Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA.
CA Cancer J Clin. 2023 Jan;73(1):17-48. doi: 10.3322/caac.21763.
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries and mortality data collected by the National Center for Health Statistics. In 2023, 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States. Cancer incidence increased for prostate cancer by 3% annually from 2014 through 2019 after two decades of decline, translating to an additional 99,000 new cases; otherwise, however, incidence trends were more favorable in men compared to women. For example, lung cancer in women decreased at one half the pace of men (1.1% vs. 2.6% annually) from 2015 through 2019, and breast and uterine corpus cancers continued to increase, as did liver cancer and melanoma, both of which stabilized in men aged 50 years and older and declined in younger men. However, a 65% drop in cervical cancer incidence during 2012 through 2019 among women in their early 20s, the first cohort to receive the human papillomavirus vaccine, foreshadows steep reductions in the burden of human papillomavirus-associated cancers, the majority of which occur in women. Despite the pandemic, and in contrast with other leading causes of death, the cancer death rate continued to decline from 2019 to 2020 (by 1.5%), contributing to a 33% overall reduction since 1991 and an estimated 3.8 million deaths averted. This progress increasingly reflects advances in treatment, which are particularly evident in the rapid declines in mortality (approximately 2% annually during 2016 through 2020) for leukemia, melanoma, and kidney cancer, despite stable/increasing incidence, and accelerated declines for lung cancer. In summary, although cancer mortality rates continue to decline, future progress may be attenuated by rising incidence for breast, prostate, and uterine corpus cancers, which also happen to have the largest racial disparities in mortality.
每年,美国癌症协会都会预估美国新癌症病例和死亡人数,并利用中央癌症登记处收集的发病率数据和国家卫生统计中心收集的死亡率数据,编制最新的基于人群的癌症发病和结果数据。2023 年,预计美国将有 195.831 例新癌症病例和 60.982 例癌症死亡。自 20 年前开始下降以来,前列腺癌的发病率在 2014 年至 2019 年期间以每年 3%的速度上升,这意味着新增病例 9.9 万例;然而,与女性相比,男性的发病趋势更为有利。例如,2015 年至 2019 年,女性肺癌的发病率下降了一半(每年 1.1%对 2.6%),而乳腺癌和子宫癌仍在继续上升,肝癌和黑色素瘤的发病率在 50 岁及以上的男性中保持稳定,在年轻男性中则有所下降。然而,在 2012 年至 2019 年期间,20 多岁的女性宫颈癌发病率下降了 65%,这是第一批接种人乳头瘤病毒疫苗的人群,预示着与人类乳头瘤病毒相关癌症的负担将大幅减少,其中大多数发生在女性身上。尽管受到疫情的影响,但与其他主要死亡原因不同,癌症死亡率从 2019 年持续下降到 2020 年(下降了 1.5%),自 1991 年以来总体下降了 33%,估计有 380 万人因此避免了死亡。这一进展越来越多地反映出治疗的进步,这在白血病、黑色素瘤和肾癌的死亡率迅速下降(2016 年至 2020 年期间每年约下降 2%)中尤为明显,尽管发病率保持稳定/上升,肺癌的死亡率也在加速下降。总之,尽管癌症死亡率继续下降,但由于乳腺癌、前列腺癌和子宫癌的发病率上升,未来的进展可能会受到影响,而这些癌症的死亡率在种族之间存在最大的差异。