美国癌症协会：2019美国癌症报告（英文版）.pptx

,Estimated New Cancer Cases* in the US in 2019,M a l es 870,970,F e m a l es 891 ,4 80,Prostate20%Lung & bronchus 13%Colon & rectum9%Urinary bladder7%Melanoma of skin7% Kidney & renal pelvis 5% Non-Hodgkin5%lymphoma,30%Breast13%Lung & bronchus 7%Colon & rectum 7%Uterine corpus 5%Melanoma of skin 4%Thyroid4%Non-Hodgkinlymphoma3%Kidney & renal pelvis 3%Pancreas3%Leukemia21%All other sites,勺Excludesbasalcellandsquamous cellskin cancesandinsitucarcinomaexcepturinary bladder,AL 28,950,AZ 37,490,AR 16,580,CA 186,920,CO 26,800,FL 131,470,GA 50,450,ID 8,390,IL 68,560,IN 35,280,IA 17,810,KS 15,340,KY 26,400,LA 26,800,MA 40,020,MN 30,560,MS 17,050,MO 35,480,MT 5,920,NE 9,780,NV 14,810,NH8,610ME8,920,NM 9,460,NY 111,870,NC 58,690,ND 3,940,OH 67,150,OK 20,540,OR 23,320,PA 79,890,RI 6,540CT 21,950,SC 29,830,SD 4,770,TN 37,350,TX 124,890,UT 11,620,VT 3,920,VA 45,440,WA 39,160,WV 12,440,WI 34,220,WY 2,930,NJ 53,400DE 5,870MD 33,140DC 3,190,HI 7,120,AK 3,090,MI 58,360,PRN/A,US 1,762,450,Estimated numbers of new cancer cases for 2019, 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.,Cancer Facts & Figures,2019,Special Section: Cancer in the Oldest Oldsee page 29,ContentsBasic Cancer Facts1Figure 1. Trends in Age-adjusted Cancer Death Rates by Site, Males, US, 1930-20162Figure 2. Trends in Age-adjusted Cancer Death Rates by Site, Females, US, 1930-20163Table 1. Estimated Number of New Cancer Cases andDeaths by Sex, US, 20194Table 2. Estimated Number of New Cases for SelectedCancers by State, US, 20195Table 3. Estimated Number of Deaths for SelectedCancers by State, US, 20196Table 4. Incidence Rates for Selected Cancers byState, US, 2011-20157Table 5. Death Rates for Selected Cancers by State,US, 2012-20168,Selected Cancers9Figure 3. Leading Sites of New Cancer Cases and Deaths 2019 Estimates10Table 6. Probability (%) of Developing Invasive Cancerduring Selected Age Intervals by Sex, US, 2013-201514Table 7. Trends in 5-year Relative Survival Rates (%)by Race, US, 1975-201418Table 8. Five-year Relative Survival Rates* (%) by Stageat Diagnosis, US, 2008-201421,Special Section: Cancer in the Oldest Old29Figure S1. Age Distribution of US Population in Millions:2016 versus 206029Figure S2. Average Annual Incidence Rates and CaseDistribution by Age, US, 2011-201530Table S1. Leading Cancer Sites of New Cancer Casesand Deaths, Ages 85+, US31Figure S3. Cancer Incidence and Mortality Rates amongAdults 85+ by Race/Ethnicity, US, 2011-201632,Figure S4. Trends in Cancer Incidence and Death Ratesby Sex, Ages 85+, US, 1975-201633Figure S5. Trends in Cancer Incidence Rates for SelectedSites, Ages 85+, US, 1995-201534Table S2. Joinpoint Trends in Cancer Incidence Rates forSelected Sites in Two Age Groups, US, 1995-201535Figure S6. Trends in Cancer Death Rates for Selected Sites,Ages 85+, US, 1975-201636Figure S7. Stage Distribution (%) for Selected Cancers inTwo Age Groups, US, 2008-201437Table S3. Screening Prevalence (%) among Adults 85+,US, 201538Figure S8. Five-year Relative Survival for Selected Cancersin Two Age Groups, US, 2008-201439Figure S9. Receipt of Surgical Treatment for Selected Cancersin Two Age Groups, US, 2011-201540,Tobacco Use44Figure 4. Proportion of Cancer Deaths Attributable toCigarette Smoking in Adults 30 Years and Older, US, 201444,Excess Body Weight, Alcohol, Diet &Physical Activity49,Cancer Disparities52Table 9. Incidence and Mortality Rates for SelectedCancers by Race and Ethnicity, US, 2011-201654,The Global Cancer Burden55,The American Cancer Society58,Sources of Statistics69American Cancer Society Recommendations for the EarlyDetection of Cancer in Average-risk Asymptomatic People71,Global Headquarters: American Cancer Society Inc. 250 Williams Street, NW, Atlanta, GA 30303-1002404-320-33332019, American Cancer Society, Inc. All rights reserved, including the right to reproduce this publicationor 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 2019.,Cancer Facts & Figures 2019,1,Basic Cancer Facts,What Is Cancer?Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death. Although the causes of cancer are not completely understood, numerous factors are known to increase the diseases occurrence, including many that are modifiable (e.g., tobacco use and excess body weight) and those that are not (e.g., inherited genetic mutations and immune conditions). These risk factors may act simultaneously or in sequence to initiate and/or promote cancer growth.Can Cancer Be Prevented?A substantial proportion of cancers could be prevented, including all cancers caused by tobacco use and other unhealthy behaviors. According to a recent study by American Cancer Society researchers, at least 42% of newly diagnosed cancers in the US about 740,000 cases in 2019 are potentially avoidable, including the 19% of all cancers that are caused by smoking and the 18% that are caused by a combination of excess body weight, physical inactivity, excess alcohol consumption, and poor nutrition. Certain 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 prevented through behavioral changes or vaccination to avoid the infection, or treatment of the infection. Many of the more than 5 million skin cancer cases that are diagnosed annually could be prevented by protecting skin from excessive sun exposure and not using indoor tanning devices.Screening can help prevent colorectal and cervical cancers by detecting precancerous lesions that can be removed. It can also detect some cancers early, when treatment is more often successful. Screening is known to help reduce mortality for cancers of the breast, colon, rectum, cervix, prostate, and lung (among current or former heavy smokers). In addition, a heightened awareness of changes in certain parts of the body, such as the breast, skin, mouth, eyes, or genitalia, may also result,in the early detection of cancer. For complete cancer screening guidelines, see page 71.,How Many People Alive Today Have Ever Had Cancer?More than 15.5 million Americans with a history of cancer were alive on January 1, 2016, most of whom were diagnosed many years ago and have no current evidence of cancer.How Many New Cases and Deaths Are Expected to Occur in 2019?More than 1.7 million new cancer cases are expected to be diagnosed in 2019 (Table 1). This estimate does not include carcinoma in situ (noninvasive cancer) of any site except urinary bladder, nor does it include basal cell or squamous cell skin cancers because these are not required to be reported to cancer registries. Table 2 provides estimated new cancer cases in 2019 by state.About 606,880 Americans are expected to die of cancer in 2019 (Table 1), which translates to about 1,660 deaths per day. Cancer is the second most common cause of death in the US, exceeded only by heart disease. Table 3 provides estimated cancer deaths by state in 2019.How Much Progress Has Been Made against Cancer?Cancer death rates are the best measure of progress against the disease because they are less affected by detection practices than incidence and survival. The overall age-adjusted cancer death rate rose during most of the 20th century, peaking in 1991 at 215 cancer deaths per 100,000 people, mainly because of the tobacco epidemic. As of 2016, the rate had dropped to 156 per 100,000 (a decline of 27%) because of reductions in smoking, as well as improvements in early detection and treatment. This decline translates into more than 2.6 million fewer cancer deaths from 1991 to 2016, progress that has been driven by steady declines in death rates for the four most common cancer types lung, colorectal, breast, and prostate (Figure 1 and Figure 2).,2,Cancer Facts & Figures 2019,Do Cancer Incidence and Death Rates Vary by State?Table 4 and Table 5 provide average annual incidence (new diagnoses) and death rates for selected cancer types by state. Lung cancer rates vary the most by state, reflecting historical differences in smoking prevalence that continue today.,Who Is at Risk of Developing Cancer?Cancer usually develops in older people; 80% of all cancers in the United States are diagnosed in people 55 years of age or older. Certain behaviors also increase risk, such as smoking, having excess body weight, and drinking alcohol. In the US, approximately 39 out of 100 men and 38 out of 100 women will develop cancer during their lifetime (Table 6). These probabilities are estimated based on cancer occurrence in the general population and may overestimate or underestimate individual risk because of differences in exposures (e.g., smoking), family history, and/or genetic susceptibility. For most,types of cancer, risk is higher with a family history of the disease. This is thought to result primarily from the inheritance of genetic variations that confer low or moderate risk and/or similar exposures to lifestyle/ environmental risk factors among family members, as opposed to inheritance of genetic alterations that confer a very high risk, which occurs much more rarely.,Relative risk is the strength of the relationship between exposure to a given risk factor and cancer. It is measured by comparing cancer occurrence in people with a certain exposure or trait to cancer occurrence in people without this characteristic. For example, men and women who smoke are about 25 times more likely to develop lung cancer than nonsmokers, so the relative risk of lung cancer among smokers is 25. Most relative risks are not this large. For example, women who have a mother, sister, or daughter with a history of breast cancer are about twice as likely to develop breast cancer as women who do not have this family history; in other words, their relative risk is about 2.,Rate per 100,000 male population,Pancreas,Colon & rectum,Prostate,Stomach,20,40,60,Figure 1. Trends in Age-adjusted Cancer Death Rates* by Site, Males, US, 1930-2016100Lung & bronchus80,Leukemia0193019351940194519501955196019651970197519801985199019952000200520102015*Per 100,000, age adjusted to the 2000 US standard population. Mortality rates for pancreatic and liver cancers are increasing.Note: Due to changes in ICD coding, numerator information has changed over time. Rates for cancers of the liver, lung and bronchus, and colon and rectum are affected by these coding changes.Source: US Mortality Volumes 1930 to 1959, US Mortality Data 1960 to 2016, National Center for Health Statistics, Centers for Disease Control and Prevention.2019, American Cancer Society, Inc., Surveillance Research,Liver,Cancer Facts & Figures 2019,3,What Percentage of People Survive Cancer?The 5-year relative survival rate for all cancers combined has increased substantially since the early 1960s, from 39% to 70% among whites and from 27% to 63% among blacks. Improvements in survival (Table 7) reflect advances in treatment, as well as earlier diagnosis for some cancers. Survival varies greatly by cancer type, as well as stage and age at diagnosis (Table 8).,Relative survival is the proportion of people who are alive for a designated time (usually 5 years) after a cancer diagnosis divided by the proportion of people of similar age, race, etc. expected to be alive in the absence of cancer based on normal life expectancy. Relative survival does not distinguish between patients who have no evidence of cancer and those who have relapsed or are still in treatment; nor does it represent the proportion of people who are cured, because cancer death can occur,beyond 5 years after diagnosis. For information about how survival rates were calculated for this report, see Sources of Statistics on page 69.,Although relative survival rates provide some indication about the average experience of cancer patients, they should be interpreted with caution for several reasons. First, 5-year survival rates do not reflect the most recent advances in detection and treatment because they are based on patients who were diagnosed at least several years in the past. Second, they do not account for many factors that influence individual survival, such as access to treatment, other illnesses, and biological or behavioral differences. Third, improvements in survival rates over time do not always indicate progress against cancer. For example, increases in average survival rates occur when screening results in the detection of cancers that would never have caused harm if left undetected (overdiagnosis).,Rate per 100,000 female population,Uterus,Pancreas,Colon & rectum,Breast,Lung & bronchus,Stomach,20,40,60,80,Figure 2. Trends in Age-adjusted Cancer Death Rates* by Site, Females, US, 1930-2016100,0193019351940194519501955196019651970197519801985199019952000200520102015*Per 100,000, age adjusted to the 2000 US standard population. Rates exclude deaths in Puerto Rico and other US territories. Uterus refers to uterine cervix and uterine corpus combined. The mortality rate for liver cancer is increasing.Note: Due to changes in ICD coding, numerator information has changed over time. Rates for cancers of the liver, lung and bronchus, colon and rectum, and uterus are affected by these coding changes.Source: US Mortality Volumes 1930 to 1959, US Mortality Data 1960 to 2016, National Center for Health Statistics, Centers for Disease Control and Prevention.2019, American Cancer Society, Inc., Surveillance Research,Liver,4,Cancer Facts & Figures 2019,Table 1. Estimated Number* of New Cancer Cases and Deaths by Sex, US, 2019Estimated New Cases,