) and by 1.1%/year among females (P=0.04). CONCLUSIONS: In the US, leukemia risks increase or decrease substantially by birth cohort for each major leukemia type except adult female CLL and pediatric AML, on the order of 1–2%/year or 20–40% per generation. These results are consistent with the hypothesis that leukemia risks are substantially affected by known (i.e. smoking, certain chemicals) or suspected (i.e. obesity) environmental and lifestyle exposures, a number of which are potentially modifiable. Disclosures: No relevant conflicts of interest to declare.

Incidence and Survival Outcomes Of Myelodysplastic Syndrome In The United States: A SEER Analysis 2001 - 2010

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5205-5205
Author(s):  
Hari Prasad Ravipati ◽  
Srinadh Annangi ◽  
Vamsi Kota
Keyword(s):  
United States ◽  
Median Survival ◽  
Conflicts Of Interest ◽  
Large Population ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Incidence Rates ◽  
Significant Difference ◽  
Metropolitan Counties

Abstract Introduction Myelodysplastic syndromes (MDS) are a group of hematological disorders leading to ineffective hematopoiesis and excess blast formation. We aimed to establish the incidence rates and median survival periods in MDS by gender, race and geographic location in a large population cohort. Methods We performed a retrospective analysis of the United States (US) SEER database for MDS cases diagnosed between 2001 and 2010 using ICD-0-3 histology codes 9980/3, 9982/3, 9983/3, 9984/3 and 9986/3. Incidence rates were calculated using the 2000 US standard population. Five-year relative survival rates were measured using the Kaplan-Meier method after excluding cases diagnosed by death certificate and autopsy. Results 14,920 cases were identified of which 87.2 % (n = 13,009) were present in age group sixty years and above. Age-adjusted incidence rates (per 100,000) for males were 14.8, 10.0, and 12.7 for white, black and other races respectively. The rates for females were 7.7, 7.1, and 7.0. On US county wise MDS case analysis, 11296 (86.8%) of cases were diagnosed in metropolitan counties and 1694 (13%) cases in nonmetropolitan counties. Median relative survival for white, black and other males were 27 months, 36 months and 24 months respectively ; 35 months, 38 months and 37 months for females. Five-year relative survival for white, black, and other males were 32.5% (95% CI 30.7- 34.3), 36.1% (95% CI 28.3 - 43.9) and 30% (95% CI 24.2 - 36.0) vs. 36.2% (95%CI 34.1 - 38.3), 41.1% (95% CI 34.4 - 47.8) and 37.3% (95% CI 30.2 - 44.5) for females. Median relative survival for cases from metropolitan and non-metropolitan counties were 31 months and 31 months respectively. Five-year relative survivals were 35.1% (95% CI 33.7-36.5) and 32.6% (95% CI 29.1-36.0) for metropolitan and non-metropolitan counties MDS cases respectively. Conclusion The incidence of MDS was higher in males compared to females with the highest rate in white males. Survival rates were similar in both sexes. No significant difference in survival rates were seen among the racial groups. No significant difference in the median survival and five-year relative survival rates were noticed between metropolitan and non-metropolitan groups. Disclosures: No relevant conflicts of interest to declare.

Shifting Breast Cancer Trends in the United States

2007 ◽  
Vol 25 (25) ◽  
pp. 3923-3929 ◽  
Author(s):  
William F. Anderson ◽  
Anne S. Reiner ◽  
Rayna K. Matsuno ◽  
Ruth M. Pfeiffer
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Breast Cancer Incidence ◽  
Age At Onset ◽  
Age Distribution ◽  
The United States ◽  
Incidence Rates ◽  
Screening Mammography ◽  
Incidence Trends ◽  
Age Related

Purpose United States breast cancer incidence rates declined during the years 1999 to 2003, and then reached a plateau. These recent trends are impressive and may indicate an end to decades of increasing incidence. Methods To put emerging incidence trends into a broader context, we examined age incidence patterns (frequency and rates) during five decades. We used age density plots, two-component mixture models, and age-period-cohort (APC) models to analyze changes in the United States breast cancer population over time. Results The National Cancer Institute's Connecticut Historical Database and Surveillance, Epidemiology, and End Results program collected 600,000+ in situ and invasive female breast cancers during the years 1950 to 2003. Before widespread screening mammography in the early 1980s, breast cancer age-at-onset distributions were bimodal, with dominant peak frequency (or mode) near age 50 years and smaller mode near age 70 years. With widespread screening mammography, bimodal age distributions shifted to predominant older ages at diagnosis. From 2000 to 2003, the bimodal age distribution returned to dominant younger ages at onset, similar to patterns before mammography screening. APC models confirmed statistically significant calendar-period (screening) effects before and after 1983 to 1987. Conclusion Breast cancer in the general United States population has a bimodal age at onset distribution, with modal ages near 50 and 70 years. Amid a background of previously increasing and recently decreasing incidence rates, breast cancer populations shifted from younger to older ages at diagnosis, and then back again. These dynamic fluctuations between early-onset and late-onset breast cancer types probably reflect a complex interaction between age-related biologic, risk factor, and screening phenomena.

scholarly journals Changing Patterns of Anal Canal Carcinoma in the United States

2013 ◽  
Vol 31 (12) ◽  
pp. 1569-1575 ◽  
Author(s):  
Rebecca A. Nelson ◽  
Alexandra M. Levine ◽  
Leslie Bernstein ◽  
David D. Smith ◽  
Lily L. Lai
Keyword(s):  
Anal Canal ◽  
Sexual Behaviors ◽  
Anal Carcinoma ◽  
The United States ◽  
Incidence Rates ◽  
Annual Percent Change ◽  
Data Set ◽  
Incidence Trends ◽  
Anal Adenocarcinoma ◽  
Time Period

Purpose Persistent human papillomavirus infection is associated with squamous cell carcinoma of the anal canal (SCCA). With changing sexual behaviors, SCCA incidence and patient demographics may also have changed in recent years. Methods The Surveillance, Epidemiology, and End Results public-use data set from 1973 to 2009 was analyzed to determine incidence trends for and demographic factors characterizing SCCA. Joinpoint analyses identified time points when incidence rates changed. For comparison, similar analyses were conducted for anal adenocarcinoma. Results Joinpoint analyses identified 1997 as the single inflection point among 11,231 patients with SCCA, at which the slope of incidence rates statistically increased (1997 to 2009 v 1973 to 1996: risk ratio [RR], 2.2; 95% CI, 2.1 to 2.3). Annual percent change (APC) increased for all SCCA stages and was the greatest for anal carcinoma in situ (CIS; APC, 14.2; 95% CI, 10.2 to 18.4). Demographic changes characterizing later versus earlier time period included younger age at diagnosis and rising incidence rates in all stage, sex, and racial groups. During 1997 to 2009, women were less likely to present with CIS (RR, 0.3; 95% CI, 0.3 to 0.3) but more likely to present with localized (RR, 1.2; 95% CI, 1.1 to 1.3) and regional SCCA (RR, 1.5; 95% CI, 1.4 to 1.7). In contrast, adenocarcinoma APCs among 1,791 patients remained stable during this time period. Conclusion CIS and SCCA incidence increased dramatically after 1997 for men and women, although men were more likely to be diagnosed with CIS. These changes likely resulted from available screening in men and argue for efforts to identify high-risk individuals who may benefit from screening.

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