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General Cancer Information

This section highlights several types of cancer and provides a definition of cancer, an overview of cancer etiology, screening, and diagnosis, and a discussion of various cancer treatment options.

The American Cancer Society defines cancer as a group of diseases characterized by uncontrolled growth and spread of transformed cells.359  Nearly all cancers develop due to genetic mutations that alter the ability of a cell to grow and divide normally.359  These genetic mutations may be inherited or, more commonly, acquired over time. Healthy cells maintain mechanisms that appropriately repair cell damage and assist in cell death when the damage is too extensive to repair.359  In cancerous cells, 1 or both of these mechanisms are usually damaged.360  The uncontrolled growth of cells or the lack of normal cell death creates a collection of excess cells that form tumors.361  These tumors can be benign or malignant.

Benign tumors are not cancerous, but they may have the potential to become cancerous. They differ from cancerous tumors in that their growth is limited, they do not invade the surrounding tissue, and they do not metastasize. Benign tumors can be removed and are seldom life-threatening. In contrast, malignant tumors are cancerous and, if left untreated, can result in death. The cells in malignant tumors are abnormal, divide uncontrollably, and can damage nearby tissues and organs. Cancer metastasizes when cells break away from a malignant tumor, enter the lymphatic or blood vessels, and circulate in the bloodstream to distant tissues, where they implant and grow.361 

There are more than 100 unique types of cancer, which can be divided into 6 major categories.8009 

  1. Carcinomas, the most common type of cancer, form in epithelial tissues. Breast cancer, prostate cancer, and colorectal cancer are examples of carcinomas.

  2. Sarcomas begin in the connective tissue that supports or surrounds other tissues and organs. Sarcomas can occur in the soft tissue (e.g., liposarcoma and Kaposi’s sarcoma) or in the bone (osteosarcoma).

  3. Lymphomas are cancers of the lymphatic system and include Hodgkin’s lymphoma and non-Hodgkin’s lymphoma.

  4. Leukemias are cancers of blood-forming tissues and blood cells. Examples of leukemia include acute lymphoblastic/lymphocytic leukemia and chronic myelogenous leukemia.

  5. Brain tumors are cancers that begin in the brain. Glioma and neuroblastoma are 2 types of brain cancer.

  6. Skin cancers originate in the skin and include melanoma and nonmelanoma tumors (basal cell and squamous cell carcinoma).

Cancer Epidemiology

According to a report from the US Centers for Disease Control (CDC), the 6 leading causes of death in the U.S. in 2005 were heart disease (26.6%), followed by cancer (22.8%), cerebrovascular events (5.9%), chronic lung disease (5.3%), accidents (4.8%), and pneumonia/influenza (2.6%); nearly 18% of all deaths were grouped as “Other Causes.”11810  As the second leading cause of death, cancer is a major source of morbidity and mortality in the U.S. Four measures are commonly used to assess the impact of cancer in the general population.

  1. The incidence rate is the number of new cases per year per 100,000 persons.

  2. The prevalence count is the number of people alive that have ever been diagnosed with a cancer.

  3. The death (or mortality) rate is the number of deaths per year per 100,000 persons.

  4. The survival rate is the proportion of patients alive at some point, subsequent to the diagnosis of their cancer.

Much of the information on cancer incidence in this section has been derived from the Surveillance, Epidemiology, and End Results (SEER) Program, which is based within the Surveillance Research Program at the National Cancer Institute.11811,  11812  Unless otherwise specified, the incidence and mortality rates from the SEER reports are age-adjusted to the 2000 US standard population.

Cancer Incidence and Prevalence

Worldwide in 2002, it was estimated that 10.9 million new cases of cancer were diagnosed, 24.6 million people were living with cancer, and there were 6.7 million cancer-related deaths worldwide. Lung cancer was the most commonly diagnosed cancer followed by breast cancer, accounting for approximately 1.35 and 1.15 million of all new cancers worldwide, respectively.364  On January 1, 2005, in the U.S., there were approximately 11,098,450 males and females alive who had a history of cancer of all sites — 5,017,159 males and 6,081,291 females. This includes any person alive on January 1, 2005 who had been diagnosed with cancer of all sites at any point prior to January 1, 2005 and includes persons with active disease and those who are cured of their disease.11812  It is estimated that 1,437,180 males and females (745,180 males and 692,000 females) will be diagnosed with cancer in 2008.11812  However, even that number may represent an underestimate, as it does not reflect cases of noninvasive cancer (except bladder cancer) nor does it include the more than 1 million expected diagnoses of basal cell and squamous cell skin cancers.8008  From 2001–2005, the median age at diagnosis for cancer of all sites was 67 years of age. Approximately 1.1% were diagnosed under age 20; 2.7% between 20 and 34; 5.9% between 35 and 44; 13.8% between 45 and 54; 21.3% between 55 and 64; 25.3% between 65 and 74; 22.4% between 75 and 84; and 7.5% 85+ years of age. The age-adjusted incidence rate was 467.4 per 100,000 males and females per year. These rates are based on cases diagnosed from 2001–2005 from 17 SEER geographic areas.11812 

The age-adjusted cancer incidence rate for all cancers across gender and race from 9 SEER geographic areas was 400.4 in 1975, reached a peak of 510 in 1992, and gradually declined to 455.5 in 2005. In 2005, the age-adjusted incidence of all cancers was slightly higher in African Americans (480.2), as compared to Caucasians (466).11811  Age-adjusted incidence data (number of cases per 100,000 people) from the SEER 9 database revealed that in 2005 the 10 most common cancers in males and females of all races in the US were prostate (142.2), female breast (117.7), lung (67.7), colorectal (48.3), corpus/uterus NOS (23.4), bladder (21.1), non-Hodgkin’s lymphoma (18.9), melanoma (18.5), kidney (14.5), and ovarian (12.4).11813 

Figure 3165 – Top 10 Cancer Sites: 2005


U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2005 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2009. Available at: http://www.cdc.gov/uscs

11815

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Cancer Mortality/Survival Rates

The estimated number of cancer survivors in the United States is more than 10 million, and approximately 565,650 Americans are expected to die of cancer in 2008.8008  From 2001–2005, the median age at death for cancer of all sites was age 73. Approximately 0.4% died under age 20; 0.9% between 20 and 34; 2.8% between 35 and 44; 9.0% between 45 and 54; 17.1% between 55 and 64; 25.6% between 65 and 74; 29.9% between 75 and 84; and 14.4% at age 85+. The age-adjusted death rate was 189.8 per 100,000 males and females per year. These rates are based on patients who died in 2001–2005 in the U.S. and are derived from the SEER 17 database.11812  In 2005, SEER 9 data revealed that the 5 cancers associated with the highest death rates (deaths per 100,000 people) were lung cancer (52.8), prostate cancer (24.7), female breast cancer (24.0), colorectal cancer (17.4), and pancreatic cancer (10.8). In 1975, the respective death rates for lung, prostate, female breast, colorectal, and pancreatic cancer were 42.5, 30.97, 31.4, 28.1, and 10.6, respectively. Overall, the mortality rate (deaths per 100,000 people) for all cancers in the U.S. dropped from 199.1 in 1975 to 184 in 2005.11811 

The overall 5-year relative survival rate for all cancers has improved from 51% between 1975 and 1977 to 66% between 1996 and 2002.8008  Accordingly, the 5-year survival rates for specific cancer types also improved, albeit to varying degrees. The respective 5-year survival rates from the SEER 9 database for lung, prostate, breast, colorectal, and pancreatic cancer in 1975 were 11.9%, 67%, 75.3%, 49.4%, and 3.0%, respectively. By 2000, the 5-year survival rates had increased to 16.2%, 99.2%, 90.6%, 66%, and 5.4%, respectively.11811  Five-year survival rates increased in both Caucasians and African Americans between 1975 and 2005, but the rates for African Americans have remained approximately 10% lower than those of Caucasians. In 1975, the overall 5-year survival rates from the SEER 9 database for Caucasians and African Americans were 50.8% and 39.5%, respectively. By 2000, the rates had increased to 68.5% and 57.9%, respectively. The overall 5-year relative survival rate for 1996-2004 from 17 SEER geographic areas was 65.3%. Five-year relative survival rates by race and sex were: 66.0% for Caucasian males; 66.4% for Caucasian females; 59.1% for African American males; 54.1% for African American females. An examination into specific cancer types and sites revealed that the 5-year survival rate for lung cancer in 2000 was approximately 5% lower in African Americans, while the rates for colorectal and breast cancer were both approximately 13% lower for African Americans, as compared to Caucasians. The rates for prostate and pancreatic cancer were comparable between Caucasians and African Americans. 11811 

These improved 5-year survival rates and lower mortality rates may reflect changes in early detection, more effective prevention and treatment programs, or changes in prevalence of risk factors. The effects of increased screening and early detection programs have produced dramatic improvements in the 5-year survival rates for female breast cancer , prostate cancer , and colorectal cancer. As of 2002, the statistics indicated that approximately 4.4 million females worldwide were alive with breast cancer (within 5 years of diagnosis), as compared to 1.4 million lung cancer survivors.364,  8000  However, while survival rates have increased and mortality rates have decreased over time for many cancers, certain cancers, namely lung and pancreatic cancer, remain highly lethal diseases.

Economic Impact of Cancer

As the second leading cause of death in the U.S., cancer is a major source of morbidity and mortality and accounts for a considerable proportion of national health care costs. Financial costs of cancer are a burden to the patient, their families, and to the community. Cost-of-cancer estimates are generally accepted as 1 measure of disease burden.8030  Typically, these estimates include 3 elements: direct costs, which account for expenses related to treatment and care of disease; morbidity costs, which measure lost income due to work disability associated with disease; and mortality costs, which measure lost income associated with premature death.8030 

The overall annual cost for cancer in the United States for 2007 was estimated at $219.2 billion: $89.0 billion for direct medical costs, $18.2 billion for costs of illness, and $112.0 billion for mortality costs.359 

Content on this page was last reviewed on January 31, 2010.

Content on this page was last changed on January 12, 2010.

References:

359.  American Cancer Society. Cancer facts & figures 2007. American Cancer Society website. http://www.cancer.org/downloads/STT/CAFF2007PWSecured.pdf. Accessed February 5, 2007.
360.  Fenton RG, Longo DL. Cancer cell biology and angiogenesis: introduction. In: Kasper DL, Braunwald E, Fauci AS, et al, eds. Harrison’s Online. Based on: Kasper DL, Braunwald E, Fauci AS, et al, eds. Harrison’s Principles of Internal Medicine. 16th ed. Columbus, OH: McGraw-Hill Professional; 2004. http://www.accessmedicine.com/content.aspx?aID=60801. Accessed July 28, 2006.
361.  Fayed L. Understanding the development of cancer. About website. http://cancer.about.com/od/newlydiagnosed/a/whatcancer.htm . Accessed February 8, 2007.
364.  Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108.
8000.  Edwards BK, Brown ML, Wingo PA, et al. Annual report to the nation on the status of cancer, 1975-2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst . 2005;97(19):1407-1427.
8008.  American Cancer Society. Cancer facts and figures 2008. American Cancer Society website. http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf . Accessed April 2, 2008.
8009.  Dana Farber Cancer Institute. What is cancer? Dana Farber Cancer Institute website. http://www.dana-farber.org/can/what/default.html . Published 2001. Updated 2008. Accessed April 2, 2008.
8030.  Brown ML, Lipscomb J, Snyder C. The burden of illness of cancer: economic cost and quality of life. Annu Rev Public Health. 2001;22:91-113.
11810.  Kung H-C, Hoyert DL Xu J, Murphy SL, Deaths: Final Data for 2005. National Vital Statistics Reports. 2008;56(10):1-124. CDC website http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf . Accessed February 24, 2009.
11811.  National Cancer Institute/SEER Program. Faststats. http://seer.cancer.gov/faststats/index.php. Accessed February 24, 2009.
11812.  Ries LAG, Melbert D, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2005, National Cancer Institute website. http://seer.cancer.gov/csr/1975_2005. Accessed 2008.
11813.  U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2005 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2009. Available at: www.cdc.gov/uscs . Accessed February 23, 2009
11815.  U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2005 Incidence and Mortality Web-based Report . Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute web site. http://www.cdc.gov/uscs .

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