Cancer Causes & Control

, Volume 21, Issue 8, pp 1227–1236 | Cite as

Age-period-cohort analysis of cancers not related to tobacco, screening, or HIV: sex and race differences

  • Yueh-Ying Han
  • Gregg E. Dinse
  • David M. Umbach
  • Devra L. Davis
  • Joel L. Weissfeld
Original paper



To identify trends in a residual category of cancers not typically associated with tobacco, screening, or human immunodeficiency virus (HIV) infection.


For persons aged 20–84, we used sex- and race-specific age-period-cohort (APC) models to describe temporal patterns of incidence (1975–2004) and mortality (1970–2004) in the U.S. for a residual cancer category that excluded non-Hodgkin lymphoma, Kaposi sarcoma, and cancer of the oral cavity and pharynx, esophagus, pancreas, larynx, lung and bronchus, urinary bladder, kidney and renal pelvis, colon and rectum, prostate, female breast, and cervix uteri.


Age-specific incidence rose (0.1–0.9% per year, on average) in every sex-race group, with factors related to both time period and birth cohort membership appearing to accelerate the increases in women. Age-specific mortality fell (0.6–0.9% per year, on average) for black and white men and women, with the declines decelerating in white women but accelerating in the other sex-race groups. Extrapolations of APC models predicted higher age-adjusted incidence rates in white women (11%), black women (5%), and white men (4%) in 2005–2009, relative to 2000–2004, and lower rates in black men (−3%), accompanied by lower age-adjusted mortality rates in every sex-race group (−8% in black men, −3% in black women, −1% in white men, and −1% in white women).


The possibility that increased incidence in women over time reflects changes in underlying risks, diagnostic practices, or better case ascertainment should be actively explored. Declining mortality may signify improvements in cancer care.


Age-period-cohort model Cancer incidence, Cancer mortality Cancer trends Tobacco Screening HIV SEER Occupational cancer Environmental cancer 

Supplementary material

10552_2010_9550_MOESM1_ESM.doc (180 kb)
Supplementary material 1 (DOC 180 kb)


  1. 1.
    Espey DK, Wu X-C, Swan J et al (2007) Annual report to the nation on the status of cancer, 1975–2004, featuring cancer in American Indians and Alaska Natives. Cancer 110(10):2119–2152CrossRefPubMedGoogle Scholar
  2. 2.
    55-Year trends in U.S. cancer death rates. Accessed 18 Jan 2008
  3. 3.
  4. 4.
    Wingo PA, Ries LA, Giovino GA et al (1999) Annual report to the nation on the status of cancer, 1973–1996, with a special section on lung cancer and tobacco smoking. J Natl Canc Inst 91(8):675–690CrossRefGoogle Scholar
  5. 5.
    Chu KC, Tarone RE, Freeman HP (2003) Trends in prostate cancer mortality among black men and white men in the United States. Cancer 97(6):1507–1516CrossRefPubMedGoogle Scholar
  6. 6.
    Weir HK, Thun MJ, Hankey BF et al (2003) Annual report to the nation on the status of cancer, 1975–2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Canc Inst 95(17):1276–1299Google Scholar
  7. 7.
    Ries LA, Wingo PA, Miller DS et al (2000) The annual report to the nation on the status of cancer, 1973–1997, with a special section on colorectal cancer. Cancer 88(10):2398–2424CrossRefPubMedGoogle Scholar
  8. 8.
    Fisher SG, Fisher RI (2004) The epidemiology of non-Hodgkin’s lymphoma. Oncogene 23(38):6524–6534CrossRefPubMedGoogle Scholar
  9. 9.
    Bailar JC 3rd, Gornik HL (1997) Cancer undefeated. N Engl J Med 336(22):1569–1574CrossRefPubMedGoogle Scholar
  10. 10.
    Holford TR (1983) The estimation of age, period and cohort effects for vital rates. Biometrics 39(2):311–324CrossRefPubMedGoogle Scholar
  11. 11.
    Dinse GE, Umbach DM, Sasco AJ, Hoel DG, Davis DL (1999) Unexplained increases in cancer incidence in the United States from 1975 to 1994: possible sentinel health indicators? Annu Rev Public Health 20:173–209CrossRefPubMedGoogle Scholar
  12. 12.
    Surveillance, Epidemiology, and End Results (SEER) Program ( SEER*Stat database: incidence—SEER 9 Regs limited-use, Nov 2006 Sub (1973–2004)—linked to county attributes—total U.S., 1969–2004 counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2007, based on the November 2006 submission
  13. 13.
    Surveillance, Epidemiology, and End Results (SEER) Program ( SEER*Stat database: mortality—all COD, public-use with state, total U.S. (1969–2004), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2007. Underlying mortality data provided by NCHS (
  14. 14.
    Cancer query systems: delay-adjusted SEER incidence rates Accessed 2 Aug 2007
  15. 15.
    Midthune DN, Fay MP, Clegg LX, Feuer EJ (2005) Modeling reporting delays and reporting corrections in cancer registry data. J Am Stat Assoc 100(469):61–70CrossRefGoogle Scholar
  16. 16.
    Breslow NE (1984) Extra-Poisson variation in log-linear models. Appl Stat 33(1):38–44CrossRefGoogle Scholar
  17. 17.
    Toossi M (2002) A century of change: the U.S. labor force from 1950 to 2050. Mon Labor Rev 125:15–28Google Scholar
  18. 18.
    Zahm SH, Blair A (2003) Occupational cancer among women: where have we been and where are we going? Am J Ind Med 44(6):565–575CrossRefPubMedGoogle Scholar
  19. 19.
    Donovan M, Tiwary CM, Axelrod D et al (2007) Personal care products that contain estrogens or xenoestrogens may increase breast cancer risk. Med Hypotheses 68(4):756–766CrossRefPubMedGoogle Scholar
  20. 20.
    The health consequences of smoking: a report of the Surgeon General. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Washington, DC, 2004Google Scholar
  21. 21.
    Lee DJ, Voti L, MacKinnon J et al (2008) Gender- and race-specific comparison of tobacco-associated cancer incidence trends in Florida with SEER regional cancer incidence data. Cancer Causes Control 19(7):711–723CrossRefPubMedGoogle Scholar
  22. 22.
    Carbone A, Gloghini A, Serraino D, Spina M (2009) HIV-associated Hodgkin lymphoma. Curr Opin HIV AIDS 4(1):3–10CrossRefPubMedGoogle Scholar
  23. 23.
    Jemal A, Thun MJ, Ries LAG et al (2008) Annual report to the nation on the status of cancer, 1975–2005, featuring trends in lung cancer, tobacco use, and tobacco control. J Natl Canc Inst 100(23):1672–1694CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Yueh-Ying Han
    • 1
  • Gregg E. Dinse
    • 2
  • David M. Umbach
    • 2
  • Devra L. Davis
    • 3
  • Joel L. Weissfeld
    • 1
    • 4
  1. 1.Department of EpidemiologyUniversity of Pittsburgh Cancer InstitutePittsburghUSA
  2. 2.Biostatistics BranchNational Institute of Environmental Health Sciences, National Institutes of HealthResearch Triangle ParkUSA
  3. 3.Environmental Health TrustMt. Sinai Medical CenterNew YorkUSA
  4. 4.U.P.M.C. Cancer PavilionPittsburghUSA

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