This project conducts a variety of descriptive epidemiologic studies to quantify cancer incidence and mortality; to investigate variations in cancer rates by demographic factors; to examine temporal trends and geographic patterns; and to identify leads for further analytical research. In conjunction with our effort to produce national maps of cancer mortality rates, we examined national mortality rates for 40 cancers by race, gender, and age. We analyzed the descriptive epidemiology for cancers of the bladder and kidney, as well as for cancers among children, among the elderly, and among women. Our analysis of the changing patterns in the incidence of esophageal and gastric cardia adenocarcinoma among white males found that the incidence of esophageal adenocarcinoma rose more than 350% since the mid-1970s, surpassing squamous cell carcinoma around 1990. We found in an analysis of colorectal cancer incidence by subsite that proximal colon cancer rates were higher among blacks than whites and have continued to increase. An analysis of kidney cancers by subsite and histologic type revealed that increasing detection of presymptomatic tumors by imaging procedures does not fully explain the upward incidence trends of renal cell carcinoma and that other factors may be contributing to the rapid increases in rates. We are analyzing the incidence data for non-Hodgkins lymphoma according to histologic type, oral cavity and pharynx cancer by subsite and histologic type, and the international variation in prostate cancer incidence. We used data from the cancer survivorship section of the 1992 National Health Interview Survey to estimate cancer prevalence, compare the estimates with those derived from cancer registry data, and investigate survivorship issues. We are also analyzing incidence data from Shanghai with our Chinese collaborators. We found that the increases in colorectal cancer rates were considerably more rapid for colon cancer, with rates approximately doubling, than they were for rectal cancer; proximal colon cancer was more common than distal colon cancer over the whole study period, whereas rates for both cancers rose with similar annual percent changes. We have analyzed in greater detail the rapidly declining incidence rates for cervical cancer.
