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Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. A total of 1,638,910 new cancer cases and 577,190 deaths from cancer are projected to occur in the United States in 2012. During the most recent 5 years for which there are data (2004-2008), overall cancer incidence rates declined slightly in men (by 0.6% per year) and were stable in women, while cancer death rates decreased by 1.8% per year in men and by 1.6% per year in women. Over the past 10 years of available data (1999-2008), cancer death rates have declined by more than 1% per year in men and women of every racial/ethnic group with the exception of American Indians/Alaska Natives, among whom rates have remained stable. The most rapid declines in death rates occurred among African American and Hispanic men (2.4% and 2.3% per year, respectively). Death rates continue to decline for all 4 major cancer sites (lung, colorectum, breast, and prostate), with lung cancer accounting for almost 40% of the total decline in men and breast cancer accounting for 34% of the total decline in women. The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of about 1,024,400 deaths from cancer. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population, with an emphasis on those groups in the lowest socioeconomic bracket. CA Cancer J Clin 2012. © 2012 American Cancer Society.


Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References

Cancer is a major public health problem in the United States and many other parts of the world. One in 4 deaths in the United States is due to cancer. In this article, we provide the expected numbers of new cancer cases and deaths in 2012 nationally and by state, as well as an overview of current cancer statistics using data through 2008, including incidence, mortality, and survival rates and trends. We also estimate the total number of deaths averted as a result of the decline in cancer death rates since the early 1990s, and provide the reported number of cancer deaths in 2008 by age for the 5 leading cancer types.

Materials and Methods

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References

Incidence and Mortality Data

Mortality data from 1930 to 2008 in the United States were obtained from the National Center for Health Statistics (NCHS).1, 2 There are several sources for cancer incidence data. The Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute reports long-term (beginning in 1973), high-quality, population-based incidence data covering up to 26% of the US population. Cancer incidence rates for long-term trends (1975-2008), 5-year relative survival rates (2001-2007), and estimations of the lifetime probability of developing cancer (2006-2008) were obtained from SEER registries.3-7 The North American Association of Central Cancer Registries (NAACCR) compiles and reports incidence data for 1995 onward from cancer registries that participate in the SEER program or the Centers for Disease Control and Prevention's National Program of Cancer Registries, covering up to 95% of the US population. State-specific incidence rates (2004-2008), incidence rates for trends by race/ethnicity (1999-2008), and incidence data (1995-2008) for projecting new cancer cases were obtained from NAACCR.8, 9 Cancer cases were classified according to the International Classification of Diseases for Oncology.10 All incidence and death rates are age-standardized to the 2000 US standard population and expressed per 100,000 persons.

Cancer incidence rates in this report are delay-adjusted whenever possible in order to account for anticipated future corrections to registry data due to inherent delays and errors in case reporting. Delay-adjusted rates primarily affect the most recent years of data for cancers that are frequently diagnosed in outpatient settings (eg, melanoma, leukemia, and prostate) and provide a more accurate portrayal of the cancer burden in the most recent time period.11 Delay-adjusted rates are available for SEER registry data and were obtained from the National Cancer Institute.12

Projected Cancer Cases and Deaths in 2012

The precise number of cancer cases diagnosed each year in the nation and in every state is unknown because cancer registration is incomplete in some states. Furthermore, the most recent year for which incidence and mortality data are available lags 3 to 4 years behind the current year due to the time required for data collection, compilation, and dissemination. Therefore, we project the numbers of new cancer cases and deaths in the United States in 2012 in order to provide an estimate of the contemporary cancer burden. The methods for projecting both new cases and deaths in 2012 have been modified, so these estimates should not be compared with those from previous years.

We projected the numbers of new malignant cancer cases that will be diagnosed in 2012 using a 2-step process that first estimates complete incidence counts by state during years for which observed data are available, and then projects these counts 4 years ahead for the United States overall and each state individually.13 To obtain estimated counts for each state through 2008, we used a spatiotemporal model based on incidence data from 1995 through 2008 for 47 states and the District of Columbia that met NAACCR's high-quality data standard for incidence, covering about 95% of the US population.14 This method accounts for expected delays in case reporting and considers geographic variations in sociodemographic and lifestyle factors, medical settings, and cancer screening behaviors as predictors of incidence. A temporal projection method (the vector autoregressive model) was then applied to the estimated counts to obtain the 2012 projections. For the complete details of this methodology, please refer to Zhu et al.13

To estimate the numbers of new breast carcinoma in situ (female) and melanoma in situ cases in 2012, we first estimated the number of in situ cases occurring annually from 2000 through 2008 in the United States by applying the age-specific incidence rates in the 17 SEER areas to the corresponding US population estimates.3, 15 We then projected the total number of cases in 2012 based on the annual percent change from 2000 through 2008 generated by the joinpoint regression model.16

We estimated the number of cancer deaths expected to occur in 2012 in the United States overall and in each state using the joinpoint regression model based on the actual number of cancer deaths from 1994 through 2008 at the state and national levels as reported to the NCHS.2, 17 For the complete details of this methodology, please refer to Chen et al.17

Other Statistics

The estimated numbers of cancer deaths averted in men and women due to the reduction in overall cancer death rates were calculated by applying the 5-year age-specific cancer death rates in the peak year for age-standardized cancer death rates (1990 in men and 1991 in women) to the corresponding age-specific populations in subsequent years through 2008 to obtain the number of expected deaths in each calendar year if the death rates had not decreased. We then summed the difference between the numbers of expected and observed deaths in each age group and calendar year for men and women separately.

Selected Findings

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References

Expected Numbers of New Cancer Cases

Table 1 presents the estimated numbers of new cases of invasive cancer expected among men and women in the United States in 2012. The overall estimate of more than 1.6 million new cases does not include carcinoma in situ of any site except the urinary bladder, nor does it include basal cell and squamous cell cancers of the skin. About 63,300 cases of breast carcinoma in situ and 55,560 cases of melanoma in situ are expected to be newly diagnosed in 2012. The estimated numbers of new cancer cases by state for selected cancers are shown in Table 2.

Table 1. Estimated New Cancer Cases and Deaths by Sex, United States, 2012*
 ESTIMATED NEW CASESESTIMATED DEATHS
 BOTH SEXESMALEFEMALEBOTH SEXESMALEFEMALE
  • *

    Rounded to the nearest 10; estimated new cases exclude basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. About 63,300 carcinoma in situ of the female breast and 55,560 melanoma in situ will be newly diagnosed in 2012.

  • Estimated deaths for colon and rectum cancers are combined.

  • More deaths than cases may reflect lack of specificity in recording underlying cause of death on death certificates or an undercount in the case estimate.

All Sites1,638,910848,170790,740577,190301,820275,370
Oral cavity & pharynx40,25028,54011,7107,8505,4402,410
 Tongue12,7709,0403,7302,0501,360690
 Mouth11,6207,0304,5901,7901,070720
 Pharynx13,51010,7902,7202,3301,730600
 Other oral cavity2,3501,6806701,6801,280400
Digestive system284,680156,760127,920142,51080,56061,950
 Esophagus17,46013,9503,51015,07012,0403,030
 Stomach21,32013,0208,30010,5406,1904,350
 Small intestine8,0704,3803,6901,150610540
 Colon103,17049,92053,25051,69026,47025,220
 Rectum40,29023,50016,790   
 Anus, anal canal, & anorectum6,2302,2503,980780300480
 Liver & intrahepatic bile duct28,72021,3707,35020,55013,9806,570
 Gallbladder & other biliary9,8104,4805,3303,2001,2401,960
 Pancreas43,92022,09021,83037,39018,85018,540
 Other digestive organs5,6901,8003,8902,1408801,260
Respiratory system244,180130,270113,910164,77091,11073,660
 Larynx12,3609,8402,5203,6502,880770
 Lung & bronchus226,160116,470109,690160,34087,75072,590
 Other respiratory organs5,6603,9601,700780480300
Bones & joints2,8901,6001,2901,410790620
Soft tissue (including heart)11,2806,1105,1703,9002,0501,850
Skin (excluding basal & squamous)81,24046,89034,35012,1908,2103,980
 Melanoma-skin76,25044,25032,0009,1806,0603,120
 Other nonepithelial skin4,9902,6402,3503,0102,150860
Breast229,0602,190226,87039,92041039,510
Genital system340,650251,90088,75058,36028,84029,520
 Uterine cervix12,170 12,1704,220 4,220
 Uterine corpus47,130 47,1308,010 8,010
 Ovary22,280 22,28015,500 15,500
 Vulva4,490 4,490950 950
 Vagina & other genital, female2,680 2,680840 840
 Prostate241,740241,740 28,17028,170 
 Testis8,5908,590 360360 
 Penis & other genital, male1,5701,570 310310 
Urinary system141,14097,61043,53029,33019,6709,660
 Urinary bladder73,51055,60017,91014,88010,5104,370
 Kidney & renal pelvis64,77040,25024,52013,5708,6504,920
 Ureter & other urinary organs2,8601,7601,100880510370
Eye & orbit2,6101,3101,300270120150
Brain & other nervous system22,91012,63010,28013,7007,7205,980
Endocrine system58,98014,60044,3802,7001,2401,460
 Thyroid56,46013,25043,2101,7807801,000
 Other endocrine2,5201,3501,170920460460
Lymphoma79,19043,12036,07020,13010,9909,140
 Hodgkin lymphoma9,0604,9604,1001,190670520
 Non-Hodgkin lymphoma70,13038,16031,97018,94010,3208,620
Myeloma21,70012,1909,51010,7106,0204,690
Leukemia47,15026,83020,32023,54013,50010,040
 Acute lymphocytic leukemia6,0503,4502,6001,440820620
 Chronic lymphocytic leukemia16,0609,4906,5704,5802,7301,850
 Acute myeloid leukemia13,7807,3506,43010,2005,7904,410
 Chronic myeloid leukemia5,4303,2102,220610370240
 Other leukemia5,8303,3302,5006,7103,7902,920
Other & unspecified primary sites31,00015,62015,38045,90025,15020,750
Table 2. Incidence Rates for All Cancers Combined, 2004 to 2008, and Estimated New Cases* for Selected Cancers by State, United States, 2012
STATEINCIDENCE RATEALL CASESFEMALE BREASTUTERINE CERVIXCOLON & RECTUMUTERINE CORPUSLEUKEMIALUNG & BRONCHUSMELANOMA OF THE SKINNON-HODGKIN LYMPHOMAPROSTATEURINARY BLADDER
  • *

    Rounded to the nearest 10; excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

  • Rates are per 100,000 and age adjusted to the 2000 US standard population.

  • Estimate is fewer than 50 cases.

  • §

    Rate is not available.

  • Note: These model-based estimates are offered as a rough guide and should be interpreted with caution. State estimates may not add to US total due to rounding and the exclusion of states with fewer than 50 cases.

Alabama469.226,4403,4502202,5405906304,4401,0901,0003,8601,050
Alaska481.03,64047029010012049070160490160
Arizona398.331,9904,4702502,7008209603,9701,6501,3904,3901,520
Arkansas458.416,1202,1501301,5903704602,7605706802,400690
California444.0165,81025,0401,45014,3704,9605,07018,0609,2507,46023,4106,880
Colorado436.922,8203,4201401,7506007302,4001,4701,0003,8301,070
Connecticut510.721,5303,1401101,7306805502,7201,2908903,3401,170
Delaware519.05,340740410170140800280220850230
Dist. of Columbia471.72,98046026080703708010054090
Florida459.0117,58015,54091010,2002,9103,31017,8605,4504,97017,1605,460
Georgia466.948,1306,9704104,0901,1701,2306,5702,1501,8407,9001,680
Hawaii438.96,6101,12050680220180860280230740220
Idaho463.07,7201,000506402102309204003201,320380
Illinois490.465,7509,0905106,0301,9001,9809,1902,4602,8708,9503,030
Indiana468.135,0604,4902503,2001,0701,0205,4601,4501,5004,3201,690
Iowa484.617,0102,350901,6805405602,3308508002,640850
Kansas468.414,0901,990901,3304204401,9106106301,890630
Kentucky519.225,1603,1601802,2806306704,4301,3701,0703,2001,080
Louisiana496.723,4803,3202002,3505206603,6608109304,040930
Maine528.48,9901,170507503002401,3404803901,320520
Maryland§31,0004,7002102,4209207804,2501,4201,2805,1901,200
Massachusetts509.938,4705,4801902,9901,2509304,9202,1901,5906,1802,000
Michigan494.257,7907,7103505,0801,7701,7008,2102,7002,5509,4502,830
Minnesota484.728,0604,1101502,3709109003,7501,1301,2904,5201,320
Mississippi481.215,1901,9901401,5803303602,5505105402,330550
Missouri471.233,4404,4402303,2501,0601,0105,3701,2801,4604,1101,510
Montana458.35,5507404701501707003202501,000270
Nebraska480.49,0301,270609102803001,2303804401,240430
Nevada464.213,7801,7701201,2603303901,9305105301,850610
New Hampshire505.38,3501,1606802802401,1304703501,260460
New Jersey509.750,6506,9703904,6301,6701,4605,9902,3402,1607,5502,480
New Mexico412.09,6401,310708402603101,0905604201,430380
New York494.8109,44014,7308509,3903,7302,97013,6204,7004,68017,0905,460
North Carolina479.751,8607,0903904,1401,3901,4107,9502,3602,0508,0102,100
North Dakota477.43,510490350110120460130160530170
Ohio472.466,5608,9904006,0202,1101,81010,2703,0302,9208,5603,160
Oklahoma483.919,2102,6301701,7804706003,3707508502,560820
Oregon473.321,3703,2001301,6706206102,9201,2909503,4601,020
Pennsylvania503.978,34010,2904607,3302,5702,34010,8903,4703,51011,8904,150
Rhode Island517.96,310870540200170860290240810330
South Carolina468.726,5703,5702202,3506707004,2701,1501,0404,1401,060
South Dakota441.54,430600420140130620170200700220
Tennessee466.835,6104,6802703,2408509206,1401,6401,4404,9001,490
Texas446.9110,47015,0501,0809,7002,6003,53014,8104,0204,75015,7303,940
Utah402.510,6201,480707802903708807804801,850420
Vermont494.24,060560330130110550220160580210
Virginia456.441,3806,1902903,2501,2201,0205,5502,1501,7006,8601,620
Washington484.035,7905,2402202,7701,0801,0504,7002,1401,6005,0601,670
West Virginia498.411,6101,430801,0803303302,0705204901,540510
Wisconsin482.431,9204,2701902,7301,0401,1104,2201,3701,4604,3101,600
Wyoming447.52,6503602407080330150110480130
United States472.61,638,910226,87012,170143,46047,13047,150226,16076,25070,130241,74073,510

Figure 1 indicates the most common cancers expected to occur in men and women in 2012. Among men, cancers of the prostate, lung and bronchus, and colorectum will account for about half of all newly diagnosed cancers; prostate cancer alone will account for 29% (241,740) of incident cases. The 3 most commonly diagnosed types of cancer among women in 2012 will be breast, lung and bronchus, and colorectum, accounting for about half of the estimated cancer cases in women. Breast cancer alone is expected to account for 29% (226,870) of all new cancer cases among women.

thumbnail image

Figure 1. Ten Leading Cancer Types for the Estimated New Cancer Cases and Deaths by Sex, United States, 2012.

*Estimates are rounded to the nearest 10 and exclude basal and squamous cell skin cancers and in situ carcinoma except urinary bladder.

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Expected Numbers of Cancer Deaths

Table 1 also shows the expected numbers of deaths from cancer projected for 2012. It is estimated that 577,190 Americans will die from cancer this year, corresponding to more than 1,500 deaths per day. Cancers of the lung and bronchus, prostate, and colorectum in men and cancers of the lung and bronchus, breast, and colorectum in women continue to be the most common causes of cancer death. These 4 cancers account for almost half of the total cancer deaths among men and women (Fig. 1). In 2012, lung cancer is expected to account for 26% of all female cancer deaths and 29% of all male cancer deaths. Table 3 provides the estimated numbers of cancer deaths in 2012 by state for selected cancers.

Table 3. Death Rates for All Cancers Combined, 2004 to 2008, and Estimated Deaths* for Selected Cancers by State, United States, 2012
STATEDEATH RATEALL SITESBRAIN & OTHER NERVOUS SYSTEMFEMALE BREASTCOLON & RECTUMLEUKEMIALIVER & INTRAHEPATIC BILE DUCTLUNG & BRONCHUSNON-HODGKIN LYMPHOMAOVARYPANCREASPROSTATE
  • *

    Rounded to the nearest 10.

  • Rates are per 100,000 and age adjusted to the 2000 US standard population.

  • Estimate is fewer than 50 deaths.

  • Note: State estimates may not add to US total due to rounding and the exclusion of states with fewer than 50 deaths.

Alabama199.910,2902307109803903203,240320300600560
Alaska181.2930708026060
Arizona156.211,0903007801,0104604402,850400330720570
Arkansas201.76,5701504206102601802,160170150370290
California165.156,6201,5404,1105,1402,4302,88012,8302,0001,6803,8603,110
Colorado156.17,1902305106803002701,690250250490380
Connecticut176.96,9401604805602702301,780230210510380
Delaware196.61,930501201707070580605012090
Dist. of Columbia198.31,010801002508060
Florida172.542,1708502,6003,6601,7601,46012,2001,4001,0402,6702,160
Georgia183.115,7903501,1401,4706004804,650470450970860
Hawaii149.22,380140240801205808060200100
Idaho167.82,640901702201308066010070190160
Illinois189.323,9705001,6502,3009907306,5907606201,5801,140
Indiana197.213,2403208501,1605603504,140450340790560
Iowa180.56,4101804005902901801,790230190390330
Kansas180.75,4001503705102501601,580200140340230
Kentucky213.69,8901905708903502503,530310220530360
Louisiana208.49,1502106609003303802,730270220570390
Maine196.03,230801802601209097011070200130
Maryland186.810,4402308109404203502,850320280720510
Massachusetts183.012,9303008001,0605004803,570420370910600
Michigan189.320,4305301,3501,7308906605,9107205501,370840
Minnesota171.59,4902406008004403202,500330260600480
Mississippi206.86,3301404406402402201,960170140370310
Missouri194.512,7103009001,1205503903,970390280800580
Montana175.72,0106011017090505807060130110
Nebraska175.43,4501002103601508090013090210190
Nevada186.14,5901403505101702101,490140120340260
New Hampshire184.22,70070180220100807508060200120
New Jersey182.616,6503401,3401,6006505404,2005504901,130720
New Mexico160.83,53090240350140170780110100240200
New York169.634,1407402,4203,0901,4301,3508,8801,0801,0102,4201,610
North Carolina189.618,4403901,2901,5306905805,6005604601,1301,020
North Dakota173.01,3009013060320509070
Ohio197.225,0305701,7502,2509707207,3508006001,7101,210
Oklahoma195.97,8002005007203102402,440260180420430
Oregon183.07,7902205106703102702,120280240520410
Pennsylvania190.228,7905701,9502,4601,1908807,7501,0308101,9401,330
Rhode Island184.92,1905013017010080620706013090
South Carolina191.19,6702206608303503002,970280220570440
South Dakota172.41,63011016070450605010080
Tennessee202.813,8803408901,2305104104,570430330790580
Texas174.736,8209002,6503,4001,4901,8309,7801,1809302,2401,630
Utah131.82,7801102502401609046011090210270
Vermont178.41,30080110503709060
Virginia185.614,6103201,1101,2905704404,150450420990660
Washington178.612,1704008009905105003,270390390810670
West Virginia207.84,6001002804401601101,460160120220160
Wisconsin181.511,2403006909205103503,000400320760570
Wyoming171.0940609025070
United States181.3577,19013,70039,51051,69023,54020,550160,34018,94015,50037,39028,170

Lifetime Probability of Developing Cancer

The lifetime probability of being diagnosed with an invasive cancer is higher for men (45%) than for women (38%) (Table 4). However, because of the earlier median age at diagnosis for breast cancer compared with other major cancers, women have a slightly higher probability of developing cancer before age 60 years. These estimates are based on the average experience of the general population and may over- or underestimate individual risk because of differences in exposure (eg, smoking history) and/or genetic susceptibility.

Table 4. Probability (%) of Developing Invasive Cancers Within Selected Age Intervals by Sex, United States, 2006 to 2008*
  BIRTH TO 3940 TO 5960 TO 6970 AND OLDERBIRTH TO DEATH
  • *

    For people free of cancer at beginning of age interval.

  • All sites excludes basal and squamous cell skin cancers and in situ cancers except urinary bladder.

  • Includes invasive and in situ cancer cases.

  • §

    Statistics for whites only.

All sitesMale1.45 (1 in 69)8.68 (1 in 12)16.00 (1 in 6)38.27 (1 in 3)44.85 (1 in 2)
 Female2.15 (1 in 46)9.10 (1 in 11)10.34 (1 in 10)26.68 (1 in 4)38.08 (1 in 3)
UrinarybladderMale0.02 (1 in 5,035)0.38 (1 in 266)0.92 (1 in 109)3.71 (1 in 27)3.84 (1 in 26)
 Female0.01 (1 in 12,682)0.12 (1 in 851)0.25 (1 in 400)0.98 (1 in 102)1.15 (1 in 87)
BreastFemale0.49 (1 in 203)3.76 (1 in 27)3.53 (1 in 28)6.58 (1 in 15)12.29 (1 in 8)
ColorectumMale0.08 (1 in 1,236)0.92 (1 in 109)1.44 (1 in 70)4.32 (1 in 23)5.27 (1 in 19)
 Female0.08 (1 in 1,258)0.73 (1 in 137)1.01 (1 in 99)3.95 (1 in 25)4.91 (1 in 20)
LeukemiaMale0.16 (1 in 614)0.22 (1 in 445)0.34 (1 in 291)1.24 (1 in 81)1.57 (1 in 64)
 Female0.14 (1 in 737)0.15 (1 in 665)0.21 (1 in 482)0.81 (1 in 123)1.14 (1 in 88)
Lung & bronchusMale0.03 (1 in 3,631)0.91 (1 in 109)2.26 (1 in 44)6.69 (1 in 15)7.66 (1 in 13)
 Female0.03 (1 in 3,285)0.76 (1 in 132)1.72 (1 in 58)4.91 (1 in 20)6.33 (1 in 16)
Melanomaof the skin§Male0.15 (1 in 677)0.63 (1 in 158)0.75 (1 in 133)1.94 (1 in 52)2.80 (1 in 36)
 Female0.27 (1 in 377)0.56 (1 in 180)0.39 (1 in 256)0.82 (1 in 123)1.83 (1 in 55)
Non-HodgkinlymphomaMale0.13 (1 in 775)0.45 (1 in 223)0.60 (1 in 167)1.77 (1 in 57)2.34 (1 in 43)
 Female0.09 (1 in 1,152)0.32 (1 in 313)0.44 (1 in 228)1.41 (1 in 71)1.94 (1 in 51)
ProstateMale0.01 (1 in 8,499)2.63 (1 in 38)6.84 (1 in 15)12.54 (1 in 8)16.48 (1 in 6)
Uterine cervixFemale0.15 (1 in 650)0.27 (1 in 373)0.13 (1 in 771)0.18 (1 in 549)0.68 (1 in 147)
Uterine corpusFemale0.07 (1 in 1,373)0.77 (1 in 130)0.87 (1 in 114)1.24 (1 in 81)2.61 (1 in 38)

Trends in Cancer Incidence

Figures 2 to 5 depict long-term trends in cancer incidence and death rates for all cancers combined and for selected cancers by sex. Table 5 shows incidence (delay-adjusted) and mortality trends for all cancers combined and for the 4 most common cancer sites based on joinpoint regression analysis. Joinpoint is a tool used to describe and quantify trends by fitting observed rates to lines connected at “joinpoints” where trends change in direction or magnitude.16, 18 According to data from the SEER 13 cancer registries, incidence rates in the most recent 5 years (2004-2008) decreased in males by 0.6% per year and were stable in females (Table 5). Incidence rates decreased for all 4 major cancer sites except the female breast, for which rates remained relatively stable from 2005 to 2008 after decreasing by 2% per year from 1999 to 2005. Lung cancer incidence rates in women began declining in the late 1990s, more than a decade after the decline began in men.6 Differences in lung cancer incidence patterns between men and women (Fig. 3) reflect historical differences in tobacco use; cigarette smoking prevalence peaked about 20 years later in women than in men.19 Recent rapid declines in colorectal cancer incidence rates have largely been attributed to increases in screening that can detect and remove precancerous polyps.20-22 Although joinpoint trend analysis shows that the incidence rate for prostate cancer declined steadily by 1.9% per year from 2000 to 2008, it is important to realize that annual rates fluctuate widely from year to year (Fig. 3), likely reflecting variation in the prevalence of prostate-specific antigen testing for the detection of prostate cancer. For example, in the SEER 13 areas, the delay-adjusted prostate cancer incidence rate increased from 152.8 (per 100,000) in 2005 to 162.8 in 2006, then dropped from 165.9 in 2007 to 151.8 in 2008.12

Table 5. Trends in Cancer Incidence (Delay-Adjusted) and Death Rates for Selected Cancers by Sex, United States, 1992 to 2008
 TREND 1TREND 2TREND 3TREND 42004-2008 AAPC
 YEARSAPCYEARSAPCYEARSAPCYEARSAPC
  • APC indicates annual percent change based on incidence (delay-adjusted) and mortality rates age adjusted to the 2000 US standard population; AAPC, average annual percent change.

  • *

    The APC or AAPC is significantly different from 0 (P < .05).

  • Note: Trends analyzed by the Joinpoint Regression Program, version 3.5.0, allowing up to 3 joinpoints. Incidence trends based on Surveillance, Epidemiology, and End Results (SEER) 13 areas.

All cancers
 Incidence
  Male and female1992-1994−3.2*1994-19990.41999-2005−0.8*2005-20080.1−0.1
  Male1992-1994−5.6*1994-2008−0.6*    −0.6*
  Female1992-19980.8*1998-2006−0.5*2006-20081.1  0.3
 Death
  Male and female1992-2001−1.0*2001-2008−1.6*    −1.6*
  Male1992-2001−1.4*2001-2008−1.8*    −1.8*
  Female1992-2002−0.7*2002-2008−1.6*    −1.6*
Lung & bronchus
 Incidence
  Male1992-2008−1.9*      −1.9*
  Female1992-19970.71997-2008−0.3*    −0.3*
 Death
  Male1992-2005−1.9*2005-2008−2.8*    −2.6*
  Female1992-20020.6*2002-2008−0.9*    −0.9*
Colorectum
 Incidence
  Male1992-1995−2.6*1995-19981.51998-2008−2.6*  −2.6*
  Female1992-1995−1.8*1995-19981.91998-2008−2.0*  −2.0*
 Death
  Male1992-2002−2.0*2002-2005−4.0*2005-2008−2.3*  −2.7*
  Female1992-2001−1.7*2001-2005−3.6*2005-2008−2.1*  −2.5*
Female breast
 Incidence1992-19991.3*1999-2005−2.0*2005-20081.1  0.3
 Death1992-1995−1.2*1995-1998−3.6*1998-2003−1.7*2003-2008−2.3*−2.3*
Prostate
 Incidence1992-1995−11.1*1995-20002.02000-2008−1.9*  −1.9*
 Death1992-1994−1.31994-2008−3.7*    −3.7*
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Figure 2. Trends in Cancer Incidence and Mortality Rates by Sex, United States, 1975 to 2008.

Rates are age adjusted to the 2000 US standard population. Incidence rates are adjusted for delays in reporting.

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Figure 3. Trends in Incidence Rates for Selected Cancers by Sex, United States, 1975 to 2008.

Rates are age adjusted to the 2000 US standard population and adjusted for delays in reporting.

*Liver includes intrahepatic bile duct.

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Figure 4. Trends in Death Rates Among Males for Selected Cancers, United States, 1930 to 2008.

Rates are age adjusted to the 2000 US standard population. Due to changes in International Classification of Diseases (ICD) coding, numerator information has changed over time. Rates for cancers of the lung and bronchus, colorectum, and liver are affected by these changes.

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thumbnail image

Figure 5. Trends in Death Rates Among Females for Selected Cancers, United States, 1930 to 2008.

Rates are age adjusted to the 2000 US standard population. Due to changes in International Classification of Diseases (ICD) coding, numerator information has changed over time. Rates for cancers of the uterus, ovary, lung and bronchus, and colorectum are affected by these changes.

*Uterus includes uterine cervix and uterine corpus.

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Trends in Cancer Mortality

Based on the most recent 5 years of mortality data (2004-2008), the overall cancer death rate decreased by 1.8% per year in males and by 1.6% per year in females. These declines have been consistent since 2001/2002 and are larger in magnitude than those occurring in the previous decade (Table 5). Death rates peaked in men in 1990 (279.8 per 100,000) and in women in 1991 (175.3 per 100,000). Between 1990/1991 and 2008, cancer death rates decreased 22.9% in men and 15.3% in women. Death rates continue to decrease for the 4 major cancer sites: lung and bronchus, colorectum, breast, and prostate (Figs. 4 and 5). Among men, reductions in death rates for lung, prostate, and colorectal cancers account for 78% of the total decrease in the cancer death rate, with lung cancer alone accounting for almost 40% of the decrease. Among women, reductions in death rates for breast and colorectal cancers account for 56% of the total decrease, with breast cancer accounting for 34% of the decrease in women. The decrease in lung cancer death rates among men since 1990 is due to the reduction in tobacco use over the past 50 years,23 while the decrease in death rates for female breast, colorectal, and prostate cancer largely reflects improvements in early detection and/or treatment.20, 24, 25

Figure 6 shows the total number of cancer deaths avoided since death rates began to decrease in 1991 in men and in 1992 in women. About 1,024,400 cancer deaths (732,900 in men and 291,500 in women) were averted from 1991/1992 through 2008 as a result of 18 years of consistent declines in cancer death rates.

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Figure 6. Total Number of Cancer Deaths Averted From 1991 to 2008 in Men and From 1992 to 2008 in Women.

The blue line represents the actual number of cancer deaths recorded in each year, and the red line represents the expected number of cancer deaths if cancer mortality rates had remained at their peak (1990 in men and 1991 in women).

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Recorded Number of Deaths From Cancer in 2008

A total of 565,469 cancer deaths were recorded in the United States in 2008, the most recent year for which actual data are available. Cancer is the second leading cause of death following heart disease, accounting for 23% of all deaths. From 2007 to 2008, the age-standardized cancer death rate decreased 1.5%, from 178.4 (per 100,000) to 175.8.

Table 6 presents the numbers of deaths from all cancers combined and from the 5 most common cancer types for each 20-year age group. Leukemia is the most common cause of cancer death among males aged younger than 40 years, while lung cancer ranks first among those aged 40 years and older. Among females, leukemia is the leading cause of cancer death among children and adolescents (those aged younger than 20 years), breast cancer ranks first among women ages 20 to 59 years, and lung cancer causes the most cancer deaths in those aged 60 years and older.

Table 6. Reported Deaths for the 5 Leading Cancers by Age and Sex, United States, 2008
ALL AGES<2020 TO 3940 TO 5960 TO 79≥80
  1. ONS indicates other nervous system.

  2. Note: Deaths within each age group do not sum to all ages combined due to the inclusion of unknown ages. “Other and unspecified malignant neoplasm” is excluded from cause of death ranking order.

  MALE  
ALL SITESALL SITESALL SITESALL SITESALL SITESALL SITES
295,2591,1304,16954,458153,63181,865
Lung & bronchusLeukemiaLeukemiaLung & bronchusLung & bronchusLung & bronchus
88,54131661615,21252,75520,288
ProstateBrain & ONSBrain & ONSColorectumColorectumProstate
28,4722904995,51613,38115,214
ColorectumBones & jointsColorectumLiver & bile ductProstateColorectum
26,935994334,24411,9577,593
PancreasSoft tissueNon-Hodgkin lymphomaPancreasPancreasUrinary bladder
17,515873173,7099,5784,338
LeukemiaOther endocrine systemLung & bronchusEsophagusEsophagusPancreas
12,711792722,5866,1404,131
  FEMALE  
ALL SITESALL SITESALL SITESALL SITESALL SITESALL SITES
270,2109094,53049,828127,19087,750
Lung & bronchusLeukemiaBreastBreastLung & bronchusLung & bronchus
70,0512821,06411,49239,77019,063
BreastBrain & ONSUterine cervixLung & bronchusBreastColorectum
40,58924341110,98017,05111,167
ColorectumBones & jointsColorectumColorectumColorectumBreast
25,924833834,07710,29110,981
PancreasOther endocrine systemLeukemiaOvaryPancreasPancreas
17,721783623,1258,5456,648
OvarySoft tissueBrain & ONSPancreasOvaryNon-Hodgkin lymphoma
14,362733052,4377,1174,109

Regional Variations in Cancer Rates

Tables 7 and 8 depict cancer incidence and death rates for selected cancers by state. Lung cancer shows the largest geographic variation in cancer occurrence by far, reflecting the large historical and continuing differences in smoking prevalence among states.23 For example, lung cancer incidence rates in Kentucky, which has highest smoking prevalence, are almost 4-fold higher than those in Utah, which has the lowest smoking prevalence. In contrast, state variations for other cancer sites are smaller in both absolute and proportionate terms. For example, the breast cancer incidence rate in Connecticut, which has the highest rate (136.2 per 100,000), is only 28% higher than that in Arizona, which has the lowest rate (106.7 per 100,000). For cancers that can be detected by screening or other testing practices, such as those of the prostate, female breast, and colorectum, state variation in incidence rates reflects differences in the use of screening tests or detection practices in addition to differences in disease occurrence.

Table 7. Incidence Rates for Selected Cancers by State, United States, 2004 to 2008
 ALL CANCERSBREASTCOLORECTUMLUNG & BRONCHUSNON-HODGKIN LYMPHOMAPROSTATEURINARY BLADDER
STATEMALEFEMALEFEMALEMALEFEMALEMALEFEMALEMALEFEMALEMALEMALEFEMALE
  • Rates are per 100,000 and age adjusted to the 2000 US standard population.

  • *

    Due to the effect of large migrations of populations on this state as a result of Hurricane Katrina in September 2005, statistics exclude cases diagnosed from July through December in 2005.

  • This state is not included in the overall US rates because its registry did not achieve high-quality data standards for one or more years during 2004 to 2008 according to the North American Association of Central Cancer Registries (NAACCR) data quality indicators.

Alabama*579.9391.1117.261.342.0106.854.119.813.8160.832.87.6
Alaska531.4441.0130.455.145.585.364.822.318.2141.539.48.6
Arizona447.5360.6106.743.432.563.948.218.013.3122.932.58.6
Arkansas556.4385.6109.056.241.4109.261.021.715.4156.432.88.4
California512.8396.9122.451.238.663.345.722.815.6146.534.38.1
Colorado498.2393.5122.348.437.057.645.022.015.8156.332.18.3
Connecticut590.0458.5136.257.442.980.260.026.317.9162.147.612.3
Delaware614.3446.9126.659.642.694.469.524.317.0181.744.411.9
Dist. of Columbia573.2398.3126.754.143.780.345.322.712.8187.924.47.7
Florida531.2402.6113.651.939.385.159.021.715.3137.335.99.1
Georgia571.9395.7119.255.740.097.354.521.714.5167.433.18.0
Hawaii503.7393.3122.459.739.870.540.720.312.4132.126.26.4
Idaho532.0408.7116.546.537.866.849.022.517.1162.536.69.2
Illinois577.0433.8123.963.946.589.959.824.216.3157.740.110.2
Indiana544.0418.6115.159.544.299.863.623.017.0132.736.79.2
Iowa563.7431.4122.561.347.188.055.326.418.4141.742.18.9
Kansas556.4420.6124.457.941.785.053.623.917.6158.137.09.3
Kentucky612.1456.4120.566.747.4130.179.524.717.3139.840.110.1
Louisiana*618.1409.9118.266.044.7105.858.624.017.1172.035.08.4
Maine612.7468.1128.958.346.097.266.626.018.6163.348.213.5
Maryland533.1411.6123.452.439.380.057.420.514.2157.033.09.7
Massachusetts588.6459.2133.456.842.082.464.124.616.6160.845.612.7
Michigan582.8432.7120.354.641.689.161.825.118.3169.441.710.7
Minnesota573.1421.1126.453.741.167.649.626.918.1184.240.79.7
Mississippi*608.1392.1112.864.745.7117.256.021.614.2174.131.37.3
Missouri547.1418.8120.659.743.1101.363.822.116.0131.835.88.4
Montana518.7410.9120.051.239.372.858.222.215.5160.736.39.7
Nebraska559.7425.4125.065.246.982.352.024.417.5157.237.29.1
Nevada507.6404.1111.751.241.179.066.820.415.7135.537.610.6
New Hampshire576.3455.7132.254.341.482.262.223.117.3154.846.013.2
New Jersey595.1453.8129.760.644.476.756.725.617.7171.046.712.2
New Mexico467.4369.5110.546.235.554.539.418.514.4137.625.97.0
New York580.9438.4124.356.743.077.354.825.517.5166.942.511.0
North Carolina576.6412.5123.355.839.9101.657.822.715.6158.837.19.1
North Dakota559.3417.1124.266.444.572.546.223.117.4169.540.89.9
Ohio551.1421.2119.858.543.694.960.023.216.2146.039.09.6
Oklahoma566.3428.0125.656.842.7103.265.623.017.7151.835.88.7
Oregon531.6431.5130.350.038.776.059.824.216.3149.238.710.0
Pennsylvania586.6449.4124.861.446.088.457.624.917.6155.845.111.0
Rhode Island603.1464.5132.559.044.890.863.224.417.5155.153.113.4
South Carolina569.1396.9119.955.641.097.953.420.514.1165.530.97.8
South Dakota515.1386.8117.455.840.976.346.620.316.7158.534.07.9
Tennessee558.0404.6117.257.442.2108.760.722.116.1142.234.48.3
Texas*529.9388.5113.754.437.882.349.922.315.8143.329.47.0
Utah476.2344.7109.542.231.234.122.323.416.0173.728.75.8
Vermont552.6453.2130.146.741.581.962.123.717.4152.143.813.1
Virginia542.1396.9124.252.339.588.054.321.214.2159.434.08.4
Washington552.5434.8129.849.537.473.458.326.517.7157.939.79.5
West Virginia581.9441.2112.664.747.4115.073.223.917.3140.440.011.1
Wisconsin555.8430.9123.453.241.078.154.328.320.1150.938.710.0
Wyoming517.6391.2114.651.239.659.548.122.414.8166.241.410.1
United States553.0416.5121.255.741.484.455.723.416.3152.937.69.4
Table 8. Death Rates for Selected Cancers by State, United States, 2004 to 2008
 ALL CANCERSBREASTCOLON & RECTUMLUNG & BRONCHUSNON-HODGKIN LYMPHOMAPANCREASPROSTATE
STATEMALEFEMALEFEMALEMALEFEMALEMALEFEMALEMALEFEMALEMALEFEMALEMALE
  1. Rates are per 100,000 and age adjusted to the 2000 US standard population.

Alabama262.0158.724.523.615.290.341.08.55.512.99.429.9
Alaska212.4157.221.721.513.562.346.37.75.111.910.422.5
Arizona186.7132.421.017.511.952.133.97.74.911.47.820.6
Arkansas254.9164.124.023.215.693.247.48.65.212.79.526.2
California197.4143.422.518.413.350.333.98.25.111.89.323.6
Colorado187.3135.720.518.313.346.132.38.24.711.28.824.3
Connecticut216.4152.523.218.113.858.539.18.25.414.410.125.7
Delaware238.5167.524.320.815.073.750.39.05.112.19.826.7
Dist. of Columbia260.4161.127.623.018.168.635.18.83.216.110.141.7
Florida209.4143.921.918.713.365.140.18.05.011.98.620.3
Georgia237.1149.523.220.714.378.938.98.04.812.88.828.6
Hawaii186.2120.717.818.810.751.827.47.24.412.99.416.8
Idaho197.9145.721.215.913.852.034.98.25.811.610.227.3
Illinois233.3162.024.723.216.269.942.09.15.613.210.126.1
Indiana247.3164.824.023.115.682.847.29.95.812.99.525.2
Iowa224.7151.722.121.315.570.039.39.25.612.18.825.1
Kansas224.7151.323.121.814.571.840.99.75.512.79.422.2
Kentucky271.2175.123.524.417.0103.056.19.36.012.39.325.6
Louisiana268.1168.626.825.816.387.845.09.35.514.010.928.6
Maine243.4164.721.520.915.475.647.39.36.012.710.025.0
Maryland229.7159.725.622.615.067.442.28.15.012.810.527.5
Massachusetts227.3156.022.320.114.464.042.78.75.413.210.324.1
Michigan231.1162.124.420.615.171.543.99.26.213.69.923.6
Minnesota208.8147.621.618.213.057.037.39.55.411.89.325.1
Mississippi276.1161.425.525.216.698.943.38.54.613.69.631.7
Missouri242.0162.725.422.115.083.146.48.55.512.99.523.1
Montana208.1153.020.717.513.959.542.48.55.612.39.328.0
Nebraska217.1147.222.022.915.664.135.99.05.912.28.724.9
Nevada214.7163.023.521.316.462.750.06.84.912.110.024.5
New Hampshire223.4159.122.820.513.963.443.78.35.112.811.025.1
New Jersey218.5160.626.522.616.059.739.18.55.713.39.923.4
New Mexico193.0136.821.519.613.445.529.56.64.811.59.324.6
New York204.6148.023.120.214.556.636.48.05.112.69.823.0
North Carolina241.4155.524.420.414.281.141.98.05.312.59.727.0
North Dakota212.8146.022.322.214.359.335.48.05.112.49.525.9
Ohio246.5165.525.923.316.078.545.09.55.613.19.726.3
Oklahoma245.4161.524.123.314.984.046.89.25.711.88.723.9
Oregon217.7158.722.519.014.162.944.39.15.912.310.326.0
Pennsylvania235.6161.124.822.715.869.940.39.45.913.59.824.5
Rhode Island234.4155.022.220.613.569.043.49.14.812.38.723.8
South Carolina245.7153.924.320.914.681.739.97.85.112.69.528.5
South Dakota214.2142.721.820.514.365.436.38.75.311.29.224.4
Tennessee261.1164.024.522.715.693.947.29.35.512.89.426.3
Texas217.8145.122.620.713.465.736.98.25.211.88.622.6
Utah158.3112.422.114.610.229.516.97.85.09.77.925.6
Vermont214.2155.521.720.215.062.543.27.75.111.59.624.3
Virginia232.7155.525.121.014.473.041.38.35.113.19.926.3
Washington211.9155.722.418.213.159.743.28.95.712.19.825.2
West Virginia257.1174.023.924.416.989.150.89.66.511.77.621.6
Wisconsin222.8154.322.119.413.661.439.29.55.912.89.726.7
Wyoming199.4150.722.119.914.652.538.28.16.312.410.422.7
United States223.0153.223.520.714.567.440.18.65.412.59.424.4

Cancer Occurrence by Race/Ethnicity

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References

Cancer incidence and death rates vary considerably among racial and ethnic groups (Table 9). For all cancer sites combined, African American men have a 15% higher incidence rate and a 33% higher death rate than white men, whereas African American women have a 6% lower incidence rate but a 16% higher death rate than white women. For the specific cancer sites listed in Table 9, incidence and death rates are consistently higher in African Americans than in whites except for cancers of the breast (incidence) and lung (incidence and mortality) among women, and kidney (mortality) among both men and women. Factors known to contribute to racial disparities in mortality vary by cancer site and include differences in exposure to underlying risk factors (eg, historical smoking prevalence for lung cancer), access to high-quality screening (breast, cervical, and colorectal cancers), and timely diagnosis and treatment for many cancers.26 The higher breast cancer incidence rate noted among white women is thought to reflect a combination of factors that affect both diagnosis (more prevalent mammography use in white women) and underlying disease occurrence (increased prevalence of risk factors in white women, such as later age at first birth and greater use of menopausal hormone therapy).27

Table 9. Incidence and Death Rates by Site, Race, and Ethnicity, United States, 2004 to 2008
 WHITEAFRICAN AMERICANASIAN AMERICAN OR PACIFIC ISLANDERAMERICAN INDIAN OR ALASKA NATIVE*HISPANIC/LATINO
  • Rates are per 100,000 population and age adjusted to the 2000 US standard population. Race and ethnicity categories are not mutually exclusive of Hispanic origin.

  • *

    Data based on Indian Health Service Contract Health Service Delivery Areas.

  • Mortality rates exclude deaths from the District of Columbia and North Dakota due to unreliable Hispanic origin data for 1 or more years.

Incidence
All sites     
 Male545.0626.2332.4427.8423.4
 Female420.8394.2284.0362.1333.5
Breast (female)122.3116.184.989.292.3
Colorectum     
 Male54.666.942.451.548.6
 Female40.349.732.741.534.2
Kidney & renal pelvis     
 Male20.822.69.927.419.4
 Female10.911.74.916.811.2
Liver & bile duct     
 Male8.614.121.715.817.0
 Female2.94.08.27.66.4
Lung & bronchus     
 Male83.7102.749.871.046.8
 Female57.251.428.151.727.0
Prostate142.8230.879.7101.2126.7
Stomach     
 Male8.516.416.813.913.8
 Female4.08.29.46.88.4
Uterine cervix7.710.67.49.812.2
Mortality
All sites     
 Male222.0295.3134.7190.0149.1
 Female152.8177.794.1138.4101.5
Breast (female)22.832.012.217.215.1
Colorectum     
 Male20.130.513.319.815.5
 Female14.020.49.914.010.3
Kidney & renal pelvis     
 Male6.06.02.68.95.2
 Female2.72.61.24.12.3
Liver & bile duct     
 Male7.211.514.711.911.6
 Female3.03.96.36.75.2
Lung & bronchus     
 Male66.985.436.750.531.9
 Female41.238.818.533.914.3
Prostate22.454.910.520.718.5
Stomach     
 Male4.510.79.28.57.7
 Female2.35.05.43.94.5
Uterine cervix2.24.32.13.43.1

Cancer incidence and death rates are lower in other racial and ethnic groups than in whites and African Americans for all cancer sites combined and for the 4 most common cancer sites. However, incidence and death rates for cancers related to infectious agents, such as those of the uterine cervix, stomach, and liver, are generally higher in minority populations than in whites. Stomach and liver cancer incidence and death rates are twice as high in Asian Americans/Pacific Islanders as in whites, reflecting an increased prevalence of chronic infection with Helicobacter pylori and hepatitis B and C viruses in this population.28 Kidney cancer incidence and death rates are the highest among American Indians/Alaska Natives; the higher prevalence of obesity and smoking in this population may contribute to this disparity.29

Cancer incidence rates can only be adjusted for delayed reporting in whites and African Americans because the long-term incidence data required for delay adjustment are not available for other racial and ethnic groups. During the past 10 years of data (1999-2008), while incidence rates (unadjusted for delayed reporting) declined by 1% or more per year among men of all racial/ethnic groups, among women only slight declines (0.4% per year) occurred in whites and Hispanics (Table 10). In contrast, cancer death rates declined by 1% or more per year among men and women of all races/ethnicities except American Indians/Alaska Natives, among whom rates remained stable. Notably, the largest declines in death rates occurred among men of African American (2.4% per year) and Hispanic (2.3% per year) heritage.

Table 10. Ten-Year Trends in Cancer Incidence and Mortality Rates by Race/Ethnicity, United States, 1999 to 2008
 1999-2008 AAPC
 INCIDENCEMORTALITY
 MALEFEMALEMALEFEMALE
  • AAPC indicates average annual percent change.

  • *

    AAPC is statistically significant (P < .05).

  • Data based on Indian Health Service Contract Health Service Delivery Areas.

  • Excludes deaths from the District of Columbia, Minnesota, New Hampshire, and North Dakota due to unreliable Hispanic origin data for some years.

  • Notes: Trends analyzed by the Joinpoint Regression Program, version 3.5.0, allowing up to 2 joinpoints. Incidence trends based on the North American Association of Central Cancer Registries (NAACCR) data. Race and ethnicity categories are not mutually exclusive of Hispanic origin.

All races/ethnicities−1.0*−0.4*−1.8*−1.3*
White−1.0*−0.4*−1.7*−1.3*
African American−1.3*−0.1−2.4*−1.5*
Asian American/Pacific Islander−1.5*0.1−1.6*−1.1*
American Indian/Alaska Native−1.1*−0.3−0.4−0.4
Hispanic−1.5*−0.4*−2.3*−1.4*

Cancer Survival

Compared with whites, African American men and women have poorer survival once cancer is diagnosed. The 5-year relative survival is lower in African Americans than in whites for every stage of diagnosis for nearly every type of cancer (Fig. 7). These disparities may result from inequalities in access to and receipt of quality health care and/or from differences in comorbidities. As shown in Figure 8, African Americans are less likely than whites to be diagnosed with cancer at a localized stage, when the disease may be more easily and successfully treated. The extent to which factors other than stage at diagnosis contribute to the overall survival differential is unclear.30 However, some studies suggest that African Americans who receive cancer treatment and medical care similar to that of whites experience similar outcomes.31

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Figure 7. Five-Year Relative Survival Rates for Selected Cancers by Race and Stage at Diagnosis, United States, 2001 to 2007.

*The standard error of the survival rate is between 5 and 10 percentage points.

†The survival rate for carcinoma in situ of the urinary bladder is 97% for All Races and Whites and 92% for African Americans.

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thumbnail image

Figure 8. Stage Distribution of Selected Cancers by Race, United States, 2001 to 2007.

*The proportions of carcinoma in situ of the urinary bladder are 51%, 51%, and 38% in All Races, Whites, and African Americans, respectively. Stage categories do not sum to 100% because sufficient information is not available to assign a stage to all cancer cases.

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There have been notable improvements since 1975 in the relative 5-year survival rates for most cancers for both whites and African Americans (Table 11). Increases in survival rates over time reflect a combination of earlier diagnosis and improvements in treatment. Cancers of the lung and pancreas have shown little improvement in survival over the past 30 years.

Table 11. Trends in 5-Year Relative Survival Rates* (%) by Race and Year of Diagnosis, United States, 1975 to 2007
 ALL RACESWHITEAFRICAN AMERICAN
 1975 TO 19771987 TO 19892001 TO 20071975 TO 19771987 TO 19892001 TO 20071975 TO 19771987 TO 19892001 TO 2007
  • *

    Survival rates are adjusted for normal life expectancy and are based on cases diagnosed in the Surveillance, Epidemiology, and End Results (SEER) 9 areas from 1975 to 1977, 1987 to 1989, and 2001 to 2007 and followed through 2008.

  • The difference in rates between 1975 to 1977 and 2001 to 2007 is statistically significant (P < .05).

  • The standard error of the survival rate is between 5 and 10 percentage points.

  • §

    Survival rate is for 1978 to 1980.

All cancers combined495667505769394359
Brain & other nervous system222935222834253140
Breast (female)758490768591627177
Colon516065516167455355
Esophagus51019611203713
Hodgkin lymphoma727986728088707281
Kidney & renal pelvis505771505771495568
Larynx666663676765595652
Leukemia344357354457333650
Liver & bile duct351536152310
Lung & bronchus121316121317111113
Melanoma of the skin828893828893587973
Myeloma252841252742303041
Non-Hodgkin lymphoma475170475271484662
Oral cavity535463545665363445
Ovary363844353843423436
Pancreas246336264
Prostate68831006985100617298
Rectum485868485969455261
Stomach152027141926161927
Testis83959683959773§8886
Thyroid929597929498909295
Urinary bladder737980748081506364
Uterine cervix697069707370655761
Uterine corpus878383888485605761

Relative survival rates cannot be calculated for some minority populations because accurate life expectancies are not available. However, based on cause-specific survival rates of cancer patients diagnosed from 2001 to 2007 in SEER areas of the United States, all minority male populations have a greater probability of dying from cancer within 5 years of diagnosis than whites.6 Among women, African Americans have the lowest 5-year cancer-specific survival, followed by American Indians/Alaska Natives, Hispanics, whites, and Asian Americans/Pacific Islanders.6 For all 4 major cancer sites (prostate, female breast, lung and bronchus, and colorectum), minority populations are generally more likely than non-Hispanic whites to be diagnosed at a distant stage of disease.32

Cancer in Children

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References

Cancer is the second most common cause of death among children ages 1 to 14 years in the United States, surpassed only by accidents; 1,284 children died from cancer in 2008. Leukemia accounts for one-third of all cancers diagnosed in children (ages 0 to 14 years), 78% of which are acute lymphocytic leukemias.6 Cancers of the brain and other nervous system are the second most common cancer type (27%), followed by soft tissue sarcomas (7%, half of which are rhabdomyosarcoma), neuroblastoma (7%), renal (Wilms) tumors (5%), and Hodgkin and non-Hodgkin lymphomas (4% each).6 From 2004 to 2008, the overall incidence rate for cancer in children aged 14 years and younger increased slightly by 0.5% per year, a trend that has been consistent since 1975. The death rate for childhood cancer has decreased by more than half over the past 3 decades, from 4.9 (per 100,000) in 1975 to 2.2 in 2008.2 Table 12 provides trends in survival rates for the most common childhood cancers. The 5-year relative survival rate for all cancers combined improved from 58% for children diagnosed between 1975 and 1977 to 83% for those diagnosed between 2001 and 2007.6 The substantial progress for all of the major childhood cancers reflects both improvements in treatment and high levels of participation in clinical trials.

Table 12. Trends in 5-Year Relative Survival Rates* (%) for Children Under Age 15 Years, United States, 1975 to 2007
 YEAR OF DIAGNOSIS
 1975 TO 19771978 TO 19801981 TO 19831984 TO 19861987 TO 19891990 TO 19921993 TO 19951996 TO 20002001 TO 2007
  • *

    Survival rates are adjusted for normal life expectancy and are based on follow-up of patients through 2008.

  • The difference in rates between 1975 to 1977 and 2001 to 2007 is statistically significant (P < .05).

  • The standard error of the survival rate is between 5 and 10 percentage points.

All cancers combined586367687276777983
Acute lymphocytic leukemia586671737883848791
Acute myeloid leukemia192627313742425264
Bone & joint504857576767746879
Brain & other nervous system575856626465717475
Hodgkin lymphoma818788918797959696
Neuroblastoma535755536376676873
Non-Hodgkin lymphoma435367707177818686
Soft tissue617569736680777482
Wilms tumor737987919292929390

Limitations

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References

The projected numbers of new cancer cases and cancer deaths should be interpreted cautiously because these estimates are model-based and may vary considerably from year to year for reasons other than changes in cancer occurrence. For instance, estimates are invariably affected by changes in method, which occur regularly as modeling techniques improve over time and cancer registration becomes more complete. Indeed, new methods were used for projecting both incident cases and deaths in 2012. In addition, not all changes in cancer trends can be captured by modeling techniques. For these reasons, we discourage the use of these estimates to track year-to-year changes in cancer occurrence and death. The data sources used for tracking cancer trends are age-standardized or age-specific cancer death rates from the NCHS and cancer incidence rates from SEER or NPCR. Nevertheless, the American Cancer Society projections of the numbers of new cancer cases and deaths provide a reasonably accurate estimate of the current cancer burden in the United States.

Errors in reporting race/ethnicity in medical records and on death certificates may result in underestimates of cancer incidence and mortality rates in nonwhite and non-African American populations. It is also important to note that cancer data in the United States are primarily reported for broad racial and ethnic minority groups that are not homogenous, and thus important differences in the cancer burden within racial/ethnic subgroups are often masked.

References

  1. Top of page
  2. Abstract
  3. Introduction
  4. Materials and Methods
  5. Selected Findings
  6. Cancer Occurrence by Race/Ethnicity
  7. Cancer in Children
  8. Limitations
  9. References
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