Hospital Discharge Rates for Four Major Cancers -- United States,
1970-1986
Cancers of the breast, cervix, colon/rectum, and lung are among
the
cancers that contribute the most morbidity and mortality in the
United
States or that are the most preventable. This report describes
national
trends in hospital discharge rates from 1970 to 1986 for these four
cancers.
Using the first-listed diagnosis in the National Hospital
Discharge
Survey (NHDS) (1) of the National Center for Health Statistics
(NCHS),
the annual number of hospital discharges for each of these cancers
was
determined.* NHDS data were obtained from a complex probability
sample
of nonfederal short-stay hospitals in the 50 states and the
District of
Columbia. Population estimates were determined from data provided
by
the Bureau of the Census (4) and Demo-Detail** (5).
During the 1980s, the number of hospital discharges per 100,000
population has declined for each cancer (Figure 1). Breast, lung,
and
colorectal cancer consistently increased from 1970 to the early
1980s
and declined thereafter. The rate of hospital discharges for
cervical
cancer fluctuated without an overall trend from 1970 to 1978, then
declined slightly. These trends are consistent with a decline in
the
overall hospital discharge rate that began in 1983 (6).
Among these four cancers, breast cancer in women had the highest
hospital discharge rate over the entire period, and lung cancer in
men
had the second highest. In 1970, rates for cervical, colorectal*s,
and
lung cancer in women ranked third, fourth, and fifth, respectively.
By
1986, cervical cancer had the lowest rate, while lung cancer rates
for
women approached those for colorectal cancer.
Hospital discharge rates for lung cancer in both men and women
increased approximately the same amount from 1970 through 1986.
Rates
for men increased 60% from 88.6 to 142.2, a difference of 53.6
discharges per 100,000 persons. Rates for women increased 304% from
20.4 to 83.3, a difference of 62.9 discharges per 100,000. The rate
ratio of men to women decreased from 4.3 to 1.7; the rate
difference
decreased from 68.2 to 58.9.
Hospital discharge rates for lung cancer increased sharply with
the
change from the ICD-8 to ICD-9-CM (2,3). The increase in the
hospital
discharge rate for lung cancer from 1978 to 1979 is 57% of the net
increase from 1970 through 1986 for men and 42% for women.
Nevertheless, even if all the 1978-79 increase is attributed to ICD
coding changes, the data indicate a substantial increase in
hospitalization rates for lung cancer.
Reported by: Epidemiology and Surveillance Br, Div of Chronic
Disease
Control, Center for Environmental Health and Injury Control, CDC.
Editorial Note
Editorial Note: Although chronic diseases are recognized as major
causes of morbidity and mortality in the United States, assessing
their
public health impact is difficult. Increasingly, investigators have
suggested the use of hospital discharge data to evaluate the impact
of
these diseases. State health departments can use hospital discharge
data, along with vital statistics, special surveys, and registries,
to
indicate disease burden. Comparing state and local patterns of
chronic
disease impact with national patterns can help guide allocation of
resources for chronic disease prevention and control programs.
Disclaimer
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