Cancer Facts & Figures 2016 WA 37,770 NH MT 8,680 ME ND VT 6,070 9,270 3,930 MN 4,050 OR 29,130 22,510 MA ID 37,620 8,120 SD WI NY 4,690 32,970 WY 110,280 MI RI 2,920 56,530 6,190 IA PA NV NE 17,100 83,560 CT 21,700 14,390 9,740 OH NJ 49,750 UT IL IN 66,020 65,090 35,180 DE 5,630 CA 11,030 CO WV 173,200 24,730 VA KS MO 11,770 MD 30,990 KY 43,190 14,530 34,270 DC 2,910 25,720 NC TN 54,450 AZ OK 37,650 32,510 NM 19,650 AR SC 9,750 16,460 27,980 MS AL GA 16,680 27,020 48,670 TX 116,690 LA 25,070 AK 3,330 FL 121,240 US 1,685,210 PR HI N/A 6,850 Estimated numbers of new cancer cases for 2016, 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: Cancer in Asian Americans, Native Hawaiians, and Pacific Islanders see page 25 Contents Basic Cancer Facts 1 Figure 1. Trends in Age-adjusted Cancer Death Rates by Site, Males, US, 1930-2012 2 Figure 2. Trends in Age-adjusted Cancer Death Rates by Site, Females, US, 1930-2012 3 Table 1. Estimated Number of New Cancer Cases and Deaths by Sex, US, 2016 4 Table 2. Estimated Number of New Cases for Selected Cancers by State, US, 2016 5 Table 3. Estimated Number of Deaths for Selected Cancers by State, US, 2016 6 Table 4. Incidence Rates for Selected Cancers by State, US, 2008-2012 7 Table 5. Death Rates for Selected Cancers by State, US, 2008-2012 8 Selected Cancers 9 Figure 3. Leading Sites of New Cancer Cases and Deaths – 2016 Estimates 10 Table 6. Probability (%) of Developing Invasive Cancer during Selected Age Intervals by Sex, US, 2010-2012 14 Table 7. Trends in 5-year Relative Survival Rates (%) by Race, US, 1975-2011 18 Table 8. Five-year Relative Survival Rates (%) by Stage at Diagnosis, US, 2005-2011 21 Special Section: Cancer in Asian Americans, Native Hawaiians, and Pacific Islanders 25 Tobacco Use 43 Figure 4. Number and Percentage (%) of Cancer Deaths Attributable to Cigarette Smoking in 2011, Adults 35 Years and Older 43 Nutrition & Physical Activity 47 Cancer Disparities 50 Table 9. Incidence and Death Rates for Selected Cancers by Site, Race, and Ethnicity, US, 2008-2012 51 Figure 5. Geographic Patterns in Lung Cancer Death Rates by State, US, 2008-2012 52 The Global Fight against Cancer 53 The American Cancer Society 55 Sources of Statistics 64 American Cancer Society Recommendations for the Early Detection of Cancer in Average-risk Asymptomatic People 66 Corporate Center: American Cancer Society Inc. 250 Williams Street, NW, Atlanta, GA 30303-1002 404-320-3333 ©2016, American Cancer Society, Inc. All rights reserved, including the right to reproduce this publication or portions thereof in any form. For written permission, address the Legal department of the American Cancer Society, 250 Williams Street, NW, Atlanta, GA 30303-1002. 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. Suggested citation: American Cancer Society. Cancer Facts & Figures 2016. Atlanta: American Cancer Society; 2016. How Many People Alive Today Have Basic Cancer Facts Ever Had Cancer? Nearly 14.5 million Americans with a history of cancer were alive on January 1, 2014. Some of these individuals were diagnosed What Is Cancer? recently and undergoing treatment, while most were diagnosed Cancer is a group of diseases characterized by the uncontrolled many years ago with no current evidence of cancer. growth and spread of abnormal cells. If the spread is not con- trolled, it can result in death. Cancer is caused by external factors, such as tobacco, infectious organisms, and an unhealthy How Many New Cases and Deaths diet, and internal factors, such as inherited genetic mutations, Are Expected to Occur This Year? hormones, and immune conditions. These factors may act About 1,685,210 new cancer cases are expected to be diagnosed together or in sequence to cause cancer. Ten or more years often in 2016 (Table 1, page 4). This estimate does not include car- pass between exposure to external factors and detectable can- cinoma in situ (noninvasive cancer) of any site except urinary cer. Treatments include surgery, radiation, chemotherapy, bladder, nor does it include basal cell or squamous cell skin can- hormone therapy, immune therapy, and targeted therapy (drugs cers because these are not required to be reported to cancer that interfere specifically with cancer cell growth). registries. Table 2 (page 5) provides estimated new cancer cases in 2016 by state. Can Cancer Be Prevented? About 595,690 Americans are expected to die of cancer in 2016, A substantial proportion of cancers could be prevented. All can- which translates to about 1,630 people per day (Table 1, page cers caused by tobacco use and heavy alcohol consumption 4). Cancer is the second most common cause of death in the could be prevented completely. In 2016, about 188,800 of the esti- US, exceeded only by heart disease, and accounts for nearly 1 of mated 595,690 cancer deaths in the US will be caused by cigarette every 4 deaths. Table 3 (page 6) provides estimated cancer smoking, according to a recent study by American Cancer Soci- deaths by state in 2016. ety epidemiologists. In addition, the World Cancer Research Fund estimates that about 20% of all cancers diagnosed in the How Much Progress Has Been Made US are related to body fatness, physical inactivity, excess alcohol in the Fight against Cancer? consumption, and/or poor nutrition, and thus could also be pre- vented. Certain cancers are related to infectious agents, such as Trends in cancer death rates are the best measure of progress human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis against cancer. The total cancer death rate rose for most of the C virus (HCV), human immunodeficiency virus (HIV), and Heli- 20th century because of the tobacco epidemic, peaking in 1991 cobacter pylori (H. pylori). Many of these cancers could be avoided at 215 cancer deaths per 100,000 persons. However, from 1991 to by preventing these infections through behavioral changes or 2012, the rate dropped 23% because of reductions in smoking, as vaccination, or by treating the infection. Many of the more than well as improvements in early detection and treatment. This 5 million skin cancer cases that are diagnosed annually could be decline translates into the avoidance of more than 1.7 million prevented by protecting skin from excessive sun exposure and cancer deaths. Death rates are declining for all four of the most not using indoor tanning devices. common cancer types – lung, colorectal, breast, and prostate (Figure 1, page 2 and Figure 2, page 3). Screening can prevent colorectal and cervical cancers by allow- ing for the detection and removal of precancerous lesions. Screening also offers the opportunity to detect some cancers Do Cancer Incidence and Death Rates early, when treatment is less extensive and more likely to be suc- Vary By State? cessful. Screening is known to help reduce mortality for cancers Tables 4 (page 7) and 5 (page 8) provide average annual of the breast, colon, rectum, cervix, and lung (among long-term incidence and death rates during 2008 to 2012 for selected cancer and/or heavy smokers). In addition, a heightened awareness of types by state. For some cancers (e.g., lung), there is substantial changes in certain parts of the body, such as the breast, skin, variation by state, whereas for others (e.g., breast), there is less mouth, eyes, or genitalia, may also result in the early detection of variation. For more information about geographic disparities in cancer. For complete cancer screening guidelines, see page 66. cancer occurrence, see page 53. Who Is at Risk of Developing Cancer? Cancer usually develops in older people; 86% of all cancers in the United States are diagnosed in people 50 years of age or older. Cancer Facts & Figures 2016 1 Certain behaviors also increase risk, such as smoking, eating an familial cancers arise from the interplay between common gene unhealthy diet, or not being physically active. Cancer research- variations and lifestyle/environmental risk factors. Only a small ers use the word “risk” in different ways, most commonly proportion of cancers are strongly hereditary, that is, caused by expressing risk as lifetime risk or relative risk. Lifetime risk an inherited genetic alteration that confers a very high risk. refers to the probability that an individual will develop or die from cancer over the course of a lifetime. In the US, the lifetime What Percentage of People risk of developing cancer is 42% (1 in 2) in men and 38% (1 in 3) in women (Table 6, page 14). These probabilities are estimated Survive Cancer? based on the overall experience of the general population and The 5-year relative survival rate for all cancers diagnosed dur- may overestimate or underestimate individual risk because of ing 2005-2011 was 69%, up from 49% during 1975-1977 (Table 7, differences in exposures (e.g., smoking), family history, and/or page 18). Improvement in survival reflects both the earlier genetic susceptibility.