Volume 53, Issue 1 p. 5-26
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Cancer Statistics, 2003

Dr. Ahmedin Jemal PhD, DVM

Dr. Ahmedin Jemal PhD, DVM

Jemal is Program Director, Cancer Occurrence, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA

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Mr. Taylor Murray

Mr. Taylor Murray

Murray is Manager, Surveillance Data Systems, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA

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Ms. Alicia Samuels MPH

Ms. Alicia Samuels MPH

Samuels is Manager, Surveillance Information Services, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA

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Ms. Asma Ghafoor MPH

Ms. Asma Ghafoor MPH

Ghafoor is Epidemiologist, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA

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Dr. Elizabeth Ward PhD

Dr. Elizabeth Ward PhD

Ward is Director, Surveillance Research, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA

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Dr. Michael J. Thun MD, MS

Dr. Michael J. Thun MD, MS

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

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First published: January/February 2003
Citations: 2,727

This article is available online at: http://CAonline.AmCancerSoc.org

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 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

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

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

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 Cases Estimated Deaths
Both Sexes Male Female Both Sexes Male Female
All Cancers 1,334,100 675,300 658,800 556,500 285,900 270,600
Oral cavity and pharynx 27,700 18,200 9,500 7,200 4,800 2,400
    Tongue 7,100 4,700 2,400 1,700 1,100 600
    Mouth 9,200 4,800 4,400 1,900 1,100 800
    Pharynx 8,300 6,300 2,000 2,000 1,400 600
    Other oral cavity 3,100 2,400 700 1,600 1,200 400
Digestive system 252,400 132,300 120,100 133,600 71,900 61,700
    Esophagus 13,900 10,600 3,300 13,000 9,900 3,100
    Stomach 22,400 13,400 9,000 12,100 7,000 5,100
    Small intestine 5,300 2,700 2,600 1,100 600 500
    Colon 105,500 49,000 56,500 57,100† 28,300† 28,800†
    Rectum 42,000 23,800 18,200
    Anus, anal canal, and anorectum 4,000 1,700 2,300 500 200 300
    Liver and intrahepatic bile duct 17,300 11,700 5,600 14,400 9,200 5,200
    Gallbladder and other biliary 6,800 3,100 3,700 3,500 1,300 2,200
    Pancreas 30,700 14,900 15,800 30,000 14,700 15,300
    Other digestive organs 4,500 1,400 3,100 1,900 700 1,200
Respiratory system 185,800 102,200 83,600 163,700 93,400 70,300
    Larynx 9,500 7,100 2,400 3,800 3,000 800
    Lung and bronchus 171,900 91,800 80,100 157,200 88,400 68,800
    Other respiratory organs 4,400 3,300 1,100 2,700 2,000 700
Bones and joints 2,400 1,300 1,100 1,300 700 600
Soft tissue (including heart) 8,300 4,500 3,800 3,900 2,000 1,900
Skin (excluding basal and squamous) 58,800 32,300 26,500 9,800 6,200 3,600
    Melanoma-skin 54,200 29,900 24,300 7,600 4,700 2,900
    Other non-epithelial skin 4,600 2,400 2,200 2,200 1,500 700
Breast 212,600 1,300 211,300 40,200 400 39,800
Genital system 313,600 229,900 83,700 56,300 29,500 26,800
   Uterine cervix 12,200 12,200 4,100 4,100
    Uterine corpus 40,100 40,100 6,800 6,800
    Ovary 25,400 25,400 14,300 14,300
    Vulva 4,000 4,000 800 800
    Vagina and other genital, female 2,000 2,000 800 800
    Prostate 220,900 220,900 28,900 28,900
    Testis 7,600 7,600 400 400
    Penis and other genital, male 1,400 1,400 200 200
Urinary system 91,700 63,300 28,400 25,100 16,400 8,700
    Urinary bladder 57,400 42,200 15,200 12,500 8,600 3,900
    Kidney and renal pelvis 31,900 19,500 12,400 11,900 7,400 4,500
    Ureter and other urinary organs 2,400 1,600 800 700 400 300
Eye and orbit 2,200 1,100 1,100 200 100 100
Brain and other nervous system 18,300 10,200 8,100 13,100 7,300 5,800
Endocrine system 23,800 6,600 17,200 2,300 1,100 1,200
    Thyroid 22,000 5,700 16,300 1,400 600 800
    Other endocrine 1,800 900 900 900 500 400
Lymphoma 61,000 32,300 28,700 24,700 12,900 11,800
    Hodgkin disease 7,600 4,000 3,600 1,300 700 600
    Non-Hodgkin lymphoma 53,400 28,300 25,100 23,400 12,200 11,200
Multiple myeloma 14,600 7,800 6,800 10,900 5,400 5,500
Leukemia 30,600 17,900 12,700 21,900 12,100 9,800
    Acute lymphocytic leukemia 3,600 2,100 1,500 1,400 800 600
    Chronic lymphocytic leukemia 7,300 4,600 2,700 4,400 2,500 1,900
    Acute myeloid leukemia 10,500 5,800 4,700 7,800 4,200 3,600
    Chronic myeloid leukemia 4,300 2,500 1,800 1,700 1,000 700
    Other leukemia‡ 4,900 2,900 2,000 6,600 3,600 3,000
Other and unspecified primary sites‡ 30,300 14,100 16,200 42,300 21,700 20,600
  • *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.
  • †Estimated deaths for colon and rectum cancers are combined.
  • ‡More deaths than cases suggests lack of specificity in recording underlying causes of death on death certificate.
  • 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.
  • American Cancer Society Surveillance Research, 2003.
Table TABLE 2. ESTIMATED NEW CANCER CASES FOR SELECTED CANCER TYPES BY STATE, US, 2003*
STATE All Cases Female Breast Uterine Cervix Colon and Rectum Uterine Corpus Leukemia Lung and Bronchus Melanoma of the Skin Non-Hodgkin Lymphoma Prostate Urinary Bladder
AL 23,600 3,400 200 2,200 600 500 3,300 900 800 4,700 800
AK 1,800 300 200 200 100 100 200 100
AZ 23,300 3,900 200 2,500 500 500 3,000 1,200 1,000 4,300 1,000
AR 14,700 2,000 100 1,500 300 300 2,200 500 600 2,600 500
CA 125,000 21,100 1,400 13,000 3,800 3,000 14,400 5,200 5,200 20,500 5,500
CO 15,200 2,500 100 1,600 400 400 1,600 800 700 2,600 600
CT 16,600 2,600 100 1,900 500 400 2,000 600 700 2,800 800
DE 4,100 700 100 400 100 100 600 200 200 600 300
DC 2,700 500 300 200 300 600 100
FL 96,100 13,500 900 10,200 2,500 2,200 13,200 4,100 3,900 15,800 4,500
GA 33,400 5,400 400 3,300 1,000 700 4,600 1,300 1,100 5,700 1,200
HI 4,900 700 500 200 100 600 100 200 900 200
ID 5,500 1,000 600 100 100 600 300 200 1,100 300
IL 59,900 10,200 600 6,800 1,900 1,400 7,400 2,100 2,400 10,100 2,600
IN 31,200 4,700 300 3,500 900 700 4,400 1,400 1,300 5,000 1,300
IA 15,300 2,300 100 1,900 500 400 1,900 600 600 2,700 600
KS 12,600 2,100 100 1,300 300 300 1,700 600 500 2,100 500
KY 22,100 3,200 200 2,400 500 400 3,500 1,000 800 3,300 900
LA 22,600 3,800 200 2,600 600 500 3,000 700 800 3,600 800
ME 7,300 1,000 800 200 100 1,000 300 300 900 400
MD 24,400 4,200 200 2,900 700 600 3,200 800 900 3,900 1,000
MA 32,700 4,700 200 3,700 900 700 4,100 1,500 1,300 5,500 1,700
MI 47,400 7,500 300 5,100 1,400 1,100 6,100 1,800 2,000 7,800 2,200
MN 21,900 3,400 100 2,300 600 600 2,500 900 1,100 4,000 900
MS 14,900 2,500 200 1,700 300 300 2,200 500 500 2,900 500
MO 29,500 4,100 200 3,300 900 700 4,200 1,300 1,100 4,500 1,100
MT 4,600 600 500 100 100 600 200 200 800 200
NE 8,100 1,100 100 1,100 300 200 1,000 300 400 1,400 300
NV 10,300 1,400 100 1,300 200 200 1,500 400 300 1,600 400
NH 6,000 800 700 100 100 800 300 300 900 300
NJ 42,300 7,400 400 4,800 1,600 1,000 5,000 1,700 1,800 6,600 2,200
NM 7,400 1,300 100 800 200 200 800 300 300 1,400 300
NY 85,900 14,800 900 10,300 3,400 2,000 10,000 2,900 3,300 14,000 4,200
NC 39,600 6,000 400 4,100 1,200 900 5,600 1,600 1,400 6,800 1,500
ND 3,100 500 300 100 100 300 100 100 500 200
OH 60,300 9,900 500 6,900 1,900 1,400 8,000 2,300 2,600 9,400 2,800
OK 17,700 2,700 200 2,000 400 400 2,600 1,000 700 2,600 700
OR 17,300 2,600 100 1,700 500 400 2,300 800 700 3,200 800
PA 70,800 11,100 600 8,600 2,300 1,600 8,700 2,700 3,000 12,000 3,400
RI 5,800 800 100 700 100 100 800 200 200 900 300
SC 20,600 3,400 200 2,300 500 400 2,800 700 700 3,800 700
SD 3,900 600 500 100 100 400 100 200 700 100
TN 30,500 4,500 300 3,200 800 700 4,500 1,400 1,200 4,700 1,000
TX 83,400 13,700 1,000 9,200 2,500 1,900 10,900 3,500 3,300 13,200 3,000
UT 6,200 1,100 700 200 200 500 400 300 1,400 300
VT 3,100 500 400 100 100 400 200 100 300 100
VA 32,800 5,400 300 3,600 1,100 700 4,300 1,400 1,300 5,500 1,200
WA 26,700 3,800 200 2,700 800 700 3,500 1,200 1,100 3,900 1,200
WV 11,300 1,600 100 1,200 400 300 1,700 400 400 1,700 500
WI 25,800 3,900 200 2,900 800 700 3,000 1,100 1,200 4,500 1,200
WY 2,300 300 300 100 100 300 100 100 400 100
US 1,334,100 211,300 12,200 147,500 40,100 30,600 171,900 54,200 53,400 220,900 57,400
  • *Rounded to the nearest 100. Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.
  • †Estimate is 50 or fewer cases.
  • 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.

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.

Details are in the caption following the image

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.

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*
State Death Rate per 100,000‡ All Cancers Brain/ Nervous System Female Breast Colon and Rectum Leukemia Liver Lung and Bronchus Non-Hodgkin Lymphoma Ovary Pancreas Prostate
AL 218.9 9,800 200 600 900 300 300 3,000 400 200 500 600
AK 198.2 700 100 100 200
AZ 187.5 9,700 200 700 1,000 400 300 2,700 400 200 500 600
AR 219.8 6,100 200 400 600 200 200 2,000 300 200 300 300
CA 186.9 52,200 1,500 4,000 5,000 2,100 1,900 13,200 2,300 1,500 2,900 2,700
CO 174.9 6,300 200 500 600 300 100 1,500 300 200 300 300
CT 199.0 6,900 200 500 700 300 200 1,800 300 200 400 400
DE 233.7 1,700 100 200 100 500 100 100 100
DC 245.8 1,100 100 100 300 100 100
FL 201.2 40,100 900 2,500 3,900 1,600 1,000 12,100 1,700 1,000 2,200 2,100
GA 211.8 13,900 300 1,000 1,300 500 300 4,200 500 400 700 700
HI 161.6 2,000 100 200 100 100 500 100 100 100
ID 185.4 2,300 100 200 200 100 600 100 100 100 100
IL 212.6 25,000 500 1,900 2,600 1,000 700 6,800 1,000 600 1,400 1,300
IN 218.4 13,000 300 900 1,300 500 300 4,000 600 400 600 700
IA 193.0 6,400 200 400 800 300 100 1,700 300 200 300 400
KS 192.7 5,200 100 400 500 200 100 1,500 200 100 300 300
KY 231.2 9,200 200 600 900 300 200 3,200 400 200 400 400
LA 237.3 9,400 200 700 1,000 400 300 2,700 400 200 500 500
ME 224.5 3,000 100 200 300 100 100 900 100 100 200 100
MD 220.9 10,200 200 800 1,100 400 200 2,900 400 300 600 500
MA 212.8 13,600 300 900 1,400 500 300 3,700 600 300 800 700
MI 207.3 19,800 500 1,400 2,000 800 500 5,600 900 500 1,100 1,100
MN 192.2 9,100 300 600 900 400 200 2,300 500 200 500 500
MS 227.3 6,200 200 500 600 200 200 2,000 200 200 300 400
MO 213.5 12,300 300 800 1,300 500 300 3,900 500 300 600 600
MT 195.7 1,900 100 100 200 100 500 100 100 100 100
NE 189.1 3,400 100 200 400 200 100 900 200 100 200 200
NV 219.9 4,300 100 300 500 200 100 1,300 100 100 200 200
NH 219.8 2,500 100 200 300 100 100 700 100 100 200 100
NJ 216.5 17,600 400 1,400 1,900 700 500 4,500 800 500 1,000 900
NM 181.9 3,100 100 200 300 100 100 700 100 100 200 200
NY 202.3 35,800 800 2,800 4,000 1,400 1,000 9,200 1,400 1,000 2,200 1,800
NC 212.2 16,500 400 1,100 1,600 600 400 5,100 600 400 900 900
ND 189.3 1,300 100 100 100 300 100 100 100
OH 218.5 25,200 600 1,900 2,700 1,000 500 7,400 1,100 600 1,300 1,200
OK 208.1 7,400 200 500 800 300 200 2,400 300 200 300 300
OR 203.0 7,200 200 500 700 300 100 2,100 300 200 400 400
PA 214.7 29,600 600 2,100 3,300 1,100 700 8,000 1,300 700 1,600 1,600
RI 219.1 2,400 100 200 300 100 100 700 100 100 100 100
SC 215.3 8,600 200 600 900 300 200 2,500 300 200 500 500
SD 195.6 1,600 100 100 200 100 400 100 100 100 100
TN 222.8 12,700 300 900 1,200 500 300 4,100 500 300 600 600
TX 203.0 34,800 900 2,600 3,600 1,300 1,200 9,900 1,400 900 1,800 1,700
UT 153.1 2,600 100 200 300 100 100 400 200 100 100 200
VT 213.3 1,300 100 200 400 100 100
VA 214.3 13,700 300 1,000 1,400 500 300 3,900 500 300 700 700
WA 198.6 11,200 300 700 1,000 500 300 3,200 500 300 600 500
WV 225.9 4,700 100 300 500 200 100 1,600 200 100 200 200
WI 200.1 10,800 300 700 1,100 500 300 2,800 500 300 600 600
WY 199.2 900 100 100 300 100
US 206.0 556,500 13,100 39,800 57,100 21,900 14,400 157,200 23,400 14,300 30,000 28,900
  • *Rounded to the nearest 100. Excludes in situ carcinomas except urinary bladder.
  • †Estimate is 50 or fewer deaths.
  • ‡Average annual rates for 1995 to 1999 are age adjusted to the 2000 US standard population.
  • Note: State estimates may not add to US total due to rounding.
  • Source: US Mortality Public Use Data Tapes, 1979 to 2000, National Center for Health Statistics, Centers for Disease Control and Prevention.

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

Details are in the caption following the image

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.

Details are in the caption following the image

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.

Details are in the caption following the image

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.

Details are in the caption following the image

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.

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 1 Line Segment 2 Line Segment 3 Line Segment 4
Year APC Year APC Year APC Year APC
All Cancers
Incidence
    Male 1973-89 1.4* 1989-92 5.0* 1992-95 -4.9* 1995-99 -0.3
    Female 1973-80 0.2 1980-87 1.6* 1987-99 0.3*
Death
    Male 1973-80 0.9* 1980-92 0.3* 1992-99 -1.5*
    Female 1973-92 0.5* 1992-99 -0.6*
Lung and bronchus
Incidence
    Male 1973-80 2.2* 1980-91 -0.2 1991-99 -2.2*
    Female 1973-81 6.3* 1981-91 3.4* 1991-99 0.5
Death
    Male 1973-80 2.2* 1980-90 0.7* 1990-97 -1.5* 1997-99 -2.8*
    Female 1973-82 6.1* 1982-90 4.1* 1990-95 1.9* 1995-99 0.2
Colon and rectum
Incidence
    Male 1973-86 1.1* 1986-95 2.1* 1995-99 0.1
    Female 1973-84 0.6* 1984-95 1.7* 1995-99 0.7
Death
    Male 1973-79 0.5 1979-87 -0.6* 1987-99 -2.0*
    Female 1973-80 -0.5* 1980-99 -1.7*
Female breast
Incidence
    All ages 1973-80 -0.6 1980-87 3.7* 1987-99 0.5*
    Under 50 1973-80 -1.5 1980-86 2.9* 1986-99 -0.3
    50 and over 1973-80 -0.3 1980-87 4.1* 1987-99 0.7*
Death
    All ages 1973-79 -0.3 1979-89 0.6* 1989-95 -1.4* 1995-99 -3.2*
    Under 50 1973-80 -1.5* 1980-89 0.1 1989-97 -2.7* 1997-99 -7.4*
    50 and over 1973-91 0.5* 1991-99 -2.1*
Prostate
Incidence
    All ages 1973-88 2.7* 1988-92 16.2* 1992-95 -11.7* 1995-99 1.4
    Under 65 1973-85 2.8* 1985-89 7.2* 1989-92 26.4* 1992-99 2.8*
    65 and over 1973-88 2.6* 1988-92 14.9* 1992-95 -15.1* 1995-99 0.3
Death
    All ages 1973-87 0.9* 1987-91 3.0* 1991-94 -0.7 1994-99 -4.3*
    Under 65 1973-87 0.3 1987-90 3.9 1990-99 -3.6*
    65 and over 1973-87 0.9* 1987-91 3.1* 1991-94 -0.5 1994-99 -4.3*
  • *The APC is significantly different from zero (p < 0.05).
  • APC = Annual Percent Change based on rates age adjusted to the 2000 US standard population.
  • Note: Trends were analyzed by joinpoint regression program with a maximum of three joinpoints, i.e., four line segments.
  • Source: SEER Cancer Statistics Review, 1973 to 1999. National Cancer Institute.8

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
Rank Cause of Death Number of Deaths Percent (%) of Total Deaths Death Rate*
All Causes 2,403,351 868.7
1 Heart Diseases 710,760 29.6 257.5
2 Cancer 553,091 23.0 199.6
3 Cerebrovascular Diseases 167,661 7.0 60.8
4 Chronic Lower Respiratory Diseases 122,009 5.1 44.2
5 Accidents (Unintentional Injuries) 97,900 4.1 34.9
6 Diabetes Mellitus 69,301 2.9 25.0
7 Influenza and Pneumonia 65,313 2.7 23.7
8 Alzheimer Disease 49,558 2.1 18.0
9 Nephritis, Nephrotic Syndrome, and Nephrosis 37,251 1.5 13.5
10 Septicemia 31,224 1.3 11.3
11 Intentional Self-harm (Suicide) 29,350 1.2 10.4
12 Chronic Liver Disease and Cirrhosis 26,552 1.1 9.6
13 Hypertension and Hypertensive Renal Disease 18,073 0.8 6.6
14 Assault (Homicide) 16,765 0.7 5.9
15 Parkinson Disease 15,682 0.7 5.7
All Other and Ill-defined Causes 392,861 16.3
  • *Rates are per 100,000 population and age adjusted to the 2000 US standard population.
  • Note: Percentages may not total 100 percent due to rounding.
  • Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.
Table TABLE 6. Reported Deaths for the Ten Leading Causes of Death, by Age and Sex, US, 2000
All Ages Ages 1 to 19 Ages 20 to 39 Ages 40 to 59 Ages 60 to 79 Ages 80+
Male Female Male Female Male Female Male Female Male Female Male Female
All Causes 1,177,578 All Causes 1,225,773 All Causes 16,922 All Causes 9,033 All Causes 64,516 All Causes 29,819 All Causes 198,868 All Causes 121,882 All Causes 499,631 All Causes 413,373 All Causes 381,634 All Causes 639,282
1. Heart Diseases 344,807 Heart Diseases 365,953 Accidents (Unintentional Injuries) 7,716 Accidents (Unintentional Injuries) 3,844 Accidents Unintentional Injuries) 20,299 Accidents Unintentional Injuries) 6,299 Heart Diseases 51,724 Cancer 47,850 Cancer 158,990 Cancer 131,871 Heart Diseases 134,168 Heart Diseases 235,370
2. Cancer 286,082 Cancer 267,009 Assault (Homicide) 2,038 Cancer 931 Intentional Self-harm (Suicide) 8,468 Cancer 5,617 Cancer 50,069 Heart Diseases 20,280 Heart Diseases 152,839 Heart Diseases 107,053 Cancer 70,883 Cancer 80,697
3. Cerebrovascular Diseases 64,769 Cerebrovascular Diseases 102,892 Intentional Self-harm Suicide) 1,595 Assault (Homicide) 603 Assault (Homicide) 7,186 Heart Diseases 2,662 Accidents (Unintentional Injuries) 17,774 Accidents Unintentional Injuries) 6,467 Chronic Lower Respiratory Diseases 32,007 Chronic Lower Respiratory Diseases 30,213 Cerebrovascular Diseases 30,966 Cerebrovascular Diseases 68,752
4. Accidents Unintentional Injuries) 63,817 Chronic Lower Respiratory Diseases 62,005 Cancer 1,248 Congenital Anomalies 516 Heart Diseases 5,257 Intentional Self-harm (Suicide) 1,809 Chronic Liver Disease & Cirrhosis 8,639 Cerebrovascular Diseases 5,479 Cerebrovascular Diseases 26,436 Cerebrovascular Diseases 27,702 Chronic Lower Respiratory Diseases 23,409 Alzheimer Disease 29,042
5. Chronic Lower Respiratory Diseases 60,004 Diabetes Mellitus 37,699 Congenital Anomalies 603 Heart Diseases 337 Cancer 4,832 Assault (Homicide) 1,735 Intentional Self-harm (Suicide) 8,112 Diabetes Mellitus 4,439 Diabetes Mellitus 16,284 Diabetes Mellitus 17,191 Influenza & Pneumonia 16,612 Chronic Lower Respiratory Diseases 27,500
6. Diabetes Mellitus 31,602 Influenza & Pneumonia 36,655 Heart Diseases 518 Intentional Self-harm (Suicide) 333 HIV Disease 3,854 HIV Disease 1,623 Cerebrovascular Diseases 6,396 Chronic Lower Respiratory Diseases 3,831 Accidents Unintentional Injuries) 10,007 Influenza & Pneumonia 7,715 Alzheimer Disease 10,201 Influenza & Pneumonia 26,844
7. Influenza & Pneumonia 28,658 Alzheimer Disease 35,120 Chronic Lower Respiratory Diseases 166 Influenza &Pneumonia 118 Chronic Liver Disease & Cirrhosis 1,012 Cerebrovascular Diseases 808 HIV Disease 6,220 Chronic Liver Disease & Cirrhosis 3,250 Influenza & Pneumonia 9,067 Nephritis Nephrotic Syndrome & Nephrosis 7,157 Diabetes Mellitus 8,684 Diabetes Mellitus 15,449
8. Intentional Self-harm (Suicide) 23,618 Accidents (Unintentional Injuries) 34,083 Influenza & Pneumonia 137 Chronic Lower Respiratory Diseases 110 Diabetes Mellitus 835 Diabetes Mellitus 586 Diabetes Mellitus 5,749 Intentional Self-harm (Suicide) 2,483 Nephritis, Nephrotic Syndrome & Nephrosis 7,557 Accidents (Unintentional Injuries) 6,771 Nephritis, Nephrotic Syndrome & Nephrosis 7,845 Nephritis, Syndrome & Nephrosis 10,497
9. Nephritis, Nephrotic Syndrome & Nephrosis 17,811 Nephritis, Nephrotic Syndrome & Nephrosis 19,440 Septicemia 114 Cerebrovascular Diseases 100 Cerebrovascular Diseases 806 Chronic Liver Disease & Cirrhosis 515 Chronic Lower Respiratory Diseases 4,025 HIV Disease 1,742 Chronic Liver Disease & Cirrhosis 6,496 Septicemia 6,116 Accidents (Unintentional Injuries) 7,437 Accidents (Unintentional Injuries) 10,320
10. Chronic Liver Disease & Cirrhosis 17,214 Septicemia 17,687 Cerebrovascular Diseases 90 Septicemia 88 Congenital Anomalies 564 Influenza & Pneumonia 411 Assault (Homicide) 2,706 Septicemia 1,673 Septicemia 5,972 Alzheimer Disease 5,962 Parkinson Disease 5,206 Septicemia 9,368
  • Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

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 < 20 20 to 39 40 to 59 60 to 79 ≥ 80
Males
All Cancers 286,082 All Cancers 1,298 All Cancers 4,832 All Cancers 50,069 All Cancers 158,990 All Cancers 70,883
Lung and Bronchus 90,415 Leukemia 430 Brain and ONS* 626 Lung and Bronchus 15,827 Lung and Bronchus 57,470 Lung and Bronchus 16,626
Prostate 31,078 Brain and ONS 307 Leukemia 611 Colon and Rectum 4,801 Colon and Rectum 15,420 Prostate 15,630
Colon and Rectum 28,484 Bones and Joints 105 Lung and Bronchus 481 Pancreas 2,929 Prostate 14,428 Colon and Rectum 7,821
Pancreas 14,238 Endocrine System 104 Non-Hodgkin Lymphoma 444 Esophagus 2,345 Pancreas 8,179 Urinary Bladder 3,222
Non-Hodgkin Lymphoma 11,812 Non-Hodgkin Lymphoma 79 Colon and Rectum 431 Liver 2,308 Non-Hodgkin Lymphoma 6,107 Leukemia 3,187
Females
All Cancers 267,009 All Cancers 973 All Cancers 5,617 All Cancers 47,850 All Cancers 131,871 All Cancers 80,697
Lung and Bronchus 65,016 Leukemia 302 Breast 1,444 Breast 11,937 Lung and Bronchus 39,311 Lung and Bronchus 14,693
Breast 41,872 Brain and ONS 238 Uterine Cervix 538 Lung and Bronchus 10,613 Breast 17,842 Colon and Rectum 12,379
Colon and Rectum 28,950 Endocrine System 82 Leukemia 452 Colon and Rectum 3,619 Colon and Rectum 12,612 Breast 10,648
Pancreas 15,094 Bones and Joints 76 Lung and Bronchus 397 Ovary 3,033 Pancreas 7,825 Pancreas 5,319
Ovary 14,060 Soft Tissue 69 Brain and ONS 354 Pancreas 1,871 Ovary 7,217 Non-Hodgkin Lymphoma 4,039
  • *ONS = Other Nervous System.
  • Note: “All Cancers” excludes in situ carcinomas except urinary bladder.
  • Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

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 Cancers Lung and Bronchus Colon and Rectum Prostate Breast
Year Male Female Male Female Male Female Male Female
1989 263,309 232,843 88,975 48,042 28,123 28,903 30,520 42,837
1990 268,283 237,039 91,014 50,136 28,484 28,674 32,378 43,391
1991 272,380 242,277 91,603 52,022 28,026 28,753 33,564 43,583
1992 274,838 245,740 91,322 54,485 28,280 28,714 34,240 43,068
1993 279,375 250,529 92,493 56,234 28,199 29,206 34,865 43,555
1994 280,465 253,845 91,825 57,535 28,471 28,936 34,902 43,644
1995 281,611 256,844 91,800 59,304 28,409 29,237 34,475 43,844
1996 281,898 257,635 91,559 60,351 27,989 28,766 34,123 43,091
1997 281,110 258,467 91,278 61,922 28,075 28,621 32,891 41,943
1998 282,065 259,467 91,399 63,075 28,024 28,950 32,203 41,737
1999 285,832 264,006 89,401 62,662 28,313 28,909 31,729 41,144
2000 286,082 267,009 90,415 65,016 28,484 28,950 31,078 41,872
  • 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.
  • Source: US Mortality Public Use Data Tapes, 1989 to 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.

CANCER OCCURRENCE BY RACE/ETHNICITY

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
White African American Asian/ Pacific Islander American Indian/ Alaska Native Hispanic†
Incidence
All Cancers
Males 568.2 703.6 408.9 277.7 393.1
Females 424.4 404.8 306.5 224.2 290.5
Total 480.4 526.6 348.6 244.6 329.6
Breast (female) 137.0 120.7 93.4 59.4 82.6
Colon and rectum
Males 64.4 70.7 58.7 40.7 43.9
Females 46.1 55.8 39.5 30.8 29.7
Total 53.9 61.9 47.9 35.2 35.7
Lung and bronchus
Males 82.9 124.1 63.8 51.4 44.1
Females 51.1 53.2 28.5 23.3 22.8
Total 64.3 82.6 44.0 35.4 31.5
Prostate 172.9 275.3 107.2 60.7 127.6
Mortality
All Cancers
Males 258.1 369.0 160.6 154.5 163.7
Females 171.2 204.5 104.4 110.4 105.7
Total 205.1 267.3 128.6 128.6 129.2
Breast (female) 29.3 37.3 13.1 14.8 17.5
Colon and rectum
Males 26.7 34.8 16.5 14.6 16.6
Females 18.4 25.4 11.6 11.3 10.6
Total 21.9 29.1 13.7 12.8 13.2
Lung and bronchus
Males 81.7 113.0 42.3 49.3 38.2
Females 41.1 39.6 19.3 24.9 13.8
Total 57.9 68.9 29.3 35.5 24.1
Prostate 32.9 75.1 15.1 18.8 22.6
  • *Rates are per 100,000 and are age adjusted to the 2000 US standard population.
  • †Hispanics are not mutually exclusive from Whites, African Americans, Asian/Pacific Islanders, and American Indians/Alaska Natives.
  • 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.
  • 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.
  • American Cancer Society Surveillance Research, 2003.

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 (%)
All Cancers † Male 1.39 (1 in 72) 8.33 (1 in 12) 32.26 (1 in 3) 43.48 (1 in 2)
Female 1.96 (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)
    Breast Female .44 (1 in 228) 4.17 (1 in 24) 7.14 (1 in 14) 13.3 (1 in 8)
    Colon and Rectum Male .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)
    Leukemia Male .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 Bronchus Male .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 Skin Male .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 Lymphoma Male .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)
    Prostate Male .005 (1 in 19,299) 2.22 (1 in 45) 13.70 (1 in 7) 16.67 (1 in 6)
Uterine Cervix Female .17 (1 in 584) .32 (1 in 314) .28 (1 in 363) .81 (1 in 123)
Uterine Corpus Female .05 (1 in 1,881) .73 (1 in 137) 1.59 (1 in 63) 2.70 (1 in 37)
  • *For those free of cancer at beginning of age interval. Based on cancer cases diagnosed during 1997 to 1999.
  • †“All Cancers” excludes basal and squamous cell skin cancers and in situ cancers except urinary bladder.
  • ‡Includes invasive and in situ cancer cases.
  • Note: The “1 in” statistic and the inverse of the percentage may not be equivalent due to rounding.
  • Source: Feuer EJ, Wun LM. DEVCAN, Probability of Developing or Dying of Cancer [software]. Version 4.2. Bethesda, MD: National Cancer Institute; 2002.
  • American Cancer Society Surveillance Research, 2003.

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

Details are in the caption following the image

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.

Details are in the caption following the image

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.

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 (%)
White African American All Races
CANCER TYPE 1974 to 1976 1983 to 1985 1992 to 1998 1974 to 1976 1983 to 1985 1992 to 1998 1974 to 1976 1983 to 1985 1992 to 1998
All Cancers 51 54 64 † 39 40 53 † 50 52 62 †
Brain 22 26 32 † 27 32 40 † 22 27 32 †
Breast (female) 75 79 88 † 63 63 73 † 75 78 86 †
Uterine cervix 70 71 72 † 64 60 60 69 69 71 †
Colon 51 58 63 † 46 49 53 † 50 58 62 †
Uterine corpus 89 85 86 † 61 54 61 88 83 84 †
Esophagus 5 9 15 † 4 6 8 † 5 8 13 †
Hodgkin disease 72 79 85 † 69 77 77 † 71 79 84 †
Kidney 52 56 62 † 49 55 60 † 52 56 62 †
Larynx 66 69 66 † 60 55 54 66 67 64
Leukemia 35 42 47 † 31 34 38 34 41 46 †
Liver 4 6 7 † 1 4 4 † 4 6 7 †
Lung and bronchus 13 14 15 † 11 11 12 † 12 14 15 †
Melanoma of the skin 80 85 89 † 67 ‡ 74 § 66 ‡ 80 85 89 †
Multiple myeloma 24 27 30 † 28 31 33 24 28 30 †
Non-Hodgkin lymphoma 48 54 56 † 49 45 46 47 54 55 †
Oral cavity 55 55 59 † 36 35 35 53 53 56 †
Ovary 37 40 53 † 41 42 53 † 37 41 53 †
Pancreas 3 3 4 † 3 5 4 3 3 4 †
Prostate 68 76 98 † 58 64 93 † 67 75 97 †
Rectum 49 56 62 † 42 44 53 † 49 55 62 †
Stomach 15 16 21 † 17 19 20 15 17 22 †
Testis 79 91 96 † 76 ‡ 88 ‡ 85 79 91 95 †
Thyroid 92 93 96 † 88 92 93 92 93 96 †
Urinary bladder 74 78 82 † 48 60 65 † 73 78 82 †
  • *Survival rates are adjusted for normal life expectancy, and are based on cases diagnosed from 1992 to 1998, followed through 1999.
  • †The difference in rates between 1974 to 1976 and 1992 to 1998 is statistically significant (p < 0.05).
  • ‡The standard error of the survival rate is between 5 and 10 percentage points.
  • §The standard error of the survival rate is greater than 10 percentage points.
  • Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002.
  • American Cancer Society Surveillance Research, 2003.

CANCER IN CHILDREN

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
Rank Cause of Death Number of Deaths Percent (%) of Total Deaths Death Rate*
All Causes 12,392 100.0 22.0
1 Accidents (Unintentional Injuries) 4,805 38.8 8.5
2 Cancer 1,434 11.6 2.5
3 Congenital Anomalies 894 7.2 1.6
4 Assault (Homicide) 727 5.9 1.3
5 Heart Diseases 452 3.6 0.8
6 Intentional Self-harm (Suicide) 307 2.5 0.5
7 Chronic Lower Respiratory Diseases 190 1.5 0.3
8 Pneumonia and Influenza 190 1.5 0.3
9 Septicemia 162 1.3 0.3
10 Cerebrovascular Diseases 123 0.9 0.2
11 Anemias 87 0.7 0.2
12 Meningitis 66 0.5 0.1
13 HIV Disease 60 0.5 0.1
14 Complications of Medical and Surgical Care 53 0.4 0.1
15 Nephritis, Nephrotic Syndrome, and Nephrosis 39 0.3 0.1
All Others 2,225 18.0
  • *Rates are per 100,000 population and age adjusted to the 2000 US standard population.
  • Note: Percentages may not total 100 percent due to rounding.
  • Source: US Mortality Public Use Data Tape, 2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.
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
Cancer Type 1974 to 1976 1977 to 1979 1980 to 1982 1983 to 1985 1986 to 1988 1989 to 1991 1992 to 1998
All Cancers 56 62 65 68 70 73 77 †
Acute Lymphocytic Leukemia 53 67 71 69 78 80 85 †
Acute Myeloid Leukemia 14 27 ‡ 24 ‡ 29 ‡ 30 ‡ 35 ‡ 46 †
Bones and Joints 55 ‡ 52 ‡ 55 ‡ 57 63 ‡ 62 73 †
Brain and Other Nervous System 55 56 56 62 63 62 70 †
Hodgkin Lymphoma 78 84 91 90 90 94 94 †
Neuroblastoma 53 53 53 55 59 68 69 †
Non-Hodgkin Lymphoma 44 50 62 71 70 75 81 †
Soft Tissue 60 68 65 76 67 78 72 †
Wilms Tumor 74 78 87 87 91 93 90 †
  • *Survival rates are adjusted for normal life expectancy and are based on follow-up of patients through 1999.
  • †The difference in rates between 1974 to 1976 and 1992 to 1998 is statistically significant (p < 0.05).
  • ‡The standard error of the survival rate is between 5 and 10 percentage points.
  • Note: “All Cancers” excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.
  • Source: Surveillance, Epidemiology, and End Results program, 1973 to 1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002.

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 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.