Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
North American Association of Central Cancer Registries, Springfield, Illinois.
Cancer. 2020 May 15;126(10):2225-2249. doi: 10.1002/cncr.32802. Epub 2020 Mar 12.
The American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries collaborate to provide annual updates on cancer occurrence and trends in the United States.
Data on new cancer diagnoses during 2001 through 2016 were obtained from the Centers for Disease Control and Prevention-funded and National Cancer Institute-funded population-based cancer registry programs and compiled by the North American Association of Central Cancer Registries. Data on cancer deaths during 2001 through 2017 were obtained from the National Center for Health Statistics' National Vital Statistics System. Trends in incidence and death rates for all cancers combined and for the leading cancer types by sex, racial/ethnic group, and age were estimated by joinpoint analysis and characterized by the average annual percent change during the most recent 5 years (2012-2016 for incidence and 2013-2017 for mortality).
Overall, cancer incidence rates decreased 0.6% on average per year during 2012 through 2016, but trends differed by sex, racial/ethnic group, and cancer type. Among males, cancer incidence rates were stable overall and among non-Hispanic white males but decreased in other racial/ethnic groups; rates increased for 5 of the 17 most common cancers, were stable for 7 cancers (including prostate), and decreased for 5 cancers (including lung and bronchus [lung] and colorectal). Among females, cancer incidence rates increased during 2012 to 2016 in all racial/ethnic groups, increasing on average 0.2% per year; rates increased for 8 of the 18 most common cancers (including breast), were stable for 6 cancers (including colorectal), and decreased for 4 cancers (including lung). Overall, cancer death rates decreased 1.5% on average per year during 2013 to 2017, decreasing 1.8% per year among males and 1.4% per year among females. During 2013 to 2017, cancer death rates decreased for all cancers combined among both males and females in each racial/ethnic group, for 11 of the 19 most common cancers among males (including lung and colorectal), and for 14 of the 20 most common cancers among females (including lung, colorectal, and breast). The largest declines in death rates were observed for melanoma of the skin (decreasing 6.1% per year among males and 6.3% among females) and lung (decreasing 4.8% per year among males and 3.7% among females). Among children younger than 15 years, cancer incidence rates increased an average of 0.8% per year during 2012 to 2016, and cancer death rates decreased an average of 1.4% per year during 2013 to 2017. Among adolescents and young adults aged 15 to 39 years, cancer incidence rates increased an average of 0.9% per year during 2012 to 2016, and cancer death rates decreased an average of 1.0% per year during 2013 to 2017.
Although overall cancer death rates continue to decline, incidence rates are leveling off among males and are increasing slightly among females. These trends reflect population changes in cancer risk factors, screening test use, diagnostic practices, and treatment advances. Many cancers can be prevented or treated effectively if they are found early. Population-based cancer incidence and mortality data can be used to inform efforts to decrease the cancer burden in the United States and regularly monitor progress toward goals.
美国癌症协会、美国疾病控制与预防中心、美国国家癌症研究所和北美癌症登记协会合作，提供美国癌症发病和趋势的年度更新。
癌症新发病例数据来源于美国疾病控制与预防中心资助和美国国家癌症研究所资助的基于人群的癌症登记项目，由北美癌症登记协会汇编而成。癌症死亡数据来源于美国国家卫生统计中心的国家生命统计系统。所有癌症以及按性别、种族/族裔和年龄划分的主要癌症类型的发病率和死亡率趋势采用 Joinpoint 分析进行估计，并通过最近 5 年（2012-2016 年为发病率，2013-2017 年为死亡率）的平均年变化百分比进行描述。
总的来说，2012 年至 2016 年期间，癌症发病率平均每年下降 0.6%，但不同性别、种族/族裔和癌症类型的趋势有所不同。在男性中，总体癌症发病率保持稳定，非西班牙裔白人男性也是如此，但其他种族/族裔群体的发病率却在下降；17 种最常见癌症中有 5 种发病率上升，7 种癌症（包括前列腺癌）保持稳定，5 种癌症（包括肺癌和支气管癌[肺癌]和结直肠癌）发病率下降。在女性中，所有种族/族裔群体的癌症发病率在 2012 年至 2016 年期间均呈上升趋势，平均每年上升 0.2%；18 种最常见癌症中有 8 种（包括乳腺癌）发病率上升，6 种癌症（包括结直肠癌）保持稳定，4 种癌症（包括肺癌）发病率下降。总的来说，2013 年至 2017 年期间，癌症死亡率平均每年下降 1.5%，男性每年下降 1.8%，女性每年下降 1.4%。在 2013 年至 2017 年期间，每个种族/族裔群体的男性和女性的所有癌症死亡率均有所下降，男性的 19 种最常见癌症中有 11 种（包括肺癌和结直肠癌），女性的 20 种最常见癌症中有 14 种（包括肺癌、结直肠癌和乳腺癌）。死亡率下降幅度最大的是皮肤黑色素瘤（男性每年下降 6.1%，女性每年下降 6.3%）和肺癌（男性每年下降 4.8%，女性每年下降 3.7%）。在 15 岁以下的儿童中，2012 年至 2016 年期间，癌症发病率平均每年上升 0.8%，2013 年至 2017 年期间，癌症死亡率平均每年下降 1.4%。在 15 至 39 岁的青少年和年轻成年人中，2012 年至 2016 年期间，癌症发病率平均每年上升 0.9%，2013 年至 2017 年期间，癌症死亡率平均每年下降 1.0%。
尽管总体癌症死亡率继续下降，但男性的死亡率趋于平稳，女性的死亡率略有上升。这些趋势反映了癌症风险因素、筛查试验使用、诊断实践和治疗进展方面的人口变化。如果及早发现，许多癌症可以得到有效预防或治疗。基于人群的癌症发病率和死亡率数据可用于指导减少美国癌症负担的工作，并定期监测实现目标的进展情况。
