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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 AND FUTURE CHALLENGES
  9. References

Each year, the American Cancer Society estimates the number 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 by using incidence data from the National Cancer Institute (NCI) and mortality data from the National Center for Health Statistics (NCHS). Incidence and death rates are age adjusted to the 2000 US standard population. In the year 2003, we estimate that 1,334,100 new cases of cancer will be diagnosed, and 556,500 people will die from cancer in the United States. Age-adjusted cancer death rates declined in both males and females in the 1990s, though the magnitude of decline is substantially higher in males than in females. In contrast, incidence rates continued to increase in females while stabilizing in males. African-American males showed the largest decline for mortality. However, African Americans still carry the highest burden of cancer with diagnosis of cancer at a later stage and poorer survival within each stage compared with Whites. In spite of the continued decline in cancer death rates in the most recent time period, the total number of recorded cancer deaths in the United States continues to increase slightly due to the aging and expanding population.


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 AND FUTURE CHALLENGES
  9. References

Cancer remains a major public health problem in the United States and in other developed countries. One in four deaths in the United States is caused by cancer. In order to provide an up-to-date perspective on the occurrence of cancer, the American Cancer Society presents this overview of cancer frequency, incidence, mortality, and survival statistics for the year 2003.

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 AND FUTURE CHALLENGES
  9. References

Data Sources

Mortality data were obtained from the National Center for Health Statistics.1 Incidence data, including five-year relative survival rates and data on lifetime probability of developing cancer, were obtained from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute covering about 10 percent of the US population.2 Population data were obtained from the US Census Bureau.3 Causes of death were coded and classified according to the International Classification of Diseases (ICD-9 and ICD-10).4,5 Cancer cases were classified according to the International Classification of Diseases for Oncology.6

Estimated New Cancer Cases

Because complete cancer registration has not yet been achieved in many states of the United States, the precise number of cases of cancer diagnosed each year in the nation and in individual states is unknown. Consequently, for the national estimate we first estimated the number of new cancer cases occurring annually in the United States from 1979 through 1999 by using age-specific cancer incidence rates collected by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program2 coupled with population data reported by the US Census Bureau.3 We then forecasted the number of cancer cases expected to be diagnosed in the United States in the year 2003 using an autoregressive quadratic model fitted to the annual cancer case estimates.7 For estimates of new cancer cases in individual states, we relied on state cancer death statistical data, and assumed that the ratio of cancer deaths to cancer cases in each state corresponded to that in the United States as a whole.

The observed national trend in prostate cancer incidence was not compatible with the selected forecasting model, as rates increased greatly between 1988 and 1992, declined sharply between 1992 and 1995, and leveled off from 1995 to 1999.8,9 This trend likely reflects extensive use of prostate-specific antigen (PSA) screening in a previously unscreened population and the subsequent increase in diagnosis of early stage cancers.10,11 We therefore assumed that the number of newly diagnosed prostate cancers can best be predicted by the trend before and after the widespread introduction of PSA screening. Our national estimate for 2003 is based on a linear projection that considers data from 1979 to 1989 and 1995 to 1999 only.

Estimated Cancer Deaths

We estimated the number of cancer deaths expected to occur in the United States and in each state in the year 2003 using underlying cause-of-death data from death certificates as reported to the National Center for Health Statistics.1 The number of cancer deaths recorded annually from 1979 to 2000 in the United States and in each state was fitted with autoregressive quadratic models7 in order to forecast the number of cancer deaths expected to occur in 2003.

Other Statistics

We provide mortality statistics for the leading causes of death as well as deaths from cancer in the year 2000. Causes of death were coded and classified according to ICD-10, replacing the ICD-9 codes used for deaths in the time interval 1979 to 1998. This report also provides updated statistics on the probability of developing cancer,12 trends in cancer mortality and incidence rates, and five-year relative survival rates for selected cancer types based on data from 1973 through 1999.2 All age-adjusted incidence and death rates are standardized to the 2000 US standard population, and expressed per 100,000 person-years. The change in the age adjustment from the 1970 to the 2000 standard population has been discussed.13,14,15 In general, rates age adjusted to the 2000 population standard are 20 to 50% higher than rates age adjusted to the 1970 standard. Therefore, the absolute rates in this year's report should not be compared with the age-adjusted rates of previous years based on the 1970 population standard.

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 AND FUTURE CHALLENGES
  9. References

Expected Numbers of New Cancer Cases

Table 1 presents the estimated number of new cancer cases expected in 2003 for men, women, and for both sexes combined. The 1,334,100 estimate of new cases of invasive cancer does not include carcinoma in situ of any type except urinary bladder, nor does it include basal and squamous cell cancers of the skin. More than one million cases of basal and squamous cell skin cancers, 55,700 cases of breast carcinoma in situ, and 37,700 cases of in situ melanoma are expected to be newly diagnosed in 2003. The estimated numbers of new cancer cases for each state and cancer type are shown in Table 2.

Table TABLE 1. Estimated New Cancer Cases and Deaths, by Sex, US, 2003*
 Estimated New CasesEstimated Deaths
 Both SexesMaleFemaleBoth SexesMaleFemale
  1. *Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder. Carcinoma in situ of the breast accounts for about 55,700 new cases annually, and in situ melanoma accounts for about 37,700 new cases annually.

  2. †Estimated deaths for colon and rectum cancers are combined.

  3. ‡More deaths than cases suggests lack of specificity in recording underlying causes of death on death certificate.

  4. Source: Estimates of new cases are based on incidence rates from 1979 to 1999, National Cancer Institute Surveillance, Epidemiology, and End Results program. Estimates of deaths are based on data from US Mortality Public Use Data Tapes, 1979 to 2000, National Center for Health Statistics, Centers for Disease Control and Prevention.

  5. American Cancer Society Surveillance Research, 2003.

All Cancers1,334,100675,300658,800556,500285,900270,600
Oral cavity and pharynx27,70018,2009,5007,2004,8002,400
    Tongue7,1004,7002,4001,7001,100600
    Mouth9,2004,8004,4001,9001,100800
    Pharynx8,3006,3002,0002,0001,400600
    Other oral cavity3,1002,4007001,6001,200400
Digestive system252,400132,300120,100133,60071,90061,700
    Esophagus13,90010,6003,30013,0009,9003,100
    Stomach22,40013,4009,00012,1007,0005,100
    Small intestine5,3002,7002,6001,100600500
    Colon105,50049,00056,50057,100†28,300†28,800†
    Rectum42,00023,80018,200   
    Anus, anal canal, and anorectum4,0001,7002,300500200300
    Liver and intrahepatic bile duct17,30011,7005,60014,4009,2005,200
    Gallbladder and other biliary6,8003,1003,7003,5001,3002,200
    Pancreas30,70014,90015,80030,00014,70015,300
    Other digestive organs4,5001,4003,1001,9007001,200
Respiratory system185,800102,20083,600163,70093,40070,300
    Larynx9,5007,1002,4003,8003,000800
    Lung and bronchus171,90091,80080,100157,20088,40068,800
    Other respiratory organs4,4003,3001,1002,7002,000700
Bones and joints2,4001,3001,1001,300700600
Soft tissue (including heart)8,3004,5003,8003,9002,0001,900
Skin (excluding basal and squamous)58,80032,30026,5009,8006,2003,600
    Melanoma-skin54,20029,90024,3007,6004,7002,900
    Other non-epithelial skin4,6002,4002,2002,2001,500700
Breast212,6001,300211,30040,20040039,800
Genital system313,600229,90083,70056,30029,50026,800
   Uterine cervix12,200 12,2004,100 4,100
    Uterine corpus40,100 40,1006,800 6,800
    Ovary25,400 25,40014,300 14,300
    Vulva4,000 4,000800 800
    Vagina and other genital, female2,000 2,000800 800
    Prostate220,900220,900 28,90028,900 
    Testis7,6007,600 400400 
    Penis and other genital, male1,4001,400 200200 
Urinary system91,70063,30028,40025,10016,4008,700
    Urinary bladder57,40042,20015,20012,5008,6003,900
    Kidney and renal pelvis31,90019,50012,40011,9007,4004,500
    Ureter and other urinary organs2,4001,600800700400300
Eye and orbit2,2001,1001,100200100100
Brain and other nervous system18,30010,2008,10013,1007,3005,800
Endocrine system23,8006,60017,2002,3001,1001,200
    Thyroid22,0005,70016,3001,400600800
    Other endocrine1,800900900900500400
Lymphoma61,00032,30028,70024,70012,90011,800
    Hodgkin disease7,6004,0003,6001,300700600
    Non-Hodgkin lymphoma53,40028,30025,10023,40012,20011,200
Multiple myeloma14,6007,8006,80010,9005,4005,500
Leukemia30,60017,90012,70021,90012,1009,800
    Acute lymphocytic leukemia3,6002,1001,5001,400800600
    Chronic lymphocytic leukemia7,3004,6002,7004,4002,5001,900
    Acute myeloid leukemia10,5005,8004,7007,8004,2003,600
    Chronic myeloid leukemia4,3002,5001,8001,7001,000700
    Other leukemia‡4,9002,9002,0006,6003,6003,000
Other and unspecified primary sites‡30,30014,10016,20042,30021,70020,600
Table TABLE 2. ESTIMATED NEW CANCER CASES FOR SELECTED CANCER TYPES BY STATE, US, 2003*
STATEAll CasesFemale BreastUterine CervixColon and RectumUterine CorpusLeukemiaLung and BronchusMelanoma of the SkinNon-Hodgkin LymphomaProstateUrinary Bladder
  1. *Rounded to the nearest 100. Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

  2. †Estimate is 50 or fewer cases.

  3. Note: These estimates are offered as a rough guide and should be interpreted with caution. They are calculated according to the distribution of estimated cancer deaths in 2003 by state. State estimates may not add to US total due to rounding.

AL23,6003,4002002,2006005003,3009008004,700800
AK1,800300200200100100200100
AZ23,3003,9002002,5005005003,0001,2001,0004,3001,000
AR14,7002,0001001,5003003002,2005006002,600500
CA125,00021,1001,40013,0003,8003,00014,4005,2005,20020,5005,500
CO15,2002,5001001,6004004001,6008007002,600600
CT16,6002,6001001,9005004002,0006007002,800800
DE4,100700100400100100600200200600300
DC2,700500300200300600100
FL96,10013,50090010,2002,5002,20013,2004,1003,90015,8004,500
GA33,4005,4004003,3001,0007004,6001,3001,1005,7001,200
HI4,900700500200100600100200900200
ID5,5001,0006001001006003002001,100300
IL59,90010,2006006,8001,9001,4007,4002,1002,40010,1002,600
IN31,2004,7003003,5009007004,4001,4001,3005,0001,300
IA15,3002,3001001,9005004001,9006006002,700600
KS12,6002,1001001,3003003001,7006005002,100500
KY22,1003,2002002,4005004003,5001,0008003,300900
LA22,6003,8002002,6006005003,0007008003,600800
ME7,3001,0008002001001,000300300900400
MD24,4004,2002002,9007006003,2008009003,9001,000
MA32,7004,7002003,7009007004,1001,5001,3005,5001,700
MI47,4007,5003005,1001,4001,1006,1001,8002,0007,8002,200
MN21,9003,4001002,3006006002,5009001,1004,000900
MS14,9002,5002001,7003003002,2005005002,900500
MO29,5004,1002003,3009007004,2001,3001,1004,5001,100
MT4,600600500100100600200200800200
NE8,1001,1001001,1003002001,0003004001,400300
NV10,3001,4001001,3002002001,5004003001,600400
NH6,000800700100100800300300900300
NJ42,3007,4004004,8001,6001,0005,0001,7001,8006,6002,200
NM7,4001,3001008002002008003003001,400300
NY85,90014,80090010,3003,4002,00010,0002,9003,30014,0004,200
NC39,6006,0004004,1001,2009005,6001,6001,4006,8001,500
ND3,100500300100100300100100500200
OH60,3009,9005006,9001,9001,4008,0002,3002,6009,4002,800
OK17,7002,7002002,0004004002,6001,0007002,600700
OR17,3002,6001001,7005004002,3008007003,200800
PA70,80011,1006008,6002,3001,6008,7002,7003,00012,0003,400
RI5,800800100700100100800200200900300
SC20,6003,4002002,3005004002,8007007003,800700
SD3,900600500100100400100200700100
TN30,5004,5003003,2008007004,5001,4001,2004,7001,000
TX83,40013,7001,0009,2002,5001,90010,9003,5003,30013,2003,000
UT6,2001,1007002002005004003001,400300
VT3,100500400100100400200100300100
VA32,8005,4003003,6001,1007004,3001,4001,3005,5001,200
WA26,7003,8002002,7008007003,5001,2001,1003,9001,200
WV11,3001,6001001,2004003001,7004004001,700500
WI25,8003,9002002,9008007003,0001,1001,2004,5001,200
WY2,300300300100100300100100400100
US1,334,100211,30012,200147,50040,10030,600171,90054,20053,400220,90057,400

Figure 1 lists the most common cancers expected to occur in men and women in 2003. Among men, cancers of the prostate, lung and bronchus, and colon and rectum comprise over 55 percent of all new incident cancers. Prostate cancer alone accounts for 33 percent (220,900) of new cancer cases in men. Based on the most current data on the stage distribution of prostate cancer cases, however, about 85 percent of these estimated new cases are expected to be diagnosed at local and regional stages, for which five-year relative survival equals 100 percent.

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Figure FIGURE 1. Ten Leading Cancer Types for the Estimated New Cancer Cases and Deaths, by Sex, US, 2003*

*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

Note: Percentages may not total 100 percent due to rounding.

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Among women, the three most commonly diagnosed cancers will be cancers of the breast, lung and bronchus, and colon and rectum. Cancers occurring at these sites are expected to account for about 55 percent of new cancer cases. Breast cancer alone is expected to account for 32 percent (211,300) of all new cancer cases among women in 2003.

Expected Number of New Cancer Deaths

Table 1 also shows the expected number of cancer deaths in 2003 for men, women, and both sexes combined. It is estimated that about 556,500 Americans will die from cancer, corresponding to 1,500 deaths per day. Cancers of the lung and bronchus, prostate, and colon and rectum in men, and cancers of the lung and bronchus, breast, and colon and rectum in women continue to be the most common causes of cancer death. These four cancers account for slightly more than half of the total cancer deaths among men and women (Figure 1). Lung cancer surpassed breast cancer as the leading cause of cancer death in women in 1987. Lung cancer is expected to account for 25 percent of all female cancer deaths in 2003. Table 3 provides the estimated number of cancer deaths in 2003 by state.

Table TABLE 3. ESTIMATED CANCER DEATHS FOR SELECTED CANCER TYPES BY STATE, US, 2003*
StateDeath Rate per 100,000‡All CancersBrain/ Nervous SystemFemale BreastColon and RectumLeukemiaLiverLung and BronchusNon-Hodgkin LymphomaOvaryPancreasProstate
  1. *Rounded to the nearest 100. Excludes in situ carcinomas except urinary bladder.

  2. †Estimate is 50 or fewer deaths.

  3. ‡Average annual rates for 1995 to 1999 are age adjusted to the 2000 US standard population.

  4. Note: State estimates may not add to US total due to rounding.

  5. Source: US Mortality Public Use Data Tapes, 1979 to 2000, National Center for Health Statistics, Centers for Disease Control and Prevention.

AL218.99,8002006009003003003,000400200500600
AK198.2700100100200
AZ187.59,7002007001,0004003002,700400200500600
AR219.86,1002004006002002002,000300200300300
CA186.952,2001,5004,0005,0002,1001,90013,2002,3001,5002,9002,700
CO174.96,3002005006003001001,500300200300300
CT199.06,9002005007003002001,800300200400400
DE233.71,700100200100500100100100
DC245.81,100100100300100100
FL201.240,1009002,5003,9001,6001,00012,1001,7001,0002,2002,100
GA211.813,9003001,0001,3005003004,200500400700700
HI161.62,000100200100100500100100100
ID185.42,300100200200100600100100100100
IL212.625,0005001,9002,6001,0007006,8001,0006001,4001,300
IN218.413,0003009001,3005003004,000600400600700
IA193.06,4002004008003001001,700300200300400
KS192.75,2001004005002001001,500200100300300
KY231.29,2002006009003002003,200400200400400
LA237.39,4002007001,0004003002,700400200500500
ME224.53,000100200300100100900100100200100
MD220.910,2002008001,1004002002,900400300600500
MA212.813,6003009001,4005003003,700600300800700
MI207.319,8005001,4002,0008005005,6009005001,1001,100
MN192.29,1003006009004002002,300500200500500
MS227.36,2002005006002002002,000200200300400
MO213.512,3003008001,3005003003,900500300600600
MT195.71,900100100200100500100100100100
NE189.13,400100200400200100900200100200200
NV219.94,3001003005002001001,300100100200200
NH219.82,500100200300100100700100100200100
NJ216.517,6004001,4001,9007005004,5008005001,000900
NM181.93,100100200300100100700100100200200
NY202.335,8008002,8004,0001,4001,0009,2001,4001,0002,2001,800
NC212.216,5004001,1001,6006004005,100600400900900
ND189.31,300100100100300100100100
OH218.525,2006001,9002,7001,0005007,4001,1006001,3001,200
OK208.17,4002005008003002002,400300200300300
OR203.07,2002005007003001002,100300200400400
PA214.729,6006002,1003,3001,1007008,0001,3007001,6001,600
RI219.12,400100200300100100700100100100100
SC215.38,6002006009003002002,500300200500500
SD195.61,600100100200100400100100100100
TN222.812,7003009001,2005003004,100500300600600
TX203.034,8009002,6003,6001,3001,2009,9001,4009001,8001,700
UT153.12,600100200300100100400200100100200
VT213.31,300100200400100100
VA214.313,7003001,0001,4005003003,900500300700700
WA198.611,2003007001,0005003003,200500300600500
WV225.94,7001003005002001001,600200100200200
WI200.110,8003007001,1005003002,800500300600600
WY199.2900100100300100
US206.0556,50013,10039,80057,10021,90014,400157,20023,40014,30030,00028,900

Trends in Cancer Incidence and Mortality

Temporal trends in age-adjusted incidence and death rates for all cancer types combined and for selected cancer types are shown in Figures 2, 3, 4, and 5. These trends have been examined formally by joinpoint analysis (Table 4). For all cancer types and races combined, cancer death rates declined by 1.5 percent per year in males and by 0.6 percent per year in females from 1992 to 1999. In contrast, incidence rates increased by 0.3 percent per year in females from 1987 to 1999 and stabilized in males from 1995 to 1999 (Figure 2). African-American men showed the largest decline in mortality.16

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Figure FIGURE 2. Annual Age-adjusted Cancer Incidence and Death Rates,* by Sex, US, 1973 to 1999

*Rates are age adjusted to the 2000 US standard population.

Source: Incidence data from Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002. Mortality data from US Mortality Public Use Data Tapes, 1960 to 1999, National Center for Health Statistics, Centers for Disease Control and Prevention.

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Figure FIGURE 3. Annual Age-adjusted Cancer Incidence Rates* Among Males and Females for Selected Cancer Types, US, 1973 to 1999

*Rates are age adjusted to the 2000 US standard population.

Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002.

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Figure FIGURE 4. Annual Age-adjusted Cancer Death Rates* Among Males for Selected Cancer Types, US, 1930 to 1999

*Rates are age adjusted to the 2000 US standard population.

Note: Due to changes in ICD coding, numerator information has changed over time. Rates for cancers of the lung and bronchus and colon and rectum are affected by these coding changes.

Source: US Mortality Public Use Data Tapes, 1960 to 1999, US Mortality Volumes 1930 to 1959, National Center for Health Statistics, Centers for Disease Control and Prevention.

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Figure FIGURE 5. Annual Age-adjusted Cancer Death Rates* Among Females for Selected Cancer Types, US, 1930 to 1999

*Rates are age adjusted to the 2000 US standard population.

†Uterus cancers are for uterine cervix and uterine corpus combined.

Note: Due to changes in ICD coding, numerator information has changed over time. Rates for cancers of the uterus, ovary, lung and bronchus, and colon and rectum are affected by these coding changes.Source: US Mortality Public Use Data Tapes, 1960 to 1999, US Mortality Volumes 1930 to 1959, National Center for Health Statistics, Centers for Disease Control and Prevention.

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Table TABLE 4. Trends in Cancer Incidence and Death Rates for All Cancer Types Combined and for Selected Cancers, by Sex, All Races, 1973 to 1999
 Line Segment 1Line Segment 2Line Segment 3Line Segment 4
 YearAPCYearAPCYearAPCYearAPC
  1. *The APC is significantly different from zero (p < 0.05).

  2. APC = Annual Percent Change based on rates age adjusted to the 2000 US standard population.

  3. Note: Trends were analyzed by joinpoint regression program with a maximum of three joinpoints, i.e., four line segments.

  4. Source: SEER Cancer Statistics Review, 1973 to 1999. National Cancer Institute.8

All Cancers        
Incidence        
    Male1973-891.4*1989-925.0*1992-95-4.9*1995-99-0.3
    Female1973-800.21980-871.6*1987-990.3*  
Death        
    Male1973-800.9*1980-920.3*1992-99-1.5*  
    Female1973-920.5*1992-99-0.6*    
Lung and bronchus        
Incidence        
    Male1973-802.2*1980-91-0.21991-99-2.2*  
    Female1973-816.3*1981-913.4*1991-990.5  
Death        
    Male1973-802.2*1980-900.7*1990-97-1.5*1997-99-2.8*
    Female1973-826.1*1982-904.1*1990-951.9*1995-990.2
Colon and rectum        
Incidence        
    Male1973-861.1*1986-952.1*1995-990.1  
    Female1973-840.6*1984-951.7*1995-990.7  
Death        
    Male1973-790.51979-87-0.6*1987-99-2.0*  
    Female1973-80-0.5*1980-99-1.7*    
Female breast        
Incidence        
    All ages1973-80-0.61980-873.7*1987-990.5*  
    Under 501973-80-1.51980-862.9*1986-99-0.3  
    50 and over1973-80-0.31980-874.1*1987-990.7*  
Death        
    All ages1973-79-0.31979-890.6*1989-95-1.4*1995-99-3.2*
    Under 501973-80-1.5*1980-890.11989-97-2.7*1997-99-7.4*
    50 and over1973-910.5*1991-99-2.1*    
Prostate        
Incidence        
    All ages1973-882.7*1988-9216.2*1992-95-11.7*1995-991.4
    Under 651973-852.8*1985-897.2*1989-9226.4*1992-992.8*
    65 and over1973-882.6*1988-9214.9*1992-95-15.1*1995-990.3
Death        
    All ages1973-870.9*1987-913.0*1991-94-0.71994-99-4.3*
    Under 651973-870.31987-903.91990-99-3.6*  
    65 and over1973-870.9*1987-913.1*1991-94-0.51994-99-4.3*

The Recorded Number of Deaths From Cancer and Other Causes in 2000

A total of 553,091 cancer deaths were recorded in the United States in 2000. This represented an increase of 3,253 deaths over the number in 1999. Cancer deaths accounted for 23.0 percent of all deaths, ranking second only to death from heart disease (Table 5). When deaths are categorized by age, sex, and cause, cancer is by far the leading cause of death among women aged 40 to 79 and among men aged 60 to 79 (Table 6). In contrast, cancer ranks fifth as a cause of death among men aged 20 to 39.

Table TABLE 5. Fifteen Leading Causes of Death, US, 2000
RankCause of DeathNumber of DeathsPercent (%) of Total DeathsDeath Rate*
  1. *Rates are per 100,000 population and age adjusted to the 2000 US standard population.

  2. Note: Percentages may not total 100 percent due to rounding.

  3. Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

 All Causes2,403,351 868.7
1Heart Diseases710,76029.6257.5
2Cancer553,09123.0199.6
3Cerebrovascular Diseases167,6617.060.8
4Chronic Lower Respiratory Diseases122,0095.144.2
5Accidents (Unintentional Injuries)97,9004.134.9
6Diabetes Mellitus69,3012.925.0
7Influenza and Pneumonia65,3132.723.7
8Alzheimer Disease49,5582.118.0
9Nephritis, Nephrotic Syndrome, and Nephrosis37,2511.513.5
10Septicemia31,2241.311.3
11Intentional Self-harm (Suicide)29,3501.210.4
12Chronic Liver Disease and Cirrhosis26,5521.19.6
13Hypertension and Hypertensive Renal Disease18,0730.86.6
14Assault (Homicide)16,7650.75.9
15Parkinson Disease15,6820.75.7
 All Other and Ill-defined Causes392,86116.3 
Table TABLE 6. Reported Deaths for the Ten Leading Causes of Death, by Age and Sex, US, 2000
 All AgesAges 1 to 19Ages 20 to 39Ages 40 to 59Ages 60 to 79Ages 80+
 MaleFemaleMaleFemaleMaleFemaleMaleFemaleMaleFemaleMaleFemale
  1. Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

 All Causes 1,177,578All Causes 1,225,773All Causes 16,922All Causes 9,033All Causes 64,516All Causes 29,819All Causes 198,868All Causes 121,882All Causes 499,631All Causes 413,373All Causes 381,634All Causes 639,282
1.Heart Diseases 344,807Heart Diseases 365,953Accidents (Unintentional Injuries) 7,716Accidents (Unintentional Injuries) 3,844Accidents Unintentional Injuries) 20,299Accidents Unintentional Injuries) 6,299Heart Diseases 51,724Cancer 47,850Cancer 158,990Cancer 131,871Heart Diseases 134,168Heart Diseases 235,370
2.Cancer 286,082Cancer 267,009Assault (Homicide) 2,038Cancer 931Intentional Self-harm (Suicide) 8,468Cancer 5,617Cancer 50,069Heart Diseases 20,280Heart Diseases 152,839Heart Diseases 107,053Cancer 70,883Cancer 80,697
3.Cerebrovascular Diseases 64,769Cerebrovascular Diseases 102,892Intentional Self-harm Suicide) 1,595Assault (Homicide) 603Assault (Homicide) 7,186Heart Diseases 2,662Accidents (Unintentional Injuries) 17,774Accidents Unintentional Injuries) 6,467Chronic Lower Respiratory Diseases 32,007Chronic Lower Respiratory Diseases 30,213Cerebrovascular Diseases 30,966Cerebrovascular Diseases 68,752
4.Accidents Unintentional Injuries) 63,817Chronic Lower Respiratory Diseases 62,005Cancer 1,248Congenital Anomalies 516Heart Diseases 5,257Intentional Self-harm (Suicide) 1,809Chronic Liver Disease & Cirrhosis 8,639Cerebrovascular Diseases 5,479Cerebrovascular Diseases 26,436Cerebrovascular Diseases 27,702Chronic Lower Respiratory Diseases 23,409Alzheimer Disease 29,042
5.Chronic Lower Respiratory Diseases 60,004Diabetes Mellitus 37,699Congenital Anomalies 603Heart Diseases 337Cancer 4,832Assault (Homicide) 1,735Intentional Self-harm (Suicide) 8,112Diabetes Mellitus 4,439Diabetes Mellitus 16,284Diabetes Mellitus 17,191Influenza & Pneumonia 16,612Chronic Lower Respiratory Diseases 27,500
6.Diabetes Mellitus 31,602Influenza & Pneumonia 36,655Heart Diseases 518Intentional Self-harm (Suicide) 333HIV Disease 3,854HIV Disease 1,623Cerebrovascular Diseases 6,396Chronic Lower Respiratory Diseases 3,831Accidents Unintentional Injuries) 10,007Influenza & Pneumonia 7,715Alzheimer Disease 10,201Influenza & Pneumonia 26,844
7.Influenza & Pneumonia 28,658Alzheimer Disease 35,120Chronic Lower Respiratory Diseases 166Influenza &Pneumonia 118Chronic Liver Disease & Cirrhosis 1,012Cerebrovascular Diseases 808HIV Disease 6,220Chronic Liver Disease & Cirrhosis 3,250Influenza & Pneumonia 9,067Nephritis Nephrotic Syndrome & Nephrosis 7,157Diabetes Mellitus 8,684Diabetes Mellitus 15,449
8.Intentional Self-harm (Suicide) 23,618Accidents (Unintentional Injuries) 34,083Influenza & Pneumonia 137Chronic Lower Respiratory Diseases 110Diabetes Mellitus 835Diabetes Mellitus 586Diabetes Mellitus 5,749Intentional Self-harm (Suicide) 2,483Nephritis, Nephrotic Syndrome & Nephrosis 7,557Accidents (Unintentional Injuries) 6,771Nephritis, Nephrotic Syndrome & Nephrosis 7,845Nephritis, Syndrome & Nephrosis 10,497
9.Nephritis, Nephrotic Syndrome & Nephrosis 17,811Nephritis, Nephrotic Syndrome & Nephrosis 19,440Septicemia 114Cerebrovascular Diseases 100Cerebrovascular Diseases 806Chronic Liver Disease & Cirrhosis 515Chronic Lower Respiratory Diseases 4,025HIV Disease 1,742Chronic Liver Disease & Cirrhosis 6,496Septicemia 6,116Accidents (Unintentional Injuries) 7,437Accidents (Unintentional Injuries) 10,320
10.Chronic Liver Disease & Cirrhosis 17,214Septicemia 17,687Cerebrovascular Diseases 90Septicemia 88Congenital Anomalies 564Influenza & Pneumonia 411Assault (Homicide) 2,706Septicemia 1,673Septicemia 5,972Alzheimer Disease 5,962Parkinson Disease 5,206Septicemia 9,368

Table 7 describes the leading site-specific causes of cancer death by age for males and females. Among men under age 20, leukemia is the most common fatal cancer, while cancer of the lung and bronchus predominates in men aged 40 years and older. Colorectal cancer is the second most common fatal cancer among men 40 to 79 years old. Among women under age 20, leukemia is the leading cause of cancer death; breast cancer ranks first as the cause of cancer death for women between ages 20 to 59 years, and lung cancer is the leading cause of cancer death for women aged 60 years and older.

Table TABLE 7. Reported Deaths for the Five Leading Cancer Types, by Sex and Age, US, 2000
All Ages< 2020 to 3940 to 5960 to 79≥ 80
  1. *ONS = Other Nervous System.

  2. Note: “All Cancers” excludes in situ carcinomas except urinary bladder.

  3. Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

Males
All Cancers 286,082All Cancers 1,298All Cancers 4,832All Cancers 50,069All Cancers 158,990All Cancers 70,883
Lung and Bronchus 90,415Leukemia 430Brain and ONS* 626Lung and Bronchus 15,827Lung and Bronchus 57,470Lung and Bronchus 16,626
Prostate 31,078Brain and ONS 307Leukemia 611Colon and Rectum 4,801Colon and Rectum 15,420Prostate 15,630
Colon and Rectum 28,484Bones and Joints 105Lung and Bronchus 481Pancreas 2,929Prostate 14,428Colon and Rectum 7,821
Pancreas 14,238Endocrine System 104Non-Hodgkin Lymphoma 444Esophagus 2,345Pancreas 8,179Urinary Bladder 3,222
Non-Hodgkin Lymphoma 11,812Non-Hodgkin Lymphoma 79Colon and Rectum 431Liver 2,308Non-Hodgkin Lymphoma 6,107Leukemia 3,187
Females
All Cancers 267,009All Cancers 973All Cancers 5,617All Cancers 47,850All Cancers 131,871All Cancers 80,697
Lung and Bronchus 65,016Leukemia 302Breast 1,444Breast 11,937Lung and Bronchus 39,311Lung and Bronchus 14,693
Breast 41,872Brain and ONS 238Uterine Cervix 538Lung and Bronchus 10,613Breast 17,842Colon and Rectum 12,379
Colon and Rectum 28,950Endocrine System 82Leukemia 452Colon and Rectum 3,619Colon and Rectum 12,612Breast 10,648
Pancreas 15,094Bones and Joints 76Lung and Bronchus 397Ovary 3,033Pancreas 7,825Pancreas 5,319
Ovary 14,060Soft Tissue 69Brain and ONS 354Pancreas 1,871Ovary 7,217Non-Hodgkin Lymphoma 4,039

The number of recorded cancer deaths among men increased by 250 from 285,832 in 1999 to 286,082 in 2000 (Table 8). In contrast to the slowly declining number of lung cancer deaths for most years after the mid-1990s, the recorded number of deaths from lung cancer increased by 1,015 among men. The increase occurred predominantly in men aged 70 years and older, reflecting the aging of the population. The number of prostate cancer deaths has continued to decline since 1995. From 1999 to 2000, the recorded number of prostate cancer deaths decreased by 651. Colon and rectum cancer deaths increased by 171.

Among women, the total number of recorded cancer deaths increased by 3,003, from 264,006 in 1999 to 267,009 in 2000 (Table 8). The increase largely reflected the greater number of lung cancer deaths. Female breast cancer deaths increased by 728. The number of colorectal cancer deaths among females has remained fairly constant in recent years.

Table TABLE 8. Trends in the Recorded Number of Cancer Deaths for Selected Cancer Types, by Sex, US, 1989 to 2000
 All CancersLung and BronchusColon and RectumProstateBreast
  1. Note: Effective with the mortality data for 1999, causes of death are classified by ICD-10, replacing ICD-9 used for 1979 to 1998 data.

  2. Source: US Mortality Public Use Data Tapes, 1989 to 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

YearMaleFemaleMaleFemaleMaleFemaleMaleFemale
1989263,309232,84388,97548,04228,12328,90330,52042,837
1990268,283237,03991,01450,13628,48428,67432,37843,391
1991272,380242,27791,60352,02228,02628,75333,56443,583
1992274,838245,74091,32254,48528,28028,71434,24043,068
1993279,375250,52992,49356,23428,19929,20634,86543,555
1994280,465253,84591,82557,53528,47128,93634,90243,644
1995281,611256,84491,80059,30428,40929,23734,47543,844
1996281,898257,63591,55960,35127,98928,76634,12343,091
1997281,110258,46791,27861,92228,07528,62132,89141,943
1998282,065259,46791,39963,07528,02428,95032,20341,737
1999285,832264,00689,40162,66228,31328,90931,72941,144
2000286,082267,00990,41565,01628,48428,95031,07841,872

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 AND FUTURE CHALLENGES
  9. References

Cancer incidence and mortality rates vary considerably among racial and ethnic groups (Table 9). Overall, African Americans have the highest incidence and mortality rates for cancer. The incidence rate for African Americans is about 10 percent higher than in Whites, 50 to 60 percent higher than in Hispanics and Asian/Pacific Islanders, and is more than twice as high as the rate for American Indians. Similarly, the death rate from all cancers combined is about 30 percent higher in African Americans than among Whites, and more than twice as high as cancer death rates in Asian/Pacific Islanders, American Indians, and Hispanics. Except for female breast cancer incidence and lung cancer death rates, where rates are highest in White females, race- and sex-specific incidence and death rates for the most common cancer types are higher for African Americans than for any of the other racial and ethnic groups.

Table TABLE 9. Average Annual Incidence and Death Rates* for Selected Cancer Types, by Race and Ethnicity, US, 1992 to 1999
  WhiteAfrican AmericanAsian/ Pacific IslanderAmerican Indian/ Alaska NativeHispanic†
  1. *Rates are per 100,000 and are age adjusted to the 2000 US standard population.

  2. †Hispanics are not mutually exclusive from Whites, African Americans, Asian/Pacific Islanders, and American Indians/Alaska Natives.

  3. Note: Incidence data are based on the 12 Surveillance, Epidemiology, and End Results program areas; Incidence data for Hispanics do not include cases from Detroit, MI, and Hawaii. Mortality data are from all states except mortality data for Hispanics, which excludes deaths occurring in Connecticut, Oklahoma, New York, and New Hampshire.

  4. Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002. Mortality data are derived from data originating from the National Center for Health Statistics, Centers for Disease Control and Prevention.

  5. American Cancer Society Surveillance Research, 2003.

Incidence
All Cancers      
 Males568.2703.6408.9277.7393.1
 Females424.4404.8306.5224.2290.5
 Total480.4526.6348.6244.6329.6
Breast (female) 137.0120.793.459.482.6
Colon and rectum      
 Males64.470.758.740.743.9
 Females46.155.839.530.829.7
 Total53.961.947.935.235.7
Lung and bronchus      
 Males82.9124.163.851.444.1
 Females51.153.228.523.322.8
 Total64.382.644.035.431.5
Prostate 172.9275.3107.260.7127.6
Mortality
All Cancers      
 Males258.1369.0160.6154.5163.7
 Females171.2204.5104.4110.4105.7
 Total205.1267.3128.6128.6129.2
Breast (female) 29.337.313.114.817.5
Colon and rectum      
 Males26.734.816.514.616.6
 Females18.425.411.611.310.6
 Total21.929.113.712.813.2
Lung and bronchus      
 Males81.7113.042.349.338.2
 Females41.139.619.324.913.8
 Total57.968.929.335.524.1
Prostate 32.975.115.118.822.6

From 1992 through 1999, cancer incidence rates decreased by 1.6 percent per year among Hispanics, by 1.3 percent for African Americans, and by 0.9 percent for Whites; while rates remained relatively stable among American Indians/Alaska Natives, and Asian/Pacific Islanders (data not shown). Similarly, the annual mortality rate for all cancer types combined decreased 1.2 percent in African Americans, in Asian/Pacific Islanders, and among Hispanics, and 0.9 percent among Whites. Rates leveled off in American Indians/Alaska Natives. For race- and sex-specific trends, African-American men showed the largest decrease for mortality during the same calendar years.

Lifetime Probability of Developing Cancer

The lifetime probability of developing cancer is higher for men (43.5 percent) than for women (38.5 percent) (Table 10). However, because of breast cancer, women have a slightly higher probability of developing cancer before the age of 60.

Table TABLE 10. Probability of Developing Invasive Cancers Over Selected Age Intervals, by Sex, 1997 to 1999*
 Age Interval
  Birth to 39 (%)40 to 59 (%)60 to 79 (%)Birth to Death (%)
  1. *For those free of cancer at beginning of age interval. Based on cancer cases diagnosed during 1997 to 1999.

  2. †“All Cancers” excludes basal and squamous cell skin cancers and in situ cancers except urinary bladder.

  3. ‡Includes invasive and in situ cancer cases.

  4. Note: The “1 in” statistic and the inverse of the percentage may not be equivalent due to rounding.

  5. Source: Feuer EJ, Wun LM. DEVCAN, Probability of Developing or Dying of Cancer [software]. Version 4.2. Bethesda, MD: National Cancer Institute; 2002.

  6. American Cancer Society Surveillance Research, 2003.

All Cancers †Male1.39 (1 in 72)8.33 (1 in 12)32.26 (1 in 3)43.48 (1 in 2)
 Female1.96 (1 in 51)9.09 (1 in 11)22.22 (1 in 5)38.46 (1 in 3)
    Bladder ‡Male.02 (1 in 4,165).41 (1 in 241)2.33 (1 in 43)3.45 (1 in 29)
 Female.01 (1 in 9,637).13 (1 in 769).65 (1 in 154)1.14 (1 in 88)
    BreastFemale.44 (1 in 228)4.17 (1 in 24)7.14 (1 in 14)13.3 (1 in 8)
    Colon and RectumMale.06 (1 in 1,617).88 (1 in 114)4.00 (1 in 25)5.88 (1 in 17)
 Female.06 (1 in 1,630).69 (1 in 145)3.03 (1 in 33)5.56 (1 in 18)
    LeukemiaMale.16 (1 in 639).20 (1 in 496).83 (1 in 121)1.45 (1 in 69)
 Female.13 (1 in 794).15 (1 in 687).45 (1 in 224)1.02 (1 in 98)
Lung and BronchusMale.03 (1 in 3,347) 5.88 (1 in 17)1.09 (1 in 92)5.88 (1 in 17)7.69 (1 in 13)
 Female.03 (1 in 3,187).83 (1 in 120)4.00 (1 in 25)5.88 (1 in 17)
Melanoma of SkinMale.13 (1 in 791).50 (1 in 202).98 (1 in 102)1.75 (1 in 57)
 Female.20 (1 in 512).39 (1 in 256).51 (1 in 198)1.23 (1 in 81)
Non-Hodgkin LymphomaMale.15 (1 in 658).46 (1 in 218)1.25 (1 in 80)2.13 (1 in 47)
 Female.08 (1 in 1,250).32 (1 in 316).99 (1 in 101)1.79 (1 in 56)
    ProstateMale.005 (1 in 19,299)2.22 (1 in 45)13.70 (1 in 7)16.67 (1 in 6)
Uterine CervixFemale.17 (1 in 584).32 (1 in 314).28 (1 in 363).81 (1 in 123)
Uterine CorpusFemale.05 (1 in 1,881).73 (1 in 137)1.59 (1 in 63)2.70 (1 in 37)

Cancer Survival by Race

A poorer probability of survival once a cancer diagnosis is made contributes to the higher cancer death rates among African-American men and women. 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, and are more likely to be diagnosed with cancer at a regional or distant stage of disease. This is true for most of the common cancer types (Figure 6). Furthermore, for nearly every cancer type, African Americans have lower five-year relative survival rates than Whites at each stage of diagnosis (Figure 7), suggesting the possible influences of differences in receipt of quality health care, tumor pathology, and comorbid conditions. The extent to which these factors, individually or collectively, contribute to the overall difference in survival is not entirely clear. However, recent findings suggested that when African Americans receive equal heath care as compared with Whites, they tend to have similar disease outcomes.17

thumbnail image

Figure FIGURE 6. Distribution of Cancer Cases for Selected Cancer Types, by Race and Stage at Diagnosis, US, 1992 to 1998

*The rate for local stage represents local and regional stages combined.

Note: Staging according to Surveillance, Epidemiology, and End Results (SEER) historic stage categories rather than the American Joint Committee on Cancer (AJCC) staging system. For each type and race, stage categories do not total 100 percent because sufficient information is not available to assign a stage to all cancer cases.

Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002.

Download figure to PowerPoint

thumbnail image

Figure FIGURE 7. Five-Year Relative Survival Rates Among Patients Diagnosed with Selected Cancer Types, by Race and Stage at Diagnosis, US, 1992 to 1998

*The rate for local stage represents local and regional stages combined.

†The standard error is between 5 and 10 percentage points.

‡Data for regional and distant stage melanoma of the skin for African Americans are not shown.

Note: Staging according to Surveillance, Epidemiology, and End Results (SEER) historic stage categories rather than the American Joint Committee on Cancer (AJCC) staging system.

Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002.

Download figure to PowerPoint

There have been notable improvements over time in the probability of survival from most of the common cancer types and from all cancers combined (Table 11). This is true for both Whites and African Americans. Cancer sites without significant improvement in survival over the past 25 years include larynx, uterine cervix, lung and bronchus, and pancreas.

Table TABLE 11. Trends in Five-Year Relative Survival Rates* (%) by Race and Year of Diagnosis, US, 1974 to 1998
Relative Five-Year Survival Rate (%)
 WhiteAfrican AmericanAll Races
CANCER TYPE1974 to 19761983 to 19851992 to 19981974 to 19761983 to 19851992 to 19981974 to 19761983 to 19851992 to 1998
  1. *Survival rates are adjusted for normal life expectancy, and are based on cases diagnosed from 1992 to 1998, followed through 1999.

  2. †The difference in rates between 1974 to 1976 and 1992 to 1998 is statistically significant (p < 0.05).

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

  4. §The standard error of the survival rate is greater than 10 percentage points.

  5. Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002.

  6. American Cancer Society Surveillance Research, 2003.

All Cancers515464 †394053 †505262 †
Brain222632 †273240 †222732 †
Breast (female)757988 †636373 †757886 †
Uterine cervix707172 †646060696971 †
Colon515863 †464953 †505862 †
Uterine corpus898586 †615461888384 †
Esophagus5915 †468 †5813 †
Hodgkin disease727985 †697777 †717984 †
Kidney525662 †495560 †525662 †
Larynx666966 †605554666764
Leukemia354247 †313438344146 †
Liver467 †144 †467 †
Lung and bronchus131415 †111112 †121415 †
Melanoma of the skin808589 †67 ‡74 §66 ‡808589 †
Multiple myeloma242730 †283133242830 †
Non-Hodgkin lymphoma485456 †494546475455 †
Oral cavity555559 †363535535356 †
Ovary374053 †414253 †374153 †
Pancreas334 †354334 †
Prostate687698 †586493 †677597 †
Rectum495662 †424453 †495562 †
Stomach151621 †171920151722 †
Testis799196 †76 ‡88 ‡85799195 †
Thyroid929396 †889293929396 †
Urinary bladder747882 †486065 †737882 †

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 AND FUTURE CHALLENGES
  9. References

Cancer is the second leading cause of death among children between the ages of one and 14 in the United States; accidents are the most frequent cause of death in this age group (Table 12). The most commonly occurring cancers found in children are leukemias (in particular, acute lymphocytic leukemia), tumors of the central and sympathetic nervous systems, lymphomas, soft-tissue sarcomas, and renal tumors.8 Over the past 25 years, there have been significant improvements in the five-year relative survival rates for many childhood cancers, especially acute lymphocytic and acute myeloid leukemia, non-Hodgkin lymphoma, and Wilms Tumor (Table 13). Between the years 1974 to 1976 and 1992 to 1999, five-year relative survival rates among children for all cancer types combined improved from 56 to 77 percent.8

Table TABLE 12. Fifteen Leading Causes of Death Among Children Aged 1 to 14, US, 2000
RankCause of DeathNumber of DeathsPercent (%) of Total DeathsDeath Rate*
  1. *Rates are per 100,000 population and age adjusted to the 2000 US standard population.

  2. Note: Percentages may not total 100 percent due to rounding.

  3. Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

 All Causes12,392100.022.0
1Accidents (Unintentional Injuries)4,80538.88.5
2Cancer1,43411.62.5
3Congenital Anomalies8947.21.6
4Assault (Homicide)7275.91.3
5Heart Diseases4523.60.8
6Intentional Self-harm (Suicide)3072.50.5
7Chronic Lower Respiratory Diseases1901.50.3
8Pneumonia and Influenza1901.50.3
9Septicemia1621.30.3
10Cerebrovascular Diseases1230.90.2
11Anemias870.70.2
12Meningitis660.50.1
13HIV Disease600.50.1
14Complications of Medical and Surgical Care530.40.1
15Nephritis, Nephrotic Syndrome, and Nephrosis390.30.1
 All Others2,22518.0 
Table TABLE 13. Trends in Five-Year Relative Cancer Survival Rates* (%) for Children Under Age 15, US, 1974 to 1998
Five-Year Relative Survival Rates (%)
Year of Diagnosis
  1. *Survival rates are adjusted for normal life expectancy and are based on follow-up of patients through 1999.

  2. †The difference in rates between 1974 to 1976 and 1992 to 1998 is statistically significant (p < 0.05).

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

  4. Note: “All Cancers” excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

  5. Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002.

Cancer Type1974 to 19761977 to 19791980 to 19821983 to 19851986 to 19881989 to 19911992 to 1998
All Cancers56626568707377 †
Acute Lymphocytic Leukemia53677169788085 †
Acute Myeloid Leukemia1427 ‡24 ‡29 ‡30 ‡35 ‡46 †
Bones and Joints55 ‡52 ‡55 ‡5763 ‡6273 †
Brain and Other Nervous System55565662636270 †
Hodgkin Lymphoma78849190909494 †
Neuroblastoma53535355596869 †
Non-Hodgkin Lymphoma44506271707581 †
Soft Tissue60686576677872 †
Wilms Tumor74788787919390 †

LIMITATIONS AND FUTURE CHALLENGES

  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 AND FUTURE CHALLENGES
  9. References

Estimates of the expected numbers of new cancer cases and cancer deaths should be interpreted cautiously. These estimates may vary considerably from year to year, particularly for less common cancers and in states with smaller populations. Unanticipated changes may occur that are not captured by our modeling effort. The estimates of new cancer cases are based on incidence rates for the geographic locations that participate in the SEER program and, therefore, may not be representative of the entire United States. For these reasons, we discourage the use of the estimates to track year-to-year changes in cancer occurrence and death. The recorded number of cancer deaths and cancer death rates from the National Center for Health Statistics and cancer incidence rates from SEER are generally the preferred data sources for tracking cancer trends, even though these data are three and four years old, respectively, at the time that the estimates are calculated.

Despite these limitations, the American Cancer Society estimates do provide evidence of current patterns of cancer incidence and mortality in the United States. Such estimates will assist us in our continuing efforts to reduce the public health burden of cancer.

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 AND FUTURE CHALLENGES
  9. References
  • 1
    National Center for Health Statistics, Division of Vital Statistics, Centers for Disease Control. Available at: http://www.cdc.gov/nchs/nvss.htm. Accessed September, 2002
  • 2
    National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch. SEER Program Public Use Data Tapes 1973–1999, November 2001 Submission. Issued: April 2002
  • 3
    US Census Bureau. Available at: http://www.census.gov. Accessed September, 2002
  • 4
    Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. Vol 1, 10th revision. Geneva, Switzerland: World Health Organization; 1992.
  • 5
    Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. Vol 1, 9th revision. Geneva, Switzerland: World Health Organization; 1975.
  • 6
    PercyC, Van HoltenV, MuirC (eds). International Classification of Diseases for Oncology. 2nd ed. Geneva, Switzerland: World Health Organization; 1990.
  • 7
    Wingo PA, Landis S, Parker S, et al. Using cancer registry and vital statistics data to estimate the number of new cancer cases and deaths in the US for the upcoming year. J Reg Management 1998; 25:4351.
  • 8
    RiesLAG, EisnerMP, KosaryCL, et al. (eds). SEER Cancer Statistics Review, 1973–1999. National Cancer Institute, Bethesda, MD. Available at: http://seer.cancer.gov/csr/1973_1999/.
  • 9
    Edwards BK, Howe HL, Ries LAG, et al. Annual report to the nation on the status of cancer, 1973–1999, featuring implication of age and aging on US cancer burden. Cancer 2002; 94:27662792.
  • 10
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