Cancer Statistics, 2005

Authors

  • Dr. Ahmedin Jemal DVM, PhD,

    1. Jemal is Program Director, Cancer Occurrence, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
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  • Mr. Taylor Murray,

    1. Murray is Manager, Surveillance Data Systems, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
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  • Dr. Elizabeth Ward PhD,

    1. Ward is Director, Surveillance Research, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
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  • Ms. Alicia Samuels MPH,

    1. Samuels is Manager, Surveillance Information Services, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
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  • Dr. Ram C. Tiwari PhD,

    1. Tiwari is Mathematical Statistician, Statistical Research and Applications Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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  • Ms. Asma Ghafoor MPH,

    1. Ghafoor is Epidemiologist, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
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  • Dr. Eric J. Feuer PhD,

    1. Feuer is Branch Chief, Statistical Research and Applications Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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  • Dr. Michael J. Thun MD, MS

    1. Thun is Vice-President, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA
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Abstract

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 based on incidence data from the National Cancer Institute and mortality data from the National Center for Health Statistics. Incidence and death rates are age-standardized to the 2000 US standard million population. A total of 1,372,910 new cancer cases and 570,280 deaths are expected in the United States in 2005. When deaths are aggregated by age, cancer has surpassed heart disease as the leading cause of death for persons younger than 85 since 1999. When adjusted to delayed reporting, cancer incidence rates stabilized in men from 1995 through 2001 but continued to increase by 0.3% per year from 1987 through 2001 in women. The death rate from all cancers combined has decreased by 1.5% per year since 1993 among men and by 0.8% per year since 1992 among women. The mortality rate has also continued to decrease from the three most common cancer sites in men (lung and bronchus, colon and rectum, and prostate) and from breast and colorectal cancers in women. Lung cancer mortality among women has leveled off after increasing for many decades. In analyses by race and ethnicity, African American men and women have 40% and 20% higher death rates from all cancers combined than White men and women, respectively. Cancer incidence and death rates are lower in other racial and ethnic groups than in Whites and African Americans for all sites combined and for the four major cancer sites. However, these groups generally have higher rates for stomach, liver, and cervical cancers than Whites. Furthermore, minority populations are more likely to be diagnosed with advanced stage disease than are Whites. Progress in reducing the burden of suffering and death from cancer can be accelerated by applying existing cancer control knowledge across all segments of the population.

INTRODUCTION

Cancer is a major public health problem in the United States and other developed countries. Currently, one in four deaths in the United States is due to cancer. In this article, we provide an overview of cancer statistics, including updated incidence, mortality, and survival rates and expected number of new cancer cases and deaths in 2005.

MATERIALS AND METHODS

Data Sources

Mortality data from 1930 to 2002 were obtained from the National Center for Health Statistics (NCHS).1 Incidence data (1975 to 2001), 5-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 (NCI), covering about 10% to 14% of the US population.2–5, [3], [4], [5] Population data were obtained from the US Census Bureau.6 Causes of death were coded and classified according to the International Classification of Diseases (ICD-8, ICD-9, and ICD-10).7–9, [8], [9] Cancer cases were classified according to the International Classification of Diseases for Oncology.10

Estimated New Cancer Cases

The precise number of cancer cases diagnosed each year in the nation and in every state is unknown because complete cancer registration has not yet been achieved in many states. Consequently, for the national estimate we first estimated the number of new cancer cases occurring annually in the United States from 1979 through 2001 using age-specific cancer incidence rates collected by the SEER program2 and population data reported by the US Census Bureau.6 We then forecasted the number of cancer cases expected to be diagnosed in the United States in the year 2005 using an autoregressive quadratic time-trend model fitted to the annual cancer case estimates.11 For estimates of new cancer cases in individual states, we projected the number of deaths from cancer in each state in 2005 and assumed that the ratio of estimated cancer deaths to cases in each state equaled that in the United States.

Estimated Cancer Deaths

We used the state-space prediction method12 to estimate the number of cancer deaths expected to occur in the United States and in each state in the year 2005. Projections are based on underlying cause of death from death certificates as reported to the NCHS.1 This model projects the number of cancer deaths expected to occur in 2005 based on the number that occurred each year from 1969 to 2002 in the United States and in each state separately.

Other Statistics

We provide mortality statistics for the leading causes of death as well as deaths from cancer in the year 2002. Causes of death for 2002 were coded and classified according to ICD-10.7 This report also provides updated statistics on trends in cancer incidence and mortality rates, the probability of developing cancer, and 5-year relative survival rates for selected cancer sites based on data from 1973 through 2001.3 All age-adjusted incidence and death rates are standardized to the 2000 US standard population and expressed per 100,000 population.

The long-term incidence trends (1975 to 2001) presented in Table 4 are adjusted for delays in reporting. Delayed reporting affects the most recent 1 to 3 years of incidence data (in this case, 1999 to 2001), especially for cancers such as melanoma and prostate cancer that are frequently diagnosed in outpatient settings. The NCI has developed a method to account for expected reporting delays in SEER registries for all cancer sites combined and several specific cancer sites when long-term incidence trends are analyzed.13 Delay-adjusted trends provide a more accurate assessment of trends in the most recent years for which data are available.

SELECTED FINDINGS

Expected Numbers of New Cancer Cases

Table 1 presents the estimated number of new cancer cases expected among men and women in the United States in 2005. The estimate of about 1.4 million new cases of invasive cancer does not include carcinoma in situ of any site except urinary bladder, nor does it include basal and squamous cell cancers of the skin. More than 1 million cases of basal and squamous cell skin cancer, approximately 58,490 cases of breast carcinoma in situ, and 46,170 cases of in situ melanoma are expected to be newly diagnosed in 2005. The estimated numbers of new cancer cases for each state and selected cancer sites are shown in Table 2.

Table TABLE 1. Estimated New Cancer Cases and Deaths by Sex, United States, 2005*
 Estimated New CasesEstimated Deaths
Both SexesMaleFemaleBoth sexesMaleFemale 
  1. *Rounded to the nearest 10; excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

  2. About 58,490 carcinoma in situ of the breast and 46,170 melanoma in situ will be newly diagnosed in 2005.

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

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

  5. Source: Estimates of new cases are based on incidence rates from 1979 to 2001, National Cancer Institute's Surveillance, Epidemiology and End Results program, nine oldest registries. Estimates of deaths are based on data from US Mortality Public Use Data Tapes, 1969 to 2002, National Center for Health Statistics, Center for Disease Control and Prevention, 2004.

All Sites1,372,910710,040662,870570,280295,280275,000
Oral cavity & pharynx29,37019,10010,2707,3204,9102,410
    Tongue7,6605,0502,6101,7301,120610
    Mouth10,0705,3704,7001,8901,100790
    Pharynx8,5906,5202,0702,1301,490640
    Other oral cavity3,0502,1608901,5701,200370
Digestive system253,500134,370119,130136,06075,02061,040
    Esophagus14,52011,2203,30013,57010,5303,040
    Stomach21,86013,5108,35011,5506,7704,780
    Small intestine5,4202,8402,5801,070580490
    Colon104,95048,29056,66056,29028,54027,750
    Rectum40,34023,53016,810   
    Anus, anal canal, & anorectum3,9901,7502,240620230390
    Liver & intrahepatic bile duct17,55012,1305,42015,42010,3305,090
    Gallbladder & other biliary7,4803,3304,1503,3401,2702,070
    Pancreas32,18016,10016,08031,80015,82015,980
    Other digestive organs5,2101,6703,5402,4009501,450
Respiratory system184,800102,42082,380168,14093,99074,150
    Larynx9,8807,9201,9603,7702,960810
    Lung & bronchus172,57093,01079,560163,51090,49073,020
    Other respiratory organs2,3501,490860860540320
Bones & joints2,5701,4801,0901,210670540
Soft tissue (including heart)9,4205,5303,8903,4901,9101,580
Skin (excluding basal & squamous)66,00037,58028,42010,5906,9203,670
    Melanoma-skin59,58033,58026,0007,7704,9102,860
    Other nonepithelial skin6,4204,0002,4202,8202,010810
Breast212,9301,690211,24040,87046040,410
Genital system321,050241,57079,48059,92031,01028,910
    Uterine cervix10,370 10,3703,710 3,710
    Uterine corpus40,880 40,8807,310 7,310
    Ovary22,220 22,22016,210 16,210
    Vulva3,870 3,870870 870
    Vagina & other genital, female2,140 2,140810 810
    Prostate232,090232,090 30,35030,350 
    Testis8,0108,010 390390 
    Penis & other genital, male1,4701,470 270270 
Urinary system101,88071,09030,79026,59017,4209,170
    Urinary bladder63,21047,01016,20013,1808,9704,210
    Kidney & renal pelvis36,16022,49013,67012,6608,0204,640
    Ureter & other urinary organs2,5101,590920750430320
Eye & orbit2,1201,0901,030230110120
Brain & other nervous system18,50010,6207,88012,7607,2805,480
Endocrine system27,6507,55020,1002,3701,0801,290
    Thyroid25,6906,50019,1901,490630860
    Other endocrine1,9601,050910880450430
Lymphoma63,74033,05030,69020,61010,9309,680
    Hodgkin disease7,3503,9803,3701,410780630
    Non-Hodgkin lymphoma56,39029,07027,32019,20010,1509,050
Multiple myeloma15,9808,6007,38011,3005,6605,640
Leukemia34,81019,64015,17022,57012,54010,030
    Acute lymphocytic leukemia3,9702,1801,7901,490850640
    Chronic lymphocytic leukemia9,7305,7803,9504,6002,5202,080
    Acute myeloid leukemia11,9606,5305,4309,0005,0403,960
    Chronic myeloid leukemia4,6002,6401,960850430420
    Other leukemia4,5502,5102,0406,6303,7002,930
Other & unspecified primary sites28,59014,66013,93046,25025,37020,880
Table TABLE 2. Estimated New Cancer Cases for Selected Cancers by State, United States, 2005*
StateAll CasesFemale BreastUterine CervixColon & RectumUterine CorpusLeukemiaLung & BronchusMelanoma of the SkinNon-Hodgkin LymphomaProstateUrinary Bladder
  1. *Rounded to the nearest 10. Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

  2. †Estimate is fewer than 50 cases. Note: These estimates are offered as a rough guide and should be interpreted with caution. State estimates are calculated according to the distribution of estimated cancer deaths in 2005 by state. State estimates may not add to US total due to rounding and exclusion of state estimates fewer than 50 cases.

AL24,3203,8202002,3006705603,3409209404,360860
AK1,93026021060502208090310100
AZ23,8803,7602002,5005006202,8701,3001,0603,9001,200
AR14,9502,0901701,6303404002,5305406502,060620
CA135,03021,1701,09014,0704,2503,38015,1505,4405,70025,0106,380
CO16,0802,560801,6504504601,7509208802,680720
CT16,9202,7202201,6805004001,9506907303,360860
DE3,800630410110120490230210610190
DC2,820520340170503108090610190
FL96,20013,4307309,8602,5202,62013,1304,6003,47019,6504,890
GA35,6505,8503603,4808908204,8001,6101,3805,6601,530
HI4,79068060540170120510150260920190
ID5,490940605401701506303802101,150340
IL59,7309,3005006,6102,0101,6207,2202,3002,2009,4102,640
IN31,9004,6001703,4101,0108204,4101,4601,4104,8901,390
IA15,9102,3001101,7005004801,7905407603,060670
KS12,9301,990801,5703903501,6305406502,060720
KY23,0203,2902202,3505004803,6801,1509702,520910
LA23,2803,8702202,5805005403,0907701,0603,440770
ME7,7508908002201509903802601,300430
MD25,4504,3902202,7607806803,2101,0701,0304,2101,150
MA33,0304,9101103,5601,0107704,0101,5301,2605,3501,870
MI50,2207,2103404,8301,4501,2506,1101,8402,1407,6502,350
MN22,8903,2401102,2206706602,6201,0001,3804,3601,150
MS14,9702,3501401,6303403702,1804605303,210480
MO30,2104,5501703,2308408304,0701,4601,5303,0601,150
MT4,910680460170140620230210990240
NE8,3301,200601,0302802501,0003803801,380340
NV11,1201,620801,2402202601,5305404401,990530
NH6,3108906201701707903103201,150380
NJ43,0007,7403404,6701,7901,1004,8301,9201,7606,4202,060
NM7,780990608802801707603103201,680340
NY87,05014,4308409,7003,2402,1709,8703,2202,94014,2204,320
NC40,5206,3303104,1001,1709905,5201,9201,7606,8101,580
ND3,08052036011011033080180610140
OH59,6809,6703906,5001,8501,5107,7902,4501,97010,8603,070
OK18,4602,8201402,0104504602,5801,0006802,450820
OR17,7202,6101401,7604504202,1601,0001,0002,9801,010
PA71,84011,3403908,1302,5701,6308,4702,9902,88013,1503,600
RI5,87078060650110120720310290840340
SC21,8603,2901702,3005005102,8807709404,210860
SD3,900520460110110430150230920190
TN31,0804,2302803,1507307604,6301,3001,3504,2801,150
TX86,88012,8601,0309,2702,4002,25011,2103,8303,05013,3803,410
UT6,3801,1506702202204604603801,150290
VT3,03047034011090390150180460190
VA33,6806,0102003,5601,0108304,4001,6101,1705,7401,390
WA27,3503,9201102,6608907203,4401,3801,4105,5101,250
WV11,1901,4101101,2602802201,7004605001,450580
WI26,3404,130802,7608407703,0601,2301,1204,0501,340
WY2,380260280606028015090610100
US1,372,910211,24010,370145,29040,88034,810172,57059,58056,390232,09063,210

Figure 1 indicates the most common cancers expected to occur in men and women in 2005. Among men, cancers of the prostate, lung and bronchus, and colon and rectum account formore than 56% of all newly diagnosed cancers. Prostate cancer alone accounts for approximately 33% (232,090) of incident cases in men. Based on cases diagnosed between 1995 and 2000, about 90% of these estimated new cases of prostate cancer are expected to be diagnosed at local or regional stages, for which 5-year relative survival approaches 100%.

Figure FIGURE 1.

 

The three most commonly diagnosed cancers among women in 2005 will be cancers of the breast, lung and bronchus, and colon and rectum, accounting for approximately 55% of estimated cancer cases in women. Breast cancer alone is expected to account for 32% (211,240) of all new cancer cases among women.

Expected Number of New Cancer Deaths

Table 1 also shows the expected number of cancer deaths in 2005 for men, women, and both sexes combined. It is estimated that approximately 570,280 Americans will die from cancer, corresponding to more than 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 fatal cancers. These four cancers account for one-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 27% of all female cancer deaths in 2005. Table 3 provides the estimated number of cancer deaths in 2005 by state for selected cancer sites.

Table TABLE 3. Age-standardized Death Rates from All Cancers Combined and Estimated Cancer Deaths from All Causes and Selected Sites by State, United States, 2005*
STATEDeath Rate per 100,000All SitesBrain/Other Nervous SystemFemale BreastColon & RectumLeukemiaLiverLung & BronchusNon-Hodgkin LymphomaOvaryPancreasProstate
  1. *Rounded to the nearest 10; excludes in situ carcinomas except urinary bladder.

  2. †Average annual rates for 1997-2001 and age-adjusted to the 2000 US standard population.

  3. ‡Estimate is fewer than 50 deaths.

  4. Note: State estimates may not add to US total due to rounding and exclusion of state estimates for fewer than 50 deaths.

  5. Source: US Mortality Public Use Data Tapes, 1969 to 2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2004.

AL214.410,1002107308903602903,160320300530570
AK199.2800508021050
AZ176.59,9202407209704002902,720360290550510
AR211.56,2101604006302602002,400220160310270
CA183.756,0901,4604,0505,4502,1902,07014,3501,9401,7203,1503,270
CO172.26,6801804906403001701,660300220400350
CT191.57,0301405206502601701,850250200430440
DE217.41,58012016080460705010080
DC241.21,1701001302906080
FL191.039,9609302,5703,8201,7001,11012,4401,1801,1202,2502,570
GA205.114,8103001,1201,3505303404,550470420770740
HI158.01,990130210801004809050150120
ID179.82,28070180210100506007080130150
IL208.924,8104801,7802,5601,0506806,8407506501,4701,230
IN214.113,2503208801,3205302504,180480380690640
IA189.76,6101604406603101201,700260210390400
KS189.45,3701303806102301201,540220160290270
KY227.09,5601606309103202003,490330230420330
LA230.49,6701907401,0003503102,930360220520450
ME212.23,220801703101007094090100180170
MD211.110,5702008401,0704402603,040350310590550
MA205.413,7202809401,3805003703,800430380850700
MI203.920,8604501,3801,8708105305,7907305901,1401,000
MN187.59,5102506208604302102,480470270550570
MS222.36,2201704506302401502,070180160330420
MO207.912,5502608701,2505402903,860520340670400
MT195.02,0405013018090505907070100130
NE184.83,4609023040016060950130100180180
NV209.54,620903104801701201,450150120230260
NH205.22,620701702401107075011060140150
NJ208.317,8603201,4801,8107104104,5806005401,050840
NM171.93,2307019034011013072011090180220
NY194.136,1607202,7603,7601,4101,0109,3501,0001,0802,2701,860
NC204.916,8303401,2101,5906403805,230600470910890
ND184.71,28010014070310608080
OH212.424,7905301,8502,5209805707,3806706601,3001,420
OK206.27,6701705407803001702,440230180360320
OR198.97,3601905006802701602,050340240410390
PA207.129,8405202,1703,1501,0607308,0309808801,6701,720
RI208.42,44050150250806068010060140110
SC209.59,0801806308903302202,730320190510550
SD191.01,6205010018070410806090120
TN216.312,9103208101,2204903004,390460350680560
TX196.836,0909102,4603,5901,4601,28010,6201,0409601,9501,750
UT151.02,650902202601406044013090170150
VT200.81,2609013060370607060
VA207.113,9902701,1501,3805403404,170400400750750
WA195.311,3603507501,0304703403,260480390690720
WV223.34,650902704901401101,610170140200190
WI194.310,9402607901,0705002902,900380320650530
WY190.8990501102705080
US199.8570,28012,76040,41056,29022,57015,420163,51019,20016,21031,80030,350

Trends in Cancer Incidence and Mortality

Figures 2 through 5, FIGURE 4 depict long-term trends in cancer incidence and death rates for all cancers combined and for selected cancer sites by sex. Table 4 shows incidence and mortality patterns for all cancer sites and for the four most common cancer sites based on joinpoint analysis. Trends in incidence were adjusted for delayed reporting in the table (joinpoint analysis) but not in the figures (Figures 2 and 3). Death rates from all cancers combined decreased by 1.5% per year from 1993 to 2001 in males and by 0.8% per year in females from1992 to 2001 (Table 4). Delay-adjusted cancer incidence rates stabilized in men from 1995 to 2001 and increased by 0.3% per year from 1987 to 2001 in women (Table 4).

Table TABLE 4. Trends in Cancer Incidence and Death Rates for Selected Cancers by Sex, All Races, 1975 to 2001
 Line Segment 1Line Segment 2Line Segment 3Line Segment 4
YearAPC*YearAPC*YearAPC*YearAPC* 
  1. *APC, annual percent change based on rates age-adjusted to the 2000 standard population.

  2. †The APC is significantly different from zero.

  3. Note: Trends were analyzed by Joinpoint Regression Program, version 2.7, with a maximum of three joinpoints (ie, four line segments). Trends in incidence are based on rates adjusted for delay in reporting.

  4. Source: Ries LAG, Eisner MP, Kosary CL, et al.3

All Cancers        
    Incidence        
        Male and female1975–19891.21989–19922.81992–1995−2.11995–20010.4
        Male1975–19891.31989–19925.21992–1995−4.71995–20010.2
        Female1975–1979−0.21979–19871.51987–20010.3  
    Death        
        Male and female1975–19900.51990–1993−0.31993–2001−1.1  
        Male1975–19791.01979–19900.31990–1993−0.41993–2001−1.5
        Female1975–19920.51992–2001−0.8    
Lung & bronchus        
    Incidence        
        Male and female1975–19822.51982–19911.01991–2001−0.8  
        Male1975–19821.41982–1991−0.41991–2001−1.9  
        Female1975–19825.51982–19903.51990–19981.11998–2001−1.3
    Death        
        Male and female1975–19803.01980–19901.81990–1995−0.21995–2001−1.0
        Male1975–19821.81982–19910.41991–2001−1.9  
        Female1975–19826.01982–19904.21990–19951.71995–20010.2
Colon & rectum        
    Incidence        
        Male and female1975–19850.81985–1995−1.81995–19981.31998–2001−2.4
        Male1975–19861.11986–1995−2.11995–19981.11998–2001−2.9
        Female1975–19850.31985–1995−1.91995–19981.81998–2001−2.3
    Death        
        Male and female1975–1984−0.51984–2001−1.8    
        Male1975–1984−0.11984–1990−1.41990–2001−2.0  
        Female1975–1984−1.01984–2001−1.8    
Female breast        
    Incidence1975–1980−0.41980–19873.71987–20010.5  
    Death1975–19900.41990–2001−2.3    
Prostate        
    Incidence1975–19882.61988–199216.51992–1995−11.51995–20012.0
    Death1975–19870.91987–19913.01991–1994−0.61994–2001−4.1
Figure FIGURE 2.

 

Figure FIGURE 3.

 

Figure FIGURE 4.

 

Figure FIGURE 5.

 

Mortality rates have continued to decrease across all four major cancer sites in men and in women except for female lung cancer in which rates have leveled off for the first time after increasing for many decades (Table 4). The incidence trends are mixed, however. Lung cancer incidence rates are declining in men and leveled off for the first time in women after increasing for many decades. Colorectal cancer incidence rates have decreased from 1998 through 2001 both in males and in females. The incidence rates of prostate cancer and female breast cancer have continued to increase, although at a slower rate than in previous years. The continuing increase may be attributable to increased screening through prostate-specific antigen testing (for prostate cancer) and mammography (for breast cancer). The increase in female breast cancer incidence may also reflect increased use of hormone replacement therapy and/or increased prevalence of obesity.14

Changes in the Recorded Number of Deaths From Cancer From 2001 to 2002

A total of 557,271 cancer deaths were recorded in the United States in 2002, the most recent year for which actual data are available. More than 3,500 additional cancer deaths were recorded in 2002 than in 2001, predominantly because of growth and aging of the population. Cancer accounted for approximately 23% of all deaths, ranking second only to heart disease (Table 5). When age-adjusted death rates are considered (Figure 6), cancer is the leading cause of death among men and women under age 85. A total of 476,009 people under age 85 died from cancer in the United States in 2002 compared with 450,637 deaths from heart disease. When cause of death is ranked within each age group, categorized in 20-year age intervals, cancer is one of the five leading causes of death in each age group among both males and females. Cancer is the leading cause of death among women aged 40 to 79 and among men aged 60 to 79 (Table 6).

Table TABLE 5. Fifteen Leading Causes of Death, United States, 2002
RankCauses 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 due to rounding. Symptoms, signs, and abnormalities and pneumonitis due to solids and liquids were excluded from the cause of death ranking order.

  3. Source: US Mortality Public Use Data Tape, 2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2004.

 All causes2,443,387 843.6
1Heart diseases696,94728.5240.1
2Cancer557,27122.8193.4
3Cerebrovascular diseases162,6726.756.0
4Chronic lower respiratory diseases124,8165.143.4
5Accidents (unintentional injuries)106,7424.436.8
6Diabetes mellitus73,2493.025.4
7Influenza & pneumonia65,6812.722.5
8Alzheimer disease58,8662.420.1
9Nephritis, nephrotic syndrome, & nephrosis40,9741.714.2
10Septicemia33,8651.411.7
11Intentional self-harm (suicide)31,6551.310.9
12Chronic liver disease & cirrhosis27,2571.19.4
13Hypertension and hypertensive renal disease20,2610.87.0
14Assault (homicide)17,6380.76.1
15Parkinson disease16,9590.75.9
 All other & ill-defined causes408,534  
Figure FIGURE 6.

 

Table TABLE 6. Ten Leading Causes of Death, by Age and Sex, United States, 2002
 All AgesAges 1 to 19Ages 20 to 39Ages 40 to 59Ages 60 to 79Ages 80+
MaleFemaleMaleFemaleMaleFemaleMaleFemaleMaleFemaleMaleFemale 
  1. Note: Symptoms, signs, and abnormalities and events of undetermined intent were excluded from the cause of death ranking order.

  2. Source: US Mortality Public Use Data Tapes, 2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2004.

 All Causes 1,199,264All Causes 1,244,123All Causes 16,848All Causes 8,972All Causes 65,934All Causes 30,002All Causes 212,519All Causes 131,100All Causes 488,179All Causes 402,852All Causes 399,785All Causes 658,805
1Heart diseases 340,933Heart diseases 356,014Accidents (unintentional injuries) 7,718Accidents (unintentional injuries) 3,778Accidents (unintentional injuries) 21,627Accidents (unintentional injuries) 6,859Heart diseases 54,028Cancer 49,570Cancer 156,527Cancer 129,699Heart diseases 136,941Heart diseases 231,969
             
2Cancer 288,768Cancer 268,503Assault (homicide) 2,035Cancer 957Intentional self-harm (suicide) 8,771Cancer 5,403Cancer 52,489Heart diseases 21,677Heart diseases 143,570Heart diseases 99,160Cancer 73,839Cancer 82,840
             
3Accidents (unintentional injuries) 69,257Cerebro-vascular disease 100,050Intentional self-harm (suicide) 1,479Assault (homicide) 636Assault (homicide) 7,827Heart diseases 2,640Accidents (unintentional injuries) 20,224Accidents (unintentional injuries) 8,076Chronic lower respiratory diseases 31,438Chronic lower respiratory diseases 29,905Cerebro-vascular diseases 30,688Cerebro-vascular diseases 67,702
             
4Cerebro-vascular disease 62,622Chronic lower respiratory diseases 64,103Cancer 1,240Congenital anomalies 552Heart diseases 5,590Intentional self-harm (suicide) 1,913Intentional self-harm (suicide) 9,325Cerebro-vascular diseases 5,536Cerebro-vascular disease 24,573Cerebro-vascular diseases 25,934Chronic lower respiratory diseases 24,411Alzheimer disease 35,225
             
5Chronic lower respiratory diseases 60,713Alzheimer disease 41,877Congenital anomalies 643Heart diseases 322Cancer 4,626Assault (homicide) 1,723Chronic liver disease & cirrhosis 9,082Diabetes mellitus 4,675Diabetes mellitus 16,886Diabetes mellitus 17,038Influenza & pneumonia 16,980Chronic lower respiratory diseases 29,619
             
6Diabetes mellitus 34,301Diabetes mellitus 38,948Heart disease 503Intentional self-harm (suicide) 298HIV disease 3,206HIV disease 1,391Diabetes mellitus 6,719Chronic lower respiratory diseases 4,089Accidents (unintentional injuries) 10,825Influenza & pneumonia 7,508Alzheimer disease 12,384Influenza & pneumonia 27,094
             
7Influenza & pneumonia 28,918Accidents (unintentional injuries) 37,485Chronic lower respiratory diseases 186Influenza & pneumonia 134Diabetes mellitus 905Cerebro-vascular disease 740HIV disease6,450Chronic liver disease & cirrhosis 3,617Influenza & pneumonia8,960Nephritis, nephrotic syndrome & nephrosis 7,375Diabetes mellitus 9,737Diabetes mellitus 16,566
             
             
8Intentional self-harm (suicide) 25,409Influenza & pneumonia 36,763Influenza & pneumonia 142Chronic lower respiratory diseases 108Chronic liver disease & cirrhosis 852Diabetes mellitus 629Cerebro-vascular diseases 6,440Intentional self-harm (suicide) 2,879Nephritis, nephrotic syndrome & nephrosis 8,077Accidents (unintentional injuries) 6,987Nephritis, nephrotic syndrome & nephrosis 9,030Nephritis, nephrotic syndrome & nephrosis 11,784
             
             
9Nephritis, nephrotic syndrome & nephrosis 19,695Nephritis, nephrotic syndrome & nephrosis 21,279Septecemia 115Septicemia 108Cerebro-vascular disease 742Chronic liver disease & cirrhosis 475Chronic lower respiratory diseases 4,274HIV disease 1,998Septicemia 6,611Septicemia 6,781Accidents (unintentional injuries) 8,236Accidents (unintentional injuries) 11,381
             
10Chronic liver disease & cirrhosis 17,401Septicemia 18,918Cerebro-vascular disease 111In Situ/Benign unknown neoplasms 90Congenital anomalies 552Congenital anomalies 431Assault (homicide) 2,875Septicemia 1,938Chronic Liver disease & cirrhosis 6,313Alzheimer disease 6,542Parkinson disease 5,805Septicemia 9,614

Table 7 presents the number of deaths from all cancers combined and the five most common cancer sites for males and females at various ages. Among men under age 40, 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 cause of cancer death among men 40 to 79 years old, and prostate cancer is the second most common among men aged 80 and older. Among women, leukemia is the leading cause of cancer death before age 20, breast cancer ranks first at ages 20 to 59 years, and lung cancer ranks first at age 60 years and older.

Table TABLE 7. Reported Deaths for the Five Leading Cancer Sites, by Age and Sex, United States, 2002
All Ages<2020 to 3940 to 5960 to 79≥80
  1. *ONS, other nervous system.

  2. Note: Others and Unspecified Primary are excluded from cause of death ranking order.

  3. Source: US Mortality Public Use Data Tapes, 2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2004.

Male
All Sites 288,768All Sites 1,282All Sites 4,626All Sites 52,489All Sites 156,527All Sites 73,839
Lung & bronchus 90,121Leukemia 382Leukemia 599Lung & bronchus 16,044Lung & bronchus 55,996Lung & bronchus 17,681
      
Prostate 30,446Brain & ONS* 327Brain & ONS* 516Colon & rectum 5,257Colon & rectum 14,973Prostate 15,795
      
Colon & rectum 28,472Other endocrine system 104Colon & rectum 413Pancreas 3,195Prostate 13,539Colon & rectum 7,820
      
Pancreas 14,877Bones & joints 96Non-Hodgkin lymphoma 401Liver & bile duct 2,733Pancreas 8,312Leukemia 3,409
      
Leukemia 12,058Soft tissue 82Lung & bronchus 394Esophagus 2,470Leukemia 5,919Urinary bladder 3,331
Female
All Sites 268,503All Sites 989All Sites 5,403All Sites 49,570All Sites 129,699All Sites 82,840
Lung & bronchus 67,509Leukemia 296Breast 1,331Breast 12,115Lung & bronchus 39,943Lung & bronchus 16,064
      
Breast 41,514Brain & ONS* 244Uterine cervix 499Lung & bronchus 11,129Breast 17,218Colon & rectum 12,030
      
Colon & rectum 28,132Other endocrine system 88Leukemia 433Colon & rectum 3,857Colon & rectum 11,904Breast 10,849
      
Pancreas 15,387Bones & joints 83Lung & bronchus 370Ovary 3,285Pancreas 7,869Pancreas 5,436
      
Ovary 14,682Soft tissue 71Brain & ONS* 349Pancreas 1,999Ovary 7,349Non-Hodgkin lymphoma 4,029

From 2001 to 2002, the number of recorded cancer deaths increased by 1,693 in men and by 1,810 in women (Table 8). The total number of deaths for the major cancers in men and women did not change substantially except for lung cancer (increased by 1,903) and colorectal cancer (decreased by 447) among women.

Table TABLE 8. Trends in the Recorded Number of Cancer Deaths for Selected Cancers, by Sex, United States, 1989 to 2002
YearAll SitesLung and BronchusColon and RectumProstateBreast
MaleFemaleMaleFemaleMaleFemaleMaleFemale 
  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 2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2004.

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
2001287,075266,69390,36765,60628,22928,57930,71941,394
2002288,768268,50390,12167,50928,47228,13230,44641,514

CANCER OCCURRENCE BY RACE AND ETHNICITY

Cancer incidence and death rates vary considerably among racial and ethnic groups (Table 9). For all cancer sites combined, African American men have a 24% higher incidence rate and 40% higher death rate than Whites. African American women have a lower incidence rate but nearly 20% higher death rate than Whites for all cancer sites combined. For the specific cancer sites listed in Table 9, incidence and death rates are consistently higher in African Americans than in Whites, except for breast cancer (incidence) and lung cancer (mortality) among women. Death rates from prostate, stomach, and cervical cancers among African Americans are more than twice the rates in Whites. Factors that contribute to these mortality differences include differences in exposure (eg, Helicobacter pylori for stomach cancer), access to regular screening (breast, cervical, and colorectal cancers), and timely, high quality treatments (many cancers). The higher breast cancer incidence rates among Whites are thought to reflect a combination of more frequent mammography, which makes diagnosis more likely, delayed age at first birth, and historically greater use of hormone replacement therapy.14

Table TABLE 9. Age-standardized Incidence and Death Rates* for Selected Cancer Sites by Race and Ethnicity, United States, 1997 to 2001
 All RacesWhiteAfrican AmericanAsian American/Pacific IslanderAmerican Indian/Alaskan NativeHispanic-Latino
  1. *Rates are per 100,000 and age-adjusted to the 2000 US standard population.

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

  3. Source: Ries LAG, Eisner MP, Kosary CL, et al.3

Incidence Rates
All sites      
    Male554.3556.5689.2385.9263.2419.8
    Female414.4429.8400.1302.8222.5309.9
Breast (Female)135.2141.7119.996.854.289.6
Colon & rectum      
    Male63.463.172.956.338.349.6
    Female46.445.956.538.632.732.5
Lung & bronchus      
    Male79.177.9117.260.546.045.2
    Female49.151.354.528.523.423.9
Prostate172.3167.4271.3100.751.2140.0
Stomach      
    Male12.610.818.821.915.717.8
    Female6.15.09.912.48.910.0
Liver & bile duct      
    Male9.17.211.821.18.313.5
    Female3.52.93.97.74.85.8
Uterine cervix9.38.911.89.56.016.2
       
Death Rates
All sites      
    Male251.1245.5347.3151.2167.0174.0
    Female166.7165.5196.5100.5113.4111.6
Breast (female)27.026.435.412.613.617.3
Colon & rectum      
    Male25.324.834.315.817.118.0
    Female17.717.124.510.811.711.6
Lung & bronchus      
    Male77.976.6104.140.249.839.6
    Female40.841.639.919.226.614.9
Prostate31.528.870.413.020.223.5
Stomach      
    Male6.65.813.311.97.39.7
    Female3.32.86.37.04.15.3
Liver & bile duct      
    Male6.76.19.315.68.310.6
    Female2.92.73.86.64.35.1
Uterine cervix2.92.65.62.82.83.6

Among other racial and ethnic groups, cancer incidence and death rates are lower for all cancer sites combined and for the four most common cancer sites than those for Whites and African Americans. However, incidence and death rates for cancers of the uterine cervix, stomach, and liver are generally higher in minority population than in Whites. Stomach and liver cancer incidence and death rates are more than twice as high in Asian/Pacific Islanders than in Whites, reflecting increased exposure to infectious agents such as H pylori and hepatitis C virus.15

Historical information to adjust for delays in reporting is not available for all racial and ethnic groups. From 1992 to 2001, incidence rates for all cancer sites combined, not adjusted for delayed reporting, decreased by 2.8% per year among American Indians/Alaskan Natives, by 1.2% per year in African Americans, by 0.7% among Asian/Pacific Islanders, by 0.6% among Hispanic-Latinos, and by 0.5% among Whites (data not shown). Similarly, the death rate from all cancers combined decreased from 1992 through 2001 by 1.6% per year in Asian/Pacific Islanders, by 1.4% among African Americans, by 0.9% among Whites, and by 0.5% among Hispanic-Latinos. The death rate from all cancers combined stabilized during this time period among American Indians/Alaskan Natives.3

Lifetime Probability of Developing Cancer

The lifetime probability of developing cancer is higher for men (46%) than for women (38%) (Table 10). However, because of the relatively early age of onset of breast cancer, women have a slightly higher probability of developing cancer before the age of 60. It is noteworthy that these estimates are based on the average experience of the general population and may overestimate or underestimate individual risk because of differences in exposure and/or genetic susceptibility.

Table TABLE 10. Probability of Developing Invasive Cancers Within Selected Age Intervals, by Sex, United States, 1999 to 2001*
  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 1999 to 2001.

  2. †The “1 in” statistic and the inverse of the percentage may not be equivalent due to rounding.

  3. ‡All sites exclude basal and squamous cell skin cancers and in situ cancers except urinary bladder.

  4. Source: DEVCAN Software, Probability of Developing or Dying of Cancer Software, Version 5.2. Statistical Research and Applications Branch, National Cancer Institute, 2005. http://srab.cancer.gov/devcan.

All sitesMale1.41 (1 in 71)8.52 (1 in 12)34.63 (1 in 3)45.59 (1 in 2)
 Female1.97 (1 in 51)9.10 (1 in 11)22.51 (1 in 4)38.18 (1 in 3)
Urinary bladderMale0.02 (1 in 4264)0.41 (1 in 243)2.42 (1 in 41)3.56 (1 in 28)
 Female0.01 (1 in 8876)0.12 (1 in 804)0.65 (1 in 153)1.13 (1 in 88)
BreastFemale0.48 (1 in 207)4.18 (1 in 24)7.49 (1 in 13)13.39 (1 in 7)
Colon & rectumMale0.07 (1 in 1484)0.90 (1 in 111)3.96 (1 in 25)5.90 (1 in 17)
 Female0.06 (1 in 1586)0.69 (1 in 145)3.04 (1 in 33)5.54 (1 in 18)
LeukemiaMale0.15 (1 in 659)0.22 (1 in 461)0.85 (1 in 118)1.47 (1 in 68)
 Female0.13 (1 in 799)0.14 (1 in 697)0.48 (1 in 206)1.04 (1 in 96)
Lung & bronchusMale0.03 (1 in 3164)1.06 (1 in 95)5.75 (1 in 17)7.63 (1 in 13)
 Female0.03 (1 in 2977)0.81 (1 in 123)3.91 (1 in 26)5.71 (1 in 18)
Melanoma of the skinMale0.13 (1 in 795)0.51 (1 in 195)1.08 (1 in 93)1.89 (1 in 53)
 Female0.21 (1 in 484)0.40 (1 in 248)0.53 (1 in 190)1.28 (1 in 78)
Non-Hodgkin lymphomaMale0.14 (1 in 724)0.46 (1 in 217)1.32 (1 in 76)2.18 (1 in 46)
 Female0.09 (1 in 1147)0.31 (1 in 328)1.00 (1 in 100)1.80 (1 in 56)
ProstateMale0.01 (1 in 9879)2.58 (1 in 39)14.76 (1 in 7)17.81 (1 in 6)
Uterine cervixFemale0.16 (1 in 636)0.29 (1 in 340)0.27 (1 in 368)0.77 (1 in 130)
Uterine corpusFemale0.06 (1 in 1632)0.72 (1 in 139)1.57 (1 in 64)2.62 (1 in 38)

Cancer Survival by Race

African American men and women have poorer probability of survival once a cancer diagnosis is made. As shown in Figure 7, 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. Five-year relative survival is lower in African Americans than in Whites at each stage of diagnosis for nearly every cancer site (Figure 8). These disparities may result from inequalities in access to and receipt of quality health care and/or from differences in comorbidities. The extent to which these factors, individually or collectively, contribute to the overall differential survival is unclear.16 However, recent findings suggest that when African Americans receive similar cancer treatment and medical care as Whites they tend to have similar disease outcomes.17

Figure FIGURE 7.

 

Figure FIGURE 8.

 

There have been notable improvements over time in the relative 5-year survival rates for the common cancer sites and all cancers combined (Table 11).3 This is true for both Whites and African Americans. Cancer sites for which survival has not improved substantially over the past 25 years include uterine corpus, uterine cervix, larynx, liver, lung, pancreas, stomach, and esophagus.

Table TABLE 11. Trends in Five-year Relative Survival Rates* (%) for Selected Cancer Sites, by Race and Year of Diagnosis, United States, 1974 to 2000
SiteRelative Five-year Survival Rate (%)
 WhiteAfrican AmericanAll Races
1974 to 19761983 to 19851995 to 20001974 to 19761983 to 19851995 to 20001974 to 19761983 to 19851995 to 2000 
  1. *Survival rates are adjusted for normal life expectancy and are based on cases diagnosed from 1974 to 1976, 1983 to 1985, and 1995 to 2000, and followed through 2001.

  2. †The difference in rates between 1974 to 1976 and 1995 to 2000 is statistically significant (P < 0.05).

  3. ‡ONS, other nervous system.

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

  5. ¶The standard error of the survival rate is greater than 10 percentage points.

  6. **Recent changes in classification of ovarian cancer, namely excluding borderline ovarian tumors, have affected 1995-2000 survival rates.

  7. Source: Ries LAG, Eisner MP, Kosary CL, et al.3

All Cancers515466394055505364
Brain & ONS222632273238222733
Breast (female)757989636475757888
Colon515964465054505863
Esophagus59164695814
Hodgkin disease727986697780717985
Kidney & renal pelvis525664495564525664
Larynx666967605551666765
Leukemia354248313439344146
Liver & bile duct468145468
Lung & bronchus131415121113131415
Melanoma of the skin81859167§7574§808591
Myeloma242732283132252832
Non-Hodgkin lymphoma485560494551475459
Oral cavity & pharynx555561363539545359
Ovary**374044414238374144
Pancreas334354334
Prostate6876100586496677599
Rectum495665424455495564
Stomach151622161924151723
Testis79919676§88§87799196
Thyroid929397889295929497
Urinary bladder747883486062737882
Uterine cervix707174646166696973
Uterine corpus898586625463888384

Relative survival rate cannot be calculated for other racial and ethnic groups because accurate life expectancies are not available. However, based on cause-specific survival rates of cancer patients diagnosed from 1992 to 2000 in SEER areas of the United States, all minority populations except Asian/Pacific Islander women have an elevated probability of dying from all cancers combined within 5 years of diagnosis compared with non-Hispanic Whites after accounting for differences in age at diagnosis.18,19, [19] For the four major cancer sites (prostate, female breast, lung and bronchus, and colon and rectum), minority populations are more likely to be diagnosed at distant stage compared with non-Hispanic Whites.19

CANCER IN CHILDREN

Cancer is the second leading cause of death among children between the ages of 1 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 in children (0 to 14 years) are leukemia (particularly acute lymphocytic leukemia), brain and other nervous system cancers, soft tissue sarcomas, non-Hodgkin lymphoma, and renal (Wilms) tumor.3 Over the past 25 years, there have been significant improvements in the 5-year relative survival rate for many childhood cancers, including non-Hodgkin lymphoma, acute lymphocytic leukemia, acute myeloid leukemia, and Wilms tumor (Table 13).3 The 5-year relative survival rate among children for all cancer sites combined improved from 56% for patients diagnosed in 1974 to 1976 to 79% for those diagnosed in 1995 to 2000.3

Table TABLE 12. Fifteen Leading Causes of Death Among Children Aged 1 to 14, United States, 2002
RankCause of DeathNumber of DeathsPercent (%) of Total Deaths*Death Rate
  1. *Percentages may not total 100 due to rounding. Symptoms, signs, and abnormalities, events of undetermined intent, certain perinatal conditions, and complications from treatment were excluded from ranking order.

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

  3. Source: US Mortality Public Use Data Tapes, 2002, National Center for Health Statistics, Centers for Disease Control and Prevention, 2004.

 All Causes12,008100.021.2
1Accidents (unintentional injuries)4,35936.37.7
2Cancer1,47412.32.6
3Congenital anomalies9477.91.7
4Assault (homicide)7796.51.4
5Heart diseases4203.50.7
6Intentional self-harm (suicide)2642.20.5
7Chronic lower respiratory disease2011.70.4
8Influenza & pneumonia2011.70.4
9Septicemia1741.40.3
10In situ & benign neoplasms1491.20.3
11Cerebrovascular disease1441.20.3
12Anemias740.60.1
13Meningitis500.40.1
14Diabetes mellitus370.30.1
15Nephritis, nephrotic syndrome, & nephrosis350.30.1
 All other causes2,70022.5 
Table TABLE 13. Trends in Five-year Relative Cancer Survival Rates* (%) for Children Under Age 15, United States, 1974 to 2000
SiteFive-year Relative Survival Rates (%)
Year of Diagnosis 
1974 to 19761977 to 19791980 to 19821983 to 19851986 to 19881989 to 19911995 to 2000 
  1. *Survival rates are adjusted for normal life expectancy and are based on follow-up of patients through 2001.

  2. †The difference in rates between 1974 to 1976 and 1995 to 2000 is statistically significant (P < 0.05).

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

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

  5. Source: Ries LAG, Eisner MP, Kosary CL, et al.3

All sites56626568717379
Acute lymphocytic leukemia53677169788085
Acute myeloidleukemia14262530333653
Bones & joints55525457636273
Brain & other nervous system55565662636273
Hodgkin disease78849190909496
Neuroblastoma53535355606866
Non-Hodgkin lymphoma45506171707585
Soft tissue60686570677875
Wilms tumor74788687919392

LIMITATIONS AND FUTURE CHALLENGES

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 efforts. 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 these estimates to track year-to-year changes in cancer occurrence and mortality. The recorded number of cancer deaths and cancer death rates from the NCHS and cancer incidence rates from SEER are generally the preferred data sources for tracking cancer trends, even though these data are 3 and 4 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 in continuing efforts to reduce the public health burden of cancer.

Ancillary