Each year, nearly 6,700 Hawai‘i residents are diagnosed with cancer and more than 2,000 die from the disease. Detailed data on the burden of cancer in Hawai‘i, including cancer incidence and mortality rates, are available in Hawai‘i Cancer Facts & Figures 2010 (CF&F). A collaborative effort of the Cancer Research Center of Hawai‘i, the American Cancer Society and the Hawai‘i Department of Health, this update of the original version published in 2003 is intended as a tool for public health education, research, and planning. The following are highlights of years 2000–2006 (a 6-year period) data as featured in Hawai‘i Cancer Facts & Figures 2010.
From the periods 1995–1999 and 2000–2005, the overall incidence of cancer in Hawai‘i remained relatively stable in both men and women while cancer mortality rates continued to decline. This is consistent with the United States pattern of continued overall declines in cancer rates.1 Decreases in incidence were observed for a number of malignancies including prostate and lung cancer in men, cervical and female breast cancer, and colorectal and stomach cancers in both males and females. Contrasting these trends, increases in incidence were observed for kidney cancers in males, thyroid cancer in females, and leukemia and melanoma in both males and females.
In 2000–2005, the average annual age-adjusted incidence of all cancers was 486 per 100,000 in men and 382 per 100,000 in women (see Figure 1). Prostate and breast cancers remained the most common cancers. For the time period 2000–2005, approximately 800 men were diagnosed with prostate cancer and 860 women with breast cancer annually. Lung cancers followed by colorectal cancers were the leading causes of cancer death in both sexes. Lung cancer was responsible for nearly 500 deaths annually.
The incidence of major cancers in Hawai‘i was generally comparable or lower than that of the United States overall. A notable exception was liver cancer. Hawai‘i continued to have the highest incidence of liver cancer in the country (age-adjusted rates of 9.6 per 100,000 in Hawai‘i vs. 6.3 per 100,000 in the United States).
Survival varied substantially for different cancers. Among the major cancers, overall five-year relative survival was poorest for cancers of the pancreas (6%), liver (13%), lung (16%), and esophagus (17%). Survival varied by stage of disease at diagnosis for most cancers. For example, five-year relative survival for colorectal cancer was 91% for localized tumors, 70% for tumors with regional spread, and only 11% for tumors with metastasis to distant sites.
Disparities were observed among Hawai‘i's major ethnic groups. Among men, overall cancer incidence rates were highest in Whites while Native Hawaiians had the highest overall incidence of cancer among women. Cancer death rates were highest in Native Hawaiian men and women. Native Hawaiians also had the greatest incidence and mortality from breast and lung cancers. Colorectal cancer incidence and mortality were highest among Japanese men and women. Melanoma incidence and mortality was predominant in White men and women. Thyroid cancer incidence was highest among Filipino men and women, although the disparity was more pronounced among Filipino women. Prostate cancer incidence was greatest among Filipinos while death rates were highest for Whites. Cervical cancer incidence was highest in Filipino and Native Hawaiian women. Kidney cancer incidence was predominant in Native Hawaiian and Chinese men. Liver cancer incidence was also highest among Chinese men. Disparities by stage of disease at diagnosis were also apparent for some cancers. For example, Native Hawaiian and Filipino women are more likely to be diagnosed with breast cancer at advanced stages. Ethnic groups were more likely to be diagnosed with skin cancer at later stages than for Whites.
Disparities were also observed among other, less populous ethnic groups. Based on the relative proportion of all cancers, excessive cancer risk is suggested for and include kidney cancers in African Americans, stomach cancers in Koreans, lung cancers in Samoans, and liver and cervical cancers in Vietnamese. Disproportionate numbers of lung, liver, cervical, and thyroid cancers were observed in Micronesians.
In addition to statewide cancer data, Cancer Facts & Figures 2010 also provides updated statewide data on obesity, physical activity, fruit and vegetable consumption, tobacco use, cancer screening utilization, health insurance coverage, as well as current cancer prevention and early detection guidelines. Featured statewide data from the Behavioral Risk Factor Surveillance System, include the following:2
- 17% of adults and 10% of high school students are smokers
- More than half the adult population is obese (22%) or overweight (35%)
- Only 51% of adults reported engaging in the recommended amounts of moderate physical activity
- Only 29% of adults reported eating at least 5 servings of fruits and vegetables daily
- 76% of women 40 and older had a mammogram within the past 3 years
- 82% of women 18 and older had a Pap smear within the past 3 years
- 58% of adults 50 and older have ever had a sigmoidoscopy or colonoscopy
The Hawai‘i Cancer Facts & Figures 2010 includes an on-line version containing the most up-to-date data on cancer in Hawai‘i's ethnically diverse populations. To obtain a free copy of Hawai‘i Cancer Facts & Figures 2010, call the University of Hawai‘i Cancer Research Center at 586-3010 or go on-line to www.crch.org.