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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.

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**Questions or messages regarding errors in formatting should be addressed to The U.S. Government's Official Web PortalDepartment of Health and Human Services
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