The 1997 data indicate the continuation of many trends observed in our previous incidence report, Cancer Incidence in New Jersey, 1992-1996. Total age-adjusted cancer incidence decreased after 1993 for both males and females and has continued to decline since then. Lung cancer rates continued to decrease for males but increased for females. Prostate cancer rates declined through 1995 and then increased slightly in more recent years, possibly reflecting the last phase of the typical pattern seen following the introduction of a widespread screening program. Breast cancer rates appear to be stable during these years and colon cancer rates have been fairly stable for both males and females. In addition, non-Hodgkin's lymphoma and malignant melanoma rates continue to increase, especially among females. These cancers have been increasing for the country as a whole. Further, the rates for some types of leukemia have increased among certain subgroups of the New Jersey population during the most recent years. Overall patterns in New Jersey continue to approximate those for the entire nation for 1991-1995, as published in Cancer in North America, 1991-1995.

Compared to preliminary data for 1996 published in our last report, 1996 incidence rates in this report for all cancers combined increased by 7% for males and 5% for females. In viewing the tables of this report, it should also be noted that the annual rates for relatively uncommon cancers tend to fluctuate more from year to year, due to the smaller number of cases, particularly in minority populations. The 1997 data presented here should be considered preliminary and rates may increase 5-7% by the time all data are complete. It should also be noted that our cancer incidence data continue to be refined and improved and minor fluctuations may be seen from previous reports.

Males (Tables 1, 3, 5): During the years 1993-1997, the overall cancer rate declined between 1993 and 1994 and has remained steady at 509 per 100,000 since that time. Rates for cancers of the lung decreased during the period. Non-Hodgkin's lymphoma and malignant melanoma of the skin increased, in a trend similar to that for the U.S. as a whole. Gallbladder cancer rates also increased since 1995, as did the myeloid leukemias, particularly chronic.

For white males (Table 3) the trends for the most common cancers were similar to those for all males.

For black males, in addition to the overall trends (Table 5), oral cancers increased after 1994. Colon cancer increased between 1993 and 1995 then decreased, possibly reflecting utilization of screening programs. Esophageal cancers decreased over this 5-year period.

Females (Tables 2, 4, 6): The overall cancer rate for all females declined slightly after 1993 (Table 2). In contrast to male rates, lung cancer rates rose during the 1993-1997 period. Bladder cancer appears to be increasing as well. For both of these cancers, smoking is a known risk factor. Declines were seen for ovarian cancer, invasive cervical cancer, and lymphocytic leukemias. In situ breast cancer rates rose markedly during these years, indicating increased rates of screening. Invasive breast cancer rates have remained stable. (See our in-depth report on breast cancer (October 1998) regarding breast cancer trends in detail.)

For white females (Table 4) the trends summarized above were most pronounced for the increase in melanoma of the skin and breast cancer in situ.

For black females (Table 6) cancers of the uterine corpus appear to have increased after 1994 and the increase in bladder cancers are particularly marked.

Tables 7 and 8 show the comparable rates for the three most common sites of cancer for men and for women, as well as the comparable rates for melanoma, non-Hodgkin's lymphoma, and for all cancer sites combined. Historically, New Jersey rates have been representative of the Northeast region, which tend to have higher cancer incidence rates than the U.S. as a whole.

When comparing cancer data between areas or over time, it is important to compare rates that are adjusted or weighted to a common standard. In this report, as is general practice in this country, we have presented rates adjusted to the 1970 U.S. population. Using this standard along with the Surveillance, Epidemiology, and End Results (SEER) multiple primary rules make it possible to compare age-adjusted rates in this publication to rates published by the North American Association of Central Cancer Registries (NAACCR) publication Cancer in North America. The most recent detailed data available from NAACCR are for the time period 1991-1995. Therefore, we have prepared comparison tables for major sites for this time period.

Among men (Table 7) for all races combined, total cancer rates were higher in New Jersey than the U.S. during 1991-1995. Cancers of the colon, prostate, and non-Hodgkin's lymphoma were higher than those for the total U.S. Lung cancer among men was higher among whites but lower for blacks in New Jersey compared to the nation, and melanoma rates were lower in New Jersey men.

Among women (Table 8) New Jersey had higher rates than the U.S. during the period 1991-1995 for total cancers, colon, lung, breast, and non-Hodgkin's lymphoma for all races combined, for blacks and for whites. Melanoma rates were lower in New Jersey women than the nation as a whole.