Cancer Facts & Figures 2018 WA 36,170 NH MT VT 8,080 ME ND 6,080 3,840 8,600 4,110 MN OR 31,270 21,520 ID MA 8,450 SD WI NY 37,130 5,100 33,340 110,800 WY MI 2,780 56,590 RI 5,920 IA PA CT 21,240 NV NE 17,630 80,960 14,060 10,320 OH NJ 53,260 UT IL IN 68,470 10,950 66,330 37,250 CA CO WV DE 6,110 178,130 25,570 VA KS MO 12,110 MD 33,810 KY 42,420 15,400 35,520 25,990 DC 3,260 NC TN 55,130 AZ OK 36,760 34,740 NM 19,030 AR SC 9,730 16,130 30,450 MS AL GA 18,130 27,830 56,920 TX 121,860 LA 25,080 AK 3,550 FL 135,170 US 1,735,350 PR HI N/A 6,280 Estimated numbers of new cancer cases for 2018, excluding basal cell and squamous cell skin cancers and in situ carcinomas except urinary bladder. Estimates are not available for Puerto Rico. Note: State estimates are offered as a rough guide and should be interpreted with caution. State estimates may not add to US total due to rounding. Special Section: Ovarian Cancer see page 28 Contents Basic Cancer Facts 1 Figure S3. Ovarian Cancer Incidence and Mortality Rates by Race and Ethnicity, US, 2010-2014 30 Figure 1. Trends in Age-adjusted Cancer Death Rates by Site, Males, US, 1930-2015 2 Figure S4. Epithelial Ovarian Cancer Incidence Rates by Age and Race, US, 2010-2014 31 Figure 2. Trends in Age-adjusted Cancer Death Rates by Site, Females, US, 1930-2015 3 Figure S5. Age-adjusted Ovarian Cancer Mortality Rates by Age Group and Race/Ethnicity, 1975-2015 32 Table 1. Estimated Number of New Cancer Cases and Deaths by Sex, US, 2018 4 Table S2. Relative Risks for Established Ovarian Cancer Risk Factors 34 Table 2. Estimated Number of New Cases for Selected Cancers by State, US, 2018 5 Figure S6. Stage Distribution (%) for Ovarian Cancer by Histology, US, 2007-2013 36 Table 3. Estimated Number of Deaths for Selected Cancers by State, US, 2018 6 Table S3. Five-year Cause-specific Survival Rates (%) for Ovarian Cancer by Stage at Diagnosis and Race/Ethnicity, Table 4. Incidence Rates for Selected Cancers by State, US, 2007-2013 37 US, 2010-2014 7 Table S4. Five-year Relative Survival Rates (%) for Ovarian Table 5. Death Rates for Selected Cancers by State, Cancer by Stage at Diagnosis and Histology, US, 2007-2013 37 US, 2011-2015 8 Tobacco Use 44 Selected Cancers 9 Figure 4. Proportion of Cancer Deaths Attributable to Figure 3. Leading Sites of New Cancer Cases and Deaths – Cigarette Smoking in Adults 30 Years and Older, US, 2014 45 2018 Estimates 10 Table 6. Probability (%) of Developing Invasive Cancer Nutrition & Physical Activity 48 during Selected Age Intervals by Sex, US, 2012-2014 14 Table 7. Trends in 5-year Relative Survival Rates (%) Cancer Disparities 52 by Race, US, 1975-2013 18 Table 9. Incidence and Mortality Rates for Selected Cancers Table 8. Five-year Relative Survival Rates (%) by Stage by Race and Ethnicity, US, 2010-2015 54 at Diagnosis, US, 2007-2013 21 The Global Cancer Burden 55 Special Section: Ovarian Cancer 28 The American Cancer Society 57 Figure S1. Female Reproductive Anatomy 28 Figure S2. Distribution (%) of Major Types of Ovarian Sources of Statistics 68 Cancer by Race/Ethnicity, 2010-2014 29 American Cancer Society Recommendations for the Early Table S1. Age-specific Probability of Developing Ovarian Detection of Cancer in Average-risk Asymptomatic People 71 Cancer for US Women 30 Global Headquarters: American Cancer Society Inc. 250 Williams Street, NW, Atlanta, GA 30303-1002 This publication attempts to summarize current scientific information about cancer. 404-320-3333 ©2018, American Cancer Society, Inc. All rights reserved, Except when specified, it does not represent the official policy of the American Cancer Society. including the right to reproduce this publication or portions thereof in any form. Suggested citation: American Cancer Society. Cancer Facts & Figures 2018. For written permission, address the Legal department of the American Cancer Society, 250 Williams Street, NW, Atlanta: American Cancer Society; 2018. Atlanta, GA 30303-1002. genitalia, may also result in the early detection of cancer. Basic Cancer Facts For complete cancer screening guidelines, see page 71. What Is Cancer? How Many People Alive Today Have Cancer is a group of diseases characterized by the Ever Had Cancer? uncontrolled growth and spread of abnormal cells. If the More than 15.5 million Americans with a history of spread is not controlled, it can result in death. Although cancer were alive on January 1, 2016. Some of these the reason why the disease develops remains unknown individuals were diagnosed recently and are still for many cancers, particularly those that occur during undergoing treatment, while most were diagnosed many childhood, there are many known cancer causes, years ago and have no current evidence of cancer. including lifestyle factors, such as tobacco use and excess body weight, and non-modifiable factors, such as inherited genetic mutations, hormones, and immune How Many New Cases and Deaths Are conditions. These risk factors may act simultaneously or Expected to Occur in 2018? in sequence to initiate and/or promote cancer growth. About 1.7 million new cancer cases are expected to be diagnosed in 2018 (Table 1, page 4). This estimate does not Can Cancer Be Prevented? include carcinoma in situ (noninvasive cancer) of any site except urinary bladder, nor does it include basal cell or A substantial proportion of cancers could be prevented, squamous cell skin cancers because these are not required including all cancers caused by tobacco use and other to be reported to cancer registries. Table 2 (page 5) unhealthy behaviors. According to a recent study by provides estimated new cancer cases in 2018 by state. American Cancer Society epidemiologists, at least 42% of newly diagnosed cancers in the US – about 729,000 cases About 609,640 Americans are expected to die of cancer in 2018 – are potentially avoidable, including 19% that are in 2018 (Table 1, page 4), which translates to about 1,670 caused by smoking and 18% that are caused by a deaths per day. Cancer is the second most common cause combination of excess body weight, physical inactivity, of death in the US, exceeded only by heart disease. Table 3 excess alcohol consumption, and poor nutrition. Certain (page 6) provides estimated cancer deaths by state in 2018. cancers caused by infectious agents, such as human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Helicobacter pylori (H. pylori), could be How Much Progress Has Been Made prevented through behavioral changes, vaccination, or against Cancer? treatment of the infection. Many of the more than 5 Cancer death rates are the best measure of progress million skin cancer cases that are diagnosed annually against cancer because they are less affected by detection could be prevented by protecting skin from excessive sun practices than incidence and survival. The overall age- exposure and not using indoor tanning devices. adjusted cancer death rate rose during most of the 20th century mainly because of the tobacco epidemic, peaking Screening can help prevent colorectal and cervical cancers in 1991 at 215 cancer deaths per 100,000 people. As of by allowing for the detection and removal of precancerous 2015, the rate had dropped to 159 per 100,000 (a decline of lesions. Screening also offers the opportunity to detect 26%) because of reductions in smoking, as well as some cancers early, when treatment is more likely to be improvements in early detection and treatment. This successful. Screening is known to help reduce mortality decline translates into more than 2.3 million fewer for cancers of the breast, colon, rectum, cervix, and lung cancer deaths from 1991 to 2015, progress that has been (among long-term current or former heavy smokers). In driven by rapid declines in death rates for the four most addition, a heightened awareness of changes in certain common cancer types – lung, colorectal, breast, and parts of the body, such as the breast, skin, mouth, eyes, or prostate (Figure 1, page 2 and Figure 2, page 3). Cancer Facts & Figures 2018 1 Do Cancer Incidence and Death Rates Relative risk is the strength of the relationship between Vary by State? exposure to a given risk factor and cancer. It is measured by comparing cancer occurrence in people with a certain Tables 4 (page 7) and 5 (page 8) provide average annual exposure or trait to cancer occurrence in people without incidence (new diagnoses) and death rates for selected this characteristic. For example, men and women who cancer types by state. The variation by state is largest for smoke are about 25 times more likely to develop lung lung cancer, reflecting historical and recent differences cancer than nonsmokers, so their relative risk of lung in smoking prevalence. cancer is 25. Most relative risks are not this large. For example, women who have a mother, sister, or daughter Who Is at Risk of Developing Cancer? with a history of breast cancer are about twice as likely to develop breast cancer as women who do not have this Cancer usually develops in older people; 87% of all family history; in other words, their relative risk is about cancers in the United States are diagnosed in people 50 2. For most types of cancer, risk is higher with a family years of age or older.