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In 2010, more than half of all new cancers were cancers of the prostate, female breast, lung, and colon/rectum. According to American Cancer Society projections, there were 1,529,560 new cases of cancer in 2010, including 217,730 cases of prostate cancer; 209,060 cases of female breast cancer; 222,520 cases of lung cancer; and 142,570, cases of colon/rectum cancer.
Cancer incidence is usually measured as the number of new cases each year for every 100,000 people (for gender-specific cancers, people of the same gender serve as the denominator) and age-adjusted (to a standard population) to allow comparisons over time.
Incidence rate: The observed number of new cancer cases per 100,000 people per year is adjusted for cancer case reporting delays, based on data from approximately 10 percent of the U.S. population.
All sites combined: Overall incidence was on the rise from 1975 to 1989, with non-significant changes in rates from 1989 to 1999. From 1999 to 2007, incidence has significantly declined. Among men, incidence rates rose from 1975 to 1992. From 1992 to 1995, cancer incidence among men significantly declined, with no significant change between 1995 and 2000. From 2000 to 2007, incidence trends among men resumed a decline. Among women, from 1975 to 1979 incidence rates were stable before rising between 1979 and 1987 and then stabilizing through 1998. From 1998 to 2007, cancer incidence among women significantly declined.
Prostate cancer: Incidence rose between 1975 and 1992 and then fell until around 1995. After a period of non-significant change from 1995 to 2000, rates declined again from 2000 to 2007.
Female breast cancer: After an initial period of no significant change, incidence rates rose between 1980 and 1987, before stabilizing from 1987 to 1998. Incidence rates fell from 1998 to 2007.
Colorectal cancer: Among males, incidence rose between 1975 and 1985; incidence rates were stable among women during these years. Among both men and women, incidence rates have fallen steadily since 1985, except for a period of non-significant change in rates among both men and women from 1995 to 1998.
Lung cancer: Incidence of lung cancer was consistently higher among males than females between 1975 and 2006. Incidence rates increased among men from 1975 until 1982, were stable from 1982 to 1991, and declined from 1991 to 2007. Lung cancer incidence rates steadily increased among women from 1975 to 2007.
In 2007, new cases of cancer occurred at the following rates:
All sites combined: 472.68 cases per 100,000 people per year
Prostate: 170.88 per 100,000 men per year
Female breast: 124.68 per 100,000 women per year
Colorectal: 51.60 per 100,000 men per year and 41.15 per 100,000 women per year
Lung: 71.82 per 100,000 men per year and 53.02 per 100,000 women per year
There is no Healthy People 2010 target for cancer incidence.
Among major racial/ethnic groups, blacks have the highest rate of new cancers, followed by whites. Comparatively, rates are lower among American Indians/Alaska Natives, Hispanics, and Asians and Pacific Islanders.
The small subset of cancer sites with the fastest increasing incidence rates (annual percent changes of 2 percent or more per year) include melanoma of the skin; cancer of the kidney and renal pelvis; thyroid; Hodgkin lymphoma, and liver and intrahepatic bile duct cancers. The incidence rates of other cancer sites are also rising; however, they are rising at rates of less than 2 percent per year. These cancers include non-Hodgkin lymphoma, childhood cancer, pancreas cancer, leukemia, testis, and esophageal cancer. Rising cancer incidence trends must be interpreted with caution, because they can reflect a “real” increase in cases, a temporary increase in cases associated with early detection, or a permanent increase in cases associated with finding cases that are histologically malignant but biologically indolent.
Cancer Sites with Decreasing Incidence Trends
Incidence rates are decreasing for all cancer sites combined and for the four leading cancers (prostate, breast, lung, and colorectal cancer); incidence rates of several other cancer sites are also decreasing. Among cancer sites with annual incidence rates of at least 5 cases per 100,000 cancers with decreasing incidence are corpus and uterus (not otherwise specified); ovary; oral cavity and pharynx; stomach; cervix uteri; and urinary bladder cancers.
Although the rate of increase in lung cancer incidence among women has slowed recently, the increasing trend remains statistically significant, and lung cancer is by far the leading cause of cancer deaths among women. This highlights the need to reduce smoking prevalence and environmental tobacco smoke (ETS) exposure among all women, focusing especially on those populations whose tobacco use and ETS exposure remains high, such as women with lower levels of education.
The recent decline in new breast cancer incidence is thought to be related to the decline in hormone replacement therapy (HRT) use and the small decline in screening using mammography. Although most major cancers are occurring less frequently, cancers of some sites are on the rise and require greater efforts at control.
For instance, incidence rates of some cancers, including melanoma of the skin, cancer of the kidney, and renal pelvis, thyroid, and liver and intrahepatic bile duct cancers, are rising with annual percent changes of greater than 2 percent. Incidence rates of some other cancers are also rising; however, they are rising at a rate of less than 2 percent per year. These cancer sites include non-Hodgkin lymphoma, childhood cancer, pancreatic cancer, leukemia, testicular cancer, and esophageal cancer.
Rising incidence rates must be interpreted with caution, because trends can reflect “real” increases in cases, temporary increase in cases with earlier detection, or additional finding of cases that are histologically malignant but biologically indolent.
Incidence rates of most leading cancers are decreasing, including female breast, prostate, colorectal and lung cancers. Incidence rates are also decreasing for other sites, including corpus and uterus; not otherwise specified; ovary; oral cavity and pharynx; stomach; brain and other nervous system; and urinary bladder.