The ACR releases the Cancer in Alaska – 2013 Report

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This report was released by the Alaska Cancer Registry Section of Chronic Disease Prevention and Health Promotion, Alaska Department of Health and Social Services.

Executive Summary

This report summarizes the most recently available information about cancer incidence rates in Alaska. Many partners in Alaska are working to reduce cancer risk, find cancers earlier, improve treatment, increase the number of people who survive cancer and improve the quality of life for cancer survivors. Information included in this report about the burden of cancer overall and specific cancers serves as a valuable resource for the planning and evaluation of these efforts.

Data are from the Alaska Cancer Registry (ACR), a population-based cancer surveillance system that is funded by the Centers for Disease Control and Prevention. ACR collects data on all newly diagnosed cases of cancer for the State of Alaska. ACR collects a wide variety of information to determine cancer incidence, mortality, treatment and survival. The data are used to:

•Determine the incidence of cancer in Alaska with respect to geographic and demographic characteristics

•Monitor trends over time

•Monitor early detection, evaluate the effectiveness of cancer control programs and identify areas in need of public health interventions

•Determine how Alaska compares with the rest of the Nation

•Serve as a resource for health planners, medical professionals, researchers and others concerned about cancer.

In 2013, ACR data showed:

•There were 2,664 new malignant cases of cancer diagnosed and 1,015 cancer deaths in Alaska.

Breast cancer was the most commonly diagnosed cancer among women (415 cases) and prostate cancer was the most commonly diagnosed cancer among men (266 cases).

•Among both men and women, lung and bronchus cancer was the second most common cancer diagnosed (323 cases), and colorectal cancer was the third most common (272 cases).

•Overall cancer incidence has decreased in Alaska during the past decade, by an average of 3.6% per year between 2008 and 2013. Cancer incidence rates have also declined in the United States overall, but the current Alaska overall cancer incidence rate (410.7 per 100,000) is lower than the United States rate (430.6 per 100,000).

•Specifically, significant declines in cancer incidence were measured during recent years in Alaska for female breast, cervix, colorectal, leukemia, lung and bronchus, non-Hodgkin lymphoma, prostate and stomach.

•The incidence rates for melanoma of the skin and uterine cancer incidence have both increased in Alaska during recent years.

Introduction

The Alaska Annual Cancer Report summarizes the most recently available information about cancer incidence rates in Alaska. This report can be used by Alaska’s Comprehensive Cancer Control Partnership stakeholders – clinical and public health professionals as well as other health advocacy partners and the public – to support continued planning and evaluation of cancer prevention and control efforts.

What is cancer?

Cancer is a group of diseases, all of which involve uncontrolled growth and spread of abnormal cells.(1) There are over 100 different types of cancer.

The human body is made up of billions of cells. Normally, body cells grow, divide, and die in an orderly fashion. Cancer cells, however, continue to grow and divide and can spread to other parts of the body. These cells accumulate and form tumors (lumps) that compress, invade, and destroy normal tissue. If cells break away from such a tumor, they can travel through the bloodstream or the lymph system to other areas of the body. There, they may settle and form “colony” tumors. In their new location, the cancer cells continue growing. The spread of a tumor to a new site is called metastasis. Not all tumors are cancerous. Benign tumors do not metastasize and, with very rare exceptions, are not life-threatening.

When cancer spreads, it is still named after the body part where it started. For example, if prostate cancer spreads to the bones, it is still prostate cancer, and if breast cancer spreads to the lungs it is still called breast cancer. However, it is possible for a person to develop multiple unrelated types of cancer in different parts of the body over their lifetime.

Cancer is also classified by its appearance under a microscope, known as “histology”. Different types of cancer vary in their rates of growth, patterns of spread, and responses to different types of treatment. That’s why people with cancer need treatment that is aimed at their specific form of the disease.

Most cancer falls into five major histology groups. Within each group there are subtypes.

• Carcinoma is a cancer that develops from cells that cover the surface of the body (skin),

glands (breast, prostate), and internal organs (lung, stomach, and intestines). Eighty to

nighty percent of all cancers fall into this category.

• Sarcoma is a cancer that occurs in connective tissues such as bones, tendons, cartilage,

fat, and muscle.

• Leukemia is a cancer that develops from cells in bone marrow that make blood, and

circulates through other tissues. Leukemia does not usually form a tumor.

• Lymphoma is a cancer that develops from cells in the immune system. Hodgkin lymphoma and non-Hodgkin lymphoma are in this group.

• Myeloma is a cancer that develops in the plasma cells of bone marrow.

Who is at risk for cancer?

Everyone. In the United States, an estimated half of all men and one-third of women will develop cancer during their lifetimes.(2) Today, millions of people are living with cancer or have been cured of the disease. The sooner a cancer is found, and the sooner treatment begins, the better the person’s chances are of a cure.

Although there are certain specific childhood cancers that have an expected early age peak and then are rarely seen in the rest of the population, the occurrence of cancer generally increases with age; most cancers occur among middle-aged or older adults. The term “lifetime risk” is the probability that an individual, over the course of a lifetime, will develop cancer or die from it. The American Cancer Society (ACS) has published lifetime risks of developing specific cancers by age and gender,(3) estimating:

• One in 7 men will develop prostate cancer

• One in 8 women will develop breast cancer

• One in 14 men and one in 17 women will develop lung or bronchus cancer

• One in 21 men and one in 23 women will develop colorectal cancer

What causes cancer?

An estimated 70% or more of the most common types of cancers are due to behavioral, occupational, and environmental factors.(4) These cover external factors that affect us, and include tobacco, diet, exercise, viruses, radiation, chemicals in the workplace, and not just what is thought of as the environmental pollution of air, water, and food.

Tobacco is the greatest risk factor for all cancers combined and is the single leading preventable cause of cancer. Excessive alcohol consumption, particularly coupled with tobacco use, and failure to eat sufficient fresh fruits, vegetables and whole grains contribute to one-third of all cancer deaths.(5) Reduction of these risk factors can be controlled by individual behavioral choices.(6) Research indicates that genes play a role, but the currently known genetic “markers” alone account for only a small proportion of cancers.

Sometimes when a family member or friend is diagnosed with cancer, the tragedy makes us more aware of others in our community with cancer and we begin to be concerned that there may be an unusually large number of cancer cases in a certain area. Sometimes this may be the case, but not often. There are a certain number of cancers that are expected to occur in any U.S. population. The leading cancers in the U.S. will almost always be found in each community and include: lung, breast, prostate, and colorectal cancer.

To download and read more of this report, go to: http://dhss.alaska.gov/dph/Chronic/Pages/Cancer/registry.aspx#data

For more information about the Alaska Cancer Registry, visit http://dhss.alaska.gov/dph/Chronic/Pages/Cancer/registry.aspx.

Footnotes:

1 For more discussion, see American Cancer Society, 2015. What is cancer? A guide for patients and families. Available at: http://www.cancer.org/cancer/cancerbasics/what-is-cancer (last accessed 12/28/16)

2 American Cancer Society (ACS), 2016. Cancer Facts and Figures 2016. Available at http://www.cancer.org/research/cancerfactsstatistics/index (last accessed 12/28/16).

3 Ibid., page 14.

4 Wu S., Powers S., Zhu W., and Hannun YA, 2016. Substantial contribution to extrinsic risk factors to cancer development. Nature, Jan 7; 529(7584): 43-47.

5 World Health Organization. Cancer Fact Sheet. Revised February 2017. Available at: http://www.who.int/mediacentre/factsheets/fs297/en/ (last accessed 3/21/17)