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Abstract
<p class="first" id="d9534205e75">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. Incidence data (through 2017) 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
2018) were collected by the National Center for Health Statistics. In 2021, 1,898,160
new cancer cases and 608,570 cancer deaths are projected to occur in the United States.
After increasing for most of the 20th century, the cancer death rate has fallen continuously
from its peak in 1991 through 2018, for a total decline of 31%, because of reductions
in smoking and improvements in early detection and treatment. This translates to 3.2
million fewer cancer deaths than would have occurred if peak rates had persisted.
Long-term declines in mortality for the 4 leading cancers have halted for prostate
cancer and slowed for breast and colorectal cancers, but accelerated for lung cancer,
which accounted for almost one-half of the total mortality decline from 2014 to 2018.
The pace of the annual decline in lung cancer mortality doubled from 3.1% during 2009
through 2013 to 5.5% during 2014 through 2018 in men, from 1.8% to 4.4% in women,
and from 2.4% to 5% overall. This trend coincides with steady declines in incidence
(2.2%-2.3%) but rapid gains in survival specifically for nonsmall cell lung cancer
(NSCLC). For example, NSCLC 2-year relative survival increased from 34% for persons
diagnosed during 2009 through 2010 to 42% during 2015 through 2016, including absolute
increases of 5% to 6% for every stage of diagnosis; survival for small cell lung cancer
remained at 14% to 15%. Improved treatment accelerated progress against lung cancer
and drove a record drop in overall cancer mortality, despite slowing momentum for
other common cancers.
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