Estimated Projection of US Cancer Incidence and Death to 2040

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Key Points

Question

How will the landscape of cancer incidences and deaths change in the next 2 decades?

Findings

In this cross-sectional study, the results estimate that leading cancer incidences and deaths in the US will be notably different in the year 2040 compared with current rankings. Estimates included increases in melanoma incidence, pancreatic cancer deaths, and liver cancer deaths, and decreases in prostate cancer incidence and breast cancer deaths.

Meaning

These estimates will be important to guide research, health care, and health policy efforts and emphasize the importance of cancer screening, early detection, and prevention.

Abstract

This cross-sectional study examines recent data from the Surveillance, Epidemiology, and End Results Program and US Census to estimate projections for US cancer incidence and deaths to 2040.

Abstract

Importance

Coping with the current and future burden of cancer requires an in-depth understanding of trends in cancer incidences and deaths. Estimated projections of cancer incidences and deaths will be important to guide future research funding allocations, health care planning, and health policy efforts.

Objective

To estimate cancer incidences and deaths in the United States to the year 2040.

Design and Setting

This cross-sectional study’s estimated projection analysis used population growth projections and current population-based cancer incidence and death rates to calculate the changes in incidences and deaths to the year 2040. Cancer-specific incidences and deaths in the US were estimated for the most common cancer types. Demographic cancer-specific delay-adjusted incidence rates from the Surveillance, Epidemiology, and End Results Program were combined with US Census Bureau population growth projections (2016) and average annual percentage changes in incidence and death rates. Statistical analyses were performed from July 2020 to February 2021.

Main Outcomes and Measures

Total cancer incidences and deaths to the year 2040.

Results

This study estimated that the most common cancers in 2040 will be breast (364 000 cases) with melanoma (219 000 cases) becoming the second most common cancer; lung, third (208 000 cases); colorectal remaining fourth (147 000 cases); and prostate cancer dropping to the fourteenth most common cancer (66 000 cases). Lung cancer (63 000 deaths) was estimated to continue as the leading cause of cancer-related death in 2040, with pancreatic cancer (46 000 deaths) and liver and intrahepatic bile duct cancer (41 000 deaths) surpassing colorectal cancer (34 000 deaths) to become the second and third most common causes of cancer-related death, respectively. Breast cancer (30 000 deaths) was estimated to decrease to the fifth most common cause of cancer death.

Conclusions and Relevance

These findings suggest that there will be marked changes in the landscape of cancer incidence and deaths by 2040.

Related collections

Most cited references 26

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Cancer statistics, 2020

Rebecca Siegel, Kimberly D Miller, Ahmedin Jemal (2020)

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.

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Record: found
Abstract: found
Article: not found

Cancer statistics, 2019

Rebecca Siegel, Kimberly D Miller, Ahmedin Jemal (2019)

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 cancer incidence, mortality, and survival. Incidence data, available through 2015, 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, available through 2016, were collected by the National Center for Health Statistics. In 2019, 1,762,450 new cancer cases and 606,880 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2006-2015) was stable in women and declined by approximately 2% per year in men, whereas the cancer death rate (2007-2016) declined annually by 1.4% and 1.8%, respectively. The overall cancer death rate dropped continuously from 1991 to 2016 by a total of 27%, translating into approximately 2,629,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the racial gap in cancer mortality is slowly narrowing, socioeconomic inequalities are widening, with the most notable gaps for the most preventable cancers. For example, compared with the most affluent counties, mortality rates in the poorest counties were 2-fold higher for cervical cancer and 40% higher for male lung and liver cancers during 2012-2016. Some states are home to both the wealthiest and the poorest counties, suggesting the opportunity for more equitable dissemination of effective cancer prevention, early detection, and treatment strategies. A broader application of existing cancer control knowledge with an emphasis on disadvantaged groups would undoubtedly accelerate progress against cancer.

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Reduced lung-cancer mortality with low-dose computed tomographic screening.

(2011)

The aggressive and heterogeneous nature of lung cancer has thwarted efforts to reduce mortality from this cancer through the use of screening. The advent of low-dose helical computed tomography (CT) altered the landscape of lung-cancer screening, with studies indicating that low-dose CT detects many tumors at early stages. The National Lung Screening Trial (NLST) was conducted to determine whether screening with low-dose CT could reduce mortality from lung cancer. From August 2002 through April 2004, we enrolled 53,454 persons at high risk for lung cancer at 33 U.S. medical centers. Participants were randomly assigned to undergo three annual screenings with either low-dose CT (26,722 participants) or single-view posteroanterior chest radiography (26,732). Data were collected on cases of lung cancer and deaths from lung cancer that occurred through December 31, 2009. The rate of adherence to screening was more than 90%. The rate of positive screening tests was 24.2% with low-dose CT and 6.9% with radiography over all three rounds. A total of 96.4% of the positive screening results in the low-dose CT group and 94.5% in the radiography group were false positive results. The incidence of lung cancer was 645 cases per 100,000 person-years (1060 cancers) in the low-dose CT group, as compared with 572 cases per 100,000 person-years (941 cancers) in the radiography group (rate ratio, 1.13; 95% confidence interval [CI], 1.03 to 1.23). There were 247 deaths from lung cancer per 100,000 person-years in the low-dose CT group and 309 deaths per 100,000 person-years in the radiography group, representing a relative reduction in mortality from lung cancer with low-dose CT screening of 20.0% (95% CI, 6.8 to 26.7; P=0.004). The rate of death from any cause was reduced in the low-dose CT group, as compared with the radiography group, by 6.7% (95% CI, 1.2 to 13.6; P=0.02). Screening with the use of low-dose CT reduces mortality from lung cancer. (Funded by the National Cancer Institute; National Lung Screening Trial ClinicalTrials.gov number, NCT00047385.).

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Author and article information

Journal

Journal ID (nlm-ta): JAMA Netw Open

Journal ID (iso-abbrev): JAMA Netw Open

Journal ID (pmc): JAMA Netw Open

Title: JAMA Network Open

Publisher: American Medical Association

ISSN (Electronic): 2574-3805

Publication date (Electronic): 7 April 2021

Publication date Collection: April 2021

Publication date PMC-release: 7 April 2021

Volume: 4

Issue: 4

Electronic Location Identifier: e214708

Affiliations

[1 ]Cancer Commons, Mountain View, California

[2 ]Pancreatic Cancer Action Network, Manhattan Beach, California

[3 ]Department of Health Services Research, Department of Dermatology, MD Anderson Cancer Center, Houston, Texas

[4 ]Department of Epidemiology, Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas

Author notes

Article Information

Accepted for Publication: February 16, 2021.

Published: April 7, 2021. doi:10.1001/jamanetworkopen.2021.4708

Corresponding Author: Lola Rahib, PhD, Cancer Commons, 650 Castro St, Ste 120-522, Mountain View, CA 94041 ( lola.rahib@ 123456cancercommons.org ).

Author Contributions: Dr Rahib had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Rahib, Matrisian, Nead.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Rahib, Nead.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Rahib.

Obtained funding: Matrisian.

Supervision: Matrisian, Nead.

Conflict of Interest Disclosures: None reported.

Funding/Support: The research was supported, in part, by the Cancer Center Support Grants (CCSG) for National Institutes of Health, National Cancer Institute–Designated Cancer Centers P30 CA016672 (Drs Wehner and Nead), the Cancer Prevention and Research Institute of Texas (CPRIT) RR190077 (Dr Nead), CPRIT RR190078 (Dr Wehner), Cancer Commons (Dr Rahib), and the Pancreatic Cancer Action Network (Dr Matrisian and Rahib).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Drs Rahib and Matrisian as employees of the Pancreatic Cancer Action Network were involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. They had full autonomy in all aspects of the study.

Additional Information: Drs Wehner and Nead are Cancer Prevention and Research Institute of Texas Scholars in Cancer Research.

Article

Publisher ID: zoi210166

DOI: 10.1001/jamanetworkopen.2021.4708

PMC ID: 8027914

PubMed ID: 33825840

SO-VID: 75db326c-9484-40ee-8d26-8d0c9498b47f

License:

This is an open access article distributed under the terms of the CC-BY License.

History

Date received : 13 September 2020

Date accepted : 16 February 2021

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Estimated Projection of US Cancer Incidence and Death to 2040

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Key Points

Question

Findings

Meaning

Abstract

Abstract

Importance

Objective

Design and Setting

Main Outcomes and Measures

Results

Conclusions and Relevance

Related collections

Cancer Metabolism

Most cited references 26

Cancer statistics, 2020

Cancer statistics, 2019

Reduced lung-cancer mortality with low-dose computed tomographic screening.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 177

Cited by 302

Most referenced authors 1,353