Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.
CA Cancer J Clin. 2020 Jan;70(1):7-30. doi: 10.3322/caac.21590. Epub 2020 Jan 8.
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2016) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2017) were collected by the National Center for Health Statistics. In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States. The cancer death rate rose until 1991, then fell continuously through 2017, resulting in an overall decline of 29% that translates into an estimated 2.9 million fewer cancer deaths than would have occurred if peak rates had persisted. This progress is driven by long-term declines in death rates for the 4 leading cancers (lung, colorectal, breast, prostate); however, over the past decade (2008-2017), reductions slowed for female breast and colorectal cancers, and halted for prostate cancer. In contrast, declines accelerated for lung cancer, from 3% annually during 2008 through 2013 to 5% during 2013 through 2017 in men and from 2% to almost 4% in women, spurring the largest ever single-year drop in overall cancer mortality of 2.2% from 2016 to 2017. Yet lung cancer still caused more deaths in 2017 than breast, prostate, colorectal, and brain cancers combined. Recent mortality declines were also dramatic for melanoma of the skin in the wake of US Food and Drug Administration approval of new therapies for metastatic disease, escalating to 7% annually during 2013 through 2017 from 1% during 2006 through 2010 in men and women aged 50 to 64 years and from 2% to 3% in those aged 20 to 49 years; annual declines of 5% to 6% in individuals aged 65 years and older are particularly striking because rates in this age group were increasing prior to 2013. It is also notable that long-term rapid increases in liver cancer mortality have attenuated in women and stabilized in men. In summary, slowing momentum for some cancers amenable to early detection is juxtaposed with notable gains for other common cancers.
每年，美国癌症协会都会预估美国新癌症病例和死亡人数，并汇编最新的基于人群的癌症发病数据。发病率数据（截至 2016 年）由监测、流行病学和结果计划、国家癌症登记处计划和北美癌症登记处协会收集。死亡率数据（截至 2017 年）由国家卫生统计中心收集。2020 年，预计美国将有 1806590 例新癌症病例和 606520 例癌症死亡。癌症死亡率在 1991 年达到顶峰，然后持续下降，直到 2017 年，总体下降了 29%，这意味着如果峰值持续下去，癌症死亡人数将减少 290 万。这一进展得益于肺癌、结直肠癌、乳腺癌和前列腺癌这 4 大主要癌症死亡率的长期下降；然而，在过去的十年里（2008-2017 年），女性乳腺癌和结直肠癌的死亡率下降速度放缓，而前列腺癌的死亡率则停止下降。相比之下，肺癌的死亡率下降速度加快，男性从 2008 年到 2013 年每年下降 3%，到 2013 年到 2017 年每年下降 5%，女性从 2%上升到近 4%，这导致 2016 年至 2017 年癌症总死亡率下降了 2.2%，这是有史以来最大的单年降幅。然而，2017 年肺癌导致的死亡人数仍然超过乳腺癌、前列腺癌、结直肠癌和脑癌的总和。在美国食品和药物管理局批准新的转移性疾病治疗方法后，皮肤黑色素瘤的近期死亡率也大幅下降，50 至 64 岁男性和女性的死亡率从 2006 年至 2010 年的每年 1%上升到 2013 年至 2017 年的每年 7%，20 至 49 岁的死亡率从每年 2%上升到 3%；65 岁及以上人群的死亡率每年下降 5%至 6%，这尤为引人注目，因为在此之前，这一年龄组的死亡率一直在上升。同样值得注意的是，女性肝癌死亡率的长期快速增长已经减弱，男性肝癌死亡率已经稳定。总之，一些易于早期发现的癌症的发展势头放缓，而其他常见癌症则取得了显著进展。
