Cancer Facts and Figures 2021
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Cancer Facts & Figures 2021 WA 42,170 NH MT VT 9,560 ME ND 6,930 4,310 10,090 4,200 MN OR 33,260 24,790 ID MA 10,240 SD WI NY 42,750 5,330 36,520 120,200 WY MI 3,050 62,150 RI 6,910 IA PA CT 22,910 NV NE 20,000 85,440 16,970 11,180 OH NJ 56,360 UT IL IN 73,320 12,750 74,980 39,010 CA CO WV DE 7,090 187,140 28,630 VA KS MO 12,500 MD 34,590 KY 46,340 16,980 37,390 30,270 DC 3,450 NC TN 63,930 AZ OK 41,980 39,640 NM 22,820 AR SC 10,970 17,980 33,030 MS AL GA 18,750 30,830 58,060 TX 133,730 LA 27,880 AK 3,190 FL 148,010 US 1,898,160 PR HI N/A 7,570 Estimated number of new cancer cases for 2021, excluding basal cell and squamous cell skin cancers and in situ carcinomas except urinary bladder. Estimates are not available for Puerto Rico. Note: Incidence counts for 2021 are model-based and thus should be interpreted with caution. State estimates may not equal US total due to rounding. Special Section: COVID-19 and Cancer see page 30 Contents Basic Cancer Facts 1 Special Section: COVID-19 and Cancer 30 Figure 1. Trends in Age-adjusted Cancer Death Rates Figure S1. Weekly Number of Deaths in the US, by Site, Males, US, 1930-2018 2 January 2018 - July 2020 31 Figure 2. Trends in Age-adjusted Cancer Death Rates Figure S2. Potential Impact of the COVID-19 Pandemic by Site, Females, US, 1930-2018 3 on Future Cancer Outcomes 33 Table 1. Estimated Number* of New Cancer Cases Figure S3. Estimated Cumulative Excess Deaths from and Deaths by Sex, US, 2021 4 Colorectal and Breast Cancers in the US Due to the COVID-19 Pandemic, 2020 to 2030 34 Table 2. Estimated Number* of New Cases for Selected Cancers by State, US, 2021 5 Figure S4. Disproportionate Burden of COVID-19 Cases, Hospitalizations, and Deaths Among People of Color Table 3. Estimated Number* of Deaths for Selected Compared to Non-Hispanic White Persons 35 Cancers by State, US, 2021 6 Table 4. Incidence Rates for Selected Cancers by State, Tobacco Use 39 US, 2013-2017 7 Figure 4. Proportion of Cancer Deaths Attributable to Table 5. Death Rates for Selected Cancers by State, Cigarette Smoking in Adults 30 Years and Older, US, 2014 39 US, 2014-2018 8 Figure 3. Leading Sites of New Cancer Cases and Deaths – Nutrition & Physical Activity 45 2021 Estimates 10 Cancer Disparities 49 Selected Cancers 10 Table 9. Incidence and Mortality Rates for Selected Table 6. Probability (%) of Developing Invasive Cancer Cancers by Race and Ethnicity, US 50 During Selected Age Intervals by Sex, US, 2015-2017* 14 The Global Cancer Burden 52 Table 7. Trends in 5-year Relative Survival Rates* (%) by Race, US, 1975-2016 18 The American Cancer Society 54 Table 8. Five-year Relative Survival Rates* (%) by Stage at Diagnosis, US, 2010-2016 21 Sources of Statistics 64 American Cancer Society Recommendations for the Early Detection of Cancer in Average-risk Asymptomatic People 67 This publication attempts to summarize current scientific information about cancer. Except when specified, it does not represent the official policy of the American Cancer Society. ©2021, American Cancer Society, Inc. All rights reserved, including the right to reproduce this publication or portions thereof in any form. Suggested citation: American Cancer Society. Cancer Facts & Figures 2021. For permission, email the American Cancer Society Atlanta: American Cancer Society; 2021. Legal department at [email protected]. these to the attention of a health care professional may Basic Cancer Facts also result in the early detection of cancer. For complete cancer screening guidelines, see page 67. What Is Cancer? Cancer is a group of diseases characterized by the How Many People Alive Today Have uncontrolled growth and spread of abnormal cells that Ever Had Cancer? can result in death if not treated. Although the causes of More than 16.9 million Americans with a history of cancer are not completely understood, numerous factors invasive cancer were alive on January 1, 2019, most of are known to increase risk, including many that are whom were diagnosed many years ago and have no potentially modifiable (e.g., tobacco use and excess body current evidence of the disease. weight) and others that are not (e.g., inherited genetic mutations). These risk factors may act simultaneously or in sequence to initiate and/or promote cancer growth. How Many New Cases and Deaths Are Expected to Occur in 2021? Can Cancer Be Prevented? Almost 1.9 million new cancer cases are expected to be diagnosed in 2021 (Table 1). This estimate excludes basal A substantial proportion of cancers could be prevented, cell and squamous cell skin cancers, which are not required including all cancers caused by tobacco use and other to be reported to cancer registries, and carcinoma in situ unhealthy behaviors. Excluding non-melanoma skin (noninvasive cancer) except for urinary bladder. Table 2 cancer, at least 42% of newly diagnosed cancers in the US – provides estimated new cancer cases in 2021 by state. about 797,000 cases in 2021 – are potentially avoidable, including the 19% of cancers caused by smoking and at Approximately 608,570 Americans are expected to die of least 18% caused by a combination of excess body weight, cancer in 2021 (Table 1), which translates to about 1,670 alcohol consumption, poor nutrition, and physical deaths per day. Cancer is the second most common cause inactivity. Certain cancers caused by infectious agents, of death in the US, exceeded only by heart disease. Table 3 such as human papillomavirus (HPV), hepatitis B virus provides estimated cancer deaths by state in 2021. (HBV), hepatitis C virus (HCV), and Helicobacter pylori (H. pylori), could be prevented through behavioral Importantly, these estimates are based on reported cancer changes or vaccination to avoid the infection, or by incidence and mortality through 2017 and 2018, respectively, treating the infection. Many of the more than 5 million and do not account for the unknown impact of COVID-19 skin cancers diagnosed annually could be prevented by on cancer diagnoses and deaths. For information on protecting skin from excessive sun exposure and not COVID-19 and cancer, see the Special Section on page 30. using indoor tanning devices. In addition, screening can help prevent colorectal and How Much Progress Has Been Made cervical cancers by detecting and removing precancers Against Cancer? in the colon, rectum, and uterine cervix. Screening can Death rates are the best measure of progress against also detect these and some other cancers early, when cancer because they are less affected by detection treatment is often less intensive and more successful. practices than incidence (new diagnoses) and survival Screening is known to reduce mortality for cancers of the rates. The overall age-adjusted cancer death rate rose breast, colon, rectum, cervix, lung (among people who during most of the 20th century, peaking in 1991 at 215 smoke, or used to smoke), and probably prostate. In cancer deaths per 100,000 people, mainly because of the addition, being aware of changes in the body, such as the smoking epidemic. As of 2018, the rate had dropped to breasts, skin, mouth, eyes, or genitalia, and bringing 149 per 100,000 (a decline of 31%) because of reductions in Cancer Facts & Figures 2021 1 smoking, as well as improvements in early detection and and having an unhealthy diet. In the US, an estimated treatment for some cancers. This decline translates into 41 out of 100 men and 39 out of 100 women will develop about 3.2 million fewer cancer deaths from 1991 to 2018, cancer during their lifetime (Table 6). However, these and is largely driven by progress against the four most probabilities are based on cancer occurrence in the common cancer types – lung, colorectal, breast, and general population and may differ because of variations prostate (Figure 1 and Figure 2). in individual exposures (e.g., smoking), family history, and/or genetic susceptibility. Do Cancer Incidence and Death Rates A family history of cancer is thought to primarily reflect Vary by State? inheritance of genetic variations that confer slight-to- Table 4 and Table 5 provide average annual incidence and moderate increased risk in concert with similar exposures death rates for selected cancer types by state. Lung to lifestyle/environmental factors among family members. cancer rates vary the most by state, reflecting historical Inheritance of genetic alterations that confer a very high differences in smoking prevalence that continue today. risk occurs much less frequently. Relative risk is the strength of the relationship between Who Is at Risk of Developing Cancer? exposure to a given risk factor and cancer. It is measured The risk of developing cancer increases with advancing by comparing the rate of cancer in a group of people with age; 80% of all cancers in the United States are diagnosed a certain exposure or trait to the rate in a group of people in people 55 years of age or older. Certain behaviors and without this characteristic. For example, men and other modifiable factors also increase risk, such as women who smoke cigarettes are about 25 times more smoking, having excess body weight, drinking alcohol, likely to develop lung cancer than people who never Figure 1. Trends in Age-adjusted Cancer Death Rates* by Site, Males, US, 1930-2018 100 Lung & bronchus 80 60 Prostate Stomach Colon & rectum 40 Rate per 100,000 male population 20 Liver† Pancreas† Leukemia 0 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 *Per 100,000, age adjusted to the 2000 US standard population.