The past, present, and future of cancer incidence in the United States: 1975 through 2020

Abstract

Background: The overall age-standardized cancer incidence rate continues to decline whereas the number of cases diagnosed each year increases. Predicting cancer incidence can help to anticipate future resource needs, evaluate primary prevention strategies, and inform research.

Methods: Surveillance, Epidemiology, and End Results data were used to estimate the number of cancers (all sites) resulting from changes in population risk, age, and size. The authors projected to 2020 nationwide age-standardized incidence rates and cases (including the top 23 cancers).

Results: Since 1975, incident cases increased among white individuals, primarily caused by an aging white population, and among black individuals, primarily caused by an increasing black population. Between 2010 and 2020, it is expected that overall incidence rates (proxy for risk) will decrease slightly among black men and stabilize in other groups. By 2020, the authors predict annual cancer cases (all races, all sites) to increase among men by 24.1% (-3.2% risk and 27.3% age/growth) to >1 million cases, and by 20.6% among women (1.2% risk and 19.4% age/growth) to >900,000 cases. The largest increases are expected for melanoma (white individuals); cancers of the prostate, kidney, liver, and urinary bladder in males; and the lung, breast, uterus, and thyroid in females.

Conclusions: Overall, the authors predict cancer incidence rates/risk to stabilize for the majority of the population; however, they expect the number of cancer cases to increase by >20%. A greater emphasis on primary prevention and early detection is needed to counter the effect of an aging and growing population on the burden of cancer.

Keywords: cancer; cancer registries; incidence; predictions; projections; surveillance.

Figure 1

(a-d) Trends in incident cases for all cancers and ages combined attributed to population risk and diagnostic practices, growth, and aging are shown. Surveillance, Epidemiology, and End Results SEER 9 registry data (1975-2009) are shown by sex and race (white vs black) in (a) white males, (b) white females, (c) black males, and (d) black females.

Figure 2

(a-m) Trends in observed (solid line) and predicted (dotted line) age-standardized incidence rates are shown for all sites combined and the top 10 cancers in men and women with the largest predicted increase in incident cases (white and black individuals), 1975 through 2020. NOS indicates not otherwise specified; IBD, inflammatory bowel disease.

Figure 2

(a-m) Trends in observed (solid line) and predicted (dotted line) age-standardized incidence rates are shown for all sites combined and the top 10 cancers in men and women with the largest predicted increase in incident cases (white and black individuals), 1975 through 2020. NOS indicates not otherwise specified; IBD, inflammatory bowel disease.

Figure 3

(a and b) Cancer site-specific incident cases predicted to be diagnosed in 2010 (dark shading) and additional cases predicted to be diagnosed in 2020 (lighter shading) are shown ranked by 2010 case counts by sex. CNS indicates central nervous system; IBD, inflammatory bowel disease.