Cancer Facts & Figures 2017 WA 35,560 NH MT VT 8,670 ME ND 6,140 4,000 8,750 4,180 MN OR 30,000 21,780 ID MA 7,310 SD WI NY 37,130 4,920 32,990 WY 107,530 MI 2,780 57,600 RI 5,870 IA PA CT 21,900 NV NE 17,230 77,710 13,840 9,520 OH NJ 51,680 UT IL IN 68,180 64,720 36,440 CA 10,990 CO WV DE 5,660 176,140 24,330 VA KS MO 11,690 MD 31,820 KY 42,770 14,400 34,400 26,220 DC 3,070 NC TN 56,900 AZ OK 37,080 35,810 NM 18,710 AR SC 10,040 16,040 28,680 MS AL GA 17,290 26,160 48,850 TX 116,200 LA 24,220 AK 3,600 FL 124,740 US 1,688,780 PR HI N/A 6,540 Estimated numbers of new cancer cases for 2017, 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: Rare Cancers in Adults see page 30 Contents Basic Cancer Facts 1 Figure 1. Trends in Age-adjusted Cancer Death Rates by Site, Males, US, 1930-2014 2 Figure 2. Trends in Age-adjusted Cancer Death Rates by Site, Females, US, 1930-2014 3 Table 1. Estimated Number of New Cancer Cases and Deaths by Sex, US, 2017 4 Table 2. Estimated Number of New Cases for Selected Cancers by State, US, 2017 5 Table 3. Estimated Number of Deaths for Selected Cancers by State, US, 2017 6 Table 4. Incidence Rates for Selected Cancers by State, US, 2009-2013 7 Table 5. Death Rates for Selected Cancers by State, US, 2010-2014 8 Selected Cancers 10 Figure 3. Leading Sites of New Cancer Cases and Deaths – 2017 Estimates 10 Table 6. Probability (%) of Developing Invasive Cancer during Selected Age Intervals by Sex, US, 2011-2013 14 Table 7. Trends in 5-year Relative Survival Rates (%) by Race, US, 1975-2012 18 Table 8. Five-year Relative Survival Rates (%) by Stage at Diagnosis, US, 2006-2012 21 Special Section: Rare Cancers in Adults 30 Tobacco Use 40 Figure 4. Proportion of Cancer Deaths Attributable to Cigarette Smoking in Adults 35 Years and Older, US, 2011 41 Nutrition & Physical Activity 45 Cancer Disparities 49 Table 9. Incidence Rates for Selected Cancers by Race and Ethnicity, US, 2009-2013 50 Table 10. Death Rates for Selected Cancers by Race and Ethnicity, US, 2010-2014 51 Figure 5. Geographic Patterns in Lung Cancer Death Rates by State, US, 2010-2014 52 The Global Cancer Burden 53 The American Cancer Society 56 Sources of Statistics 69 American Cancer Society Recommendations for the Early Detection of Cancer in Average-risk Asymptomatic People 71 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 Except when specified, it does not represent the official policy of the American Cancer Society. ©2017, 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 2017. For written permission, address the Legal department of the American Cancer Society, 250 Williams Street, NW, Atlanta: American Cancer Society; 2017. Atlanta, GA 30303-1002. reduce mortality for cancers of the breast, colon, rectum, Basic Cancer Facts cervix, and lung (among long-term and/or heavy smokers). In addition, a heightened awareness of changes in certain What Is Cancer? parts of the body, such as the breast, skin, mouth, eyes, or genitalia, may also result in the early detection of cancer. Cancer is a group of diseases characterized by the For complete cancer screening guidelines, see page 71. uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death. Although the reason for many cancers, particularly those that occur How Many People Alive Today Have during childhood, remains unknown, established cancer Ever Had Cancer? causes include lifestyle (external) factors, such as tobacco More than 15.5 million Americans with a history of use and excess body weight, and non-modifiable (internal) cancer were alive on January 1, 2016. Some of these factors, such as inherited genetic mutations, hormones, individuals were diagnosed recently and are still and immune conditions. These risk factors may act undergoing treatment, while most were diagnosed many simultaneously or in sequence to initiate and/or promote years ago and have no current evidence of cancer. cancer growth. Ten or more years often pass between exposure to external factors and detectable cancer. How Many New Cases and Deaths Are Expected to Occur in 2017? Can Cancer Be Prevented? About 1,688,780 new cancer cases are expected to be A substantial proportion of cancers could be prevented, diagnosed in 2017 (Table 1, page 4). This estimate does including all cancers caused by tobacco use and heavy not include carcinoma in situ (noninvasive cancer) of any alcohol consumption. In 2017, about 190,500 of the site except urinary bladder, nor does it include basal cell or estimated 600,920 cancer deaths in the US will be caused squamous cell skin cancers because these are not required by cigarette smoking, according to a recent study by to be reported to cancer registries. Table 2 (page 5) American Cancer Society epidemiologists. In addition, the provides estimated new cancer cases in 2017 by state. World Cancer Research Fund estimates that 20% of all cancers diagnosed in the US are caused by a combination About 600,920 Americans are expected to die of cancer of excess body weight, physical inactivity, excess alcohol in 2017, which translates to about 1,650 people per day consumption, and poor nutrition, and thus could also be (Table 1, page 4). Cancer is the second most common prevented. Certain cancers caused by infectious agents, cause of death in the US, exceeded only by heart disease, such as human papillomavirus (HPV), hepatitis B virus and accounts for nearly 1 of every 4 deaths. Table 3 (page (HBV), hepatitis C virus (HCV), human immunodeficiency 6) provides estimated cancer deaths by state in 2017. virus (HIV), and Helicobacter pylori (H. pylori), could be prevented through behavioral changes, vaccination, or treatment of the infection. Many of the more than 5 million How Much Progress Has Been Made skin cancer cases that are diagnosed annually could be against Cancer? prevented by protecting skin from excessive sun exposure Trends in cancer death rates are the best measure of and not using indoor tanning devices. progress against cancer. The overall cancer death rate rose during most of the 20th century because of the Screening can help prevent colorectal and cervical cancers tobacco epidemic, peaking in 1991 at 215 cancer deaths by allowing for the detection and removal of precancerous per 100,000 persons. However, as of 2014 the rate had lesions. Screening also offers the opportunity to detect dropped to 161 per 100,000 (a decline of 25%) because of some cancers early, when treatment is less extensive and reductions in smoking, as well as improvements in early more likely to be successful. Screening is known to help detection and treatment. This decline translates into Cancer Facts & Figures 2017 1 more than 2.1 million fewer cancer deaths over the past physically active. In the US, approximately 41 out of 100 two decades, progress that is driven by rapid declines in men and 38 out of 100 women will develop cancer during death rates for the four most common cancer types – their lifetime (Table 6, page 14). These probabilities are lung, colorectal, breast, and prostate (Figures 1 and 2). estimated based on cancer occurrence in the general population and may overestimate or underestimate individual risk because of differences in exposures (e.g., Do Cancer Incidence and Death Rates smoking), family history, and/or genetic susceptibility. Vary by State? Tables 4 (page 7) and 5 (page 8) provide average Relative risk is the strength of the relationship between annual incidence (new diagnoses) and death rates for exposure to a given risk factor and cancer. It is measured selected cancer types by state. The variation by state is by comparing cancer occurrence in people with a certain much larger for some cancers (e.g., lung) than for others exposure or trait to cancer occurrence in people without (e.g., non-Hodgkin lymphoma). For more information about this characteristic. For example, men and women who geographic disparities in cancer occurrence, see page 53. smoke are about 25 times more likely to develop lung cancer than nonsmokers, so their relative risk of lung cancer is 25. Most relative risks are not this large. For Who Is at Risk of Developing Cancer? example, women who have a mother, sister, or daughter Cancer usually develops in older people; 87% of all with a history of breast cancer are about twice as likely to cancers in the United States are diagnosed in people 50 develop breast cancer as women who do not have this years of age or older. Certain behaviors also increase risk, family history; in other words, their relative risk is about such as smoking, eating an unhealthy diet, or not being 2. For most types of cancer, risk is higher with a family Figure 1.