[David O’Brien]

In Alaska we are not complete enough yet to make this determination for 2015. However, on a somewhat related note, I did make an interesting observation at the request of our Comp Cancer program manager a few weeks ago to look at early and late stage prostate cancer incidence. Late stage incidence has pretty much stayed constant over the last 15 years or so, at about 20 cases per 100,000 males. However, early stage incidence was steady at about 150 until 2008 when it started dropping starting in 2009 each year and was at 94 in 2014. This suggested to her that the falling rate is indicative of the reduced prevalence of prostate screening nationwide and that this screening has only been catching early stage prostate cancer. On the mortality side, the prostate cancer rates have fallen pretty linearly since 1998 except for 2013 and 2014, where the slope has changed dramatically and became less steep, suggesting a slowing of the rate of decrease over time. While these are only 2 data points, this may be a reflection of fewer prostate cases being diagnosed due to screening.

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[David O’Brien]

I have access to the NCR & SEER Incidence State RAD file for 1999-2013 via SEER*Stat. For the most recent 5 years of data (2009-2013), I see that the age-adjusted rates for in situ colorectal cancer range from a high of 4.0 per 100,000 in PA to a low of 0.4 in WA, an order of magnitude as you point out. The number of cases in WA is relatively small (111) compared to PA (2,582). Even though the population of PA is about twice that of WA, the number of cases in WA seems unusually low. My own state of AK is at 1.8, which is just below the national rate is 2.0. So it may very well be a reporting issue as Jim Hofferkamp suggests in his response to your question. And interesting thing to note is that the national rate has fallen by about half (4.1 to 1.9) from 1999 to 2013, and the number of cases have dropped significantly (10,445 to 6,908).

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