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Cancer Statistics, 2021. ​

Literature Information ​

DOI10.3322/caac.21654
PMID33433946
JournalCA: a cancer journal for clinicians
Impact Factor232.4
JCR QuartileQ1
Publication Year2021
Times Cited9449
Keywordscancer cases, cancer statistics, death rates, incidence, mortality
Literature TypeJournal Article, Research Support, Non-U.S. Gov't
ISSN0007-9235
Pages7-33
Issue71(1)
AuthorsRebecca L Siegel, Kimberly D Miller, Hannah E Fuchs, Ahmedin Jemal

TL;DR ​

The American Cancer Society projects 1,898,160 new cancer cases and 608,570 cancer deaths in the U.S. for 2021, marking a significant decline in the cancer death rate since its peak in 1991, largely due to reduced smoking and advancements in detection and treatment, particularly for lung cancer. While mortality rates for leading cancers have slowed or halted, the rapid improvement in survival rates for nonsmall cell lung cancer has contributed to a notable overall reduction in cancer mortality, highlighting the importance of continued efforts in cancer research and treatment advancements.

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cancer cases · cancer statistics · death rates · incidence · mortality

Abstract ​

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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Primary Questions Addressed ​

  1. What are the specific factors contributing to the decline in lung cancer mortality rates compared to other cancers?
  2. How do the trends in cancer incidence and mortality differ among various demographic groups in the United States?
  3. What advancements in treatment have been most significant in improving survival rates for nonsmall cell lung cancer (NSCLC)?
  4. How do early detection methods for cancer vary by type, and what impact do they have on overall survival rates?
  5. What role does smoking cessation play in the overall trends observed in cancer mortality rates, particularly for lung cancer?

Key Findings ​

1. Research Background and Purpose ​

The "Cancer Statistics, 2021" report by the American Cancer Society aims to provide comprehensive estimates of cancer incidence and mortality in the United States. It synthesizes population-based data to inform stakeholders about the current state of cancer epidemiology, trends in cancer incidence and mortality, and the impact of public health interventions. The report serves as a crucial resource for researchers, healthcare professionals, and policymakers to understand cancer trends and to guide future research and cancer control efforts.

2. Major Methods and Findings ​

The report utilizes data collected from several authoritative sources: the Surveillance, Epidemiology, and End Results Program, the National Program of Cancer Registries, and the North American Association of Central Cancer Registries for incidence data (up to 2017), and the National Center for Health Statistics for mortality data (up to 2018). In 2021, an estimated 1,898,160 new cancer cases and 608,570 cancer deaths are projected in the United States. The report highlights a significant overall decline in cancer mortality of 31% since its peak in 1991, attributed to reductions in smoking rates and advancements in early detection and treatment methodologies. While there are long-term declines in mortality for the four leading cancers, trends vary: prostate cancer mortality declines have plateaued, while lung cancer mortality has seen an accelerated decrease, contributing to nearly half of the total mortality decline observed between 2014 and 2018.

3. Core Conclusions ​

The report concludes that while progress against cancer mortality has been achieved, this progress is not uniform across all cancer types. Lung cancer mortality has significantly improved due to better treatments and increased survival rates, particularly for non-small cell lung cancer (NSCLC), which has shown notable improvements in two-year relative survival rates from 34% (2009-2010) to 42% (2015-2016). Conversely, survival rates for small cell lung cancer remain stagnant. The accelerated decline in lung cancer mortality and the overall reduction in cancer death rates underscore the effectiveness of public health initiatives aimed at smoking cessation and innovations in cancer treatment.

4. Research Significance and Impact ​

The findings of this report are vital for understanding the changing landscape of cancer in the United States. The continued decline in overall cancer mortality, particularly linked to lung cancer, reflects the positive impacts of preventive measures and advancements in medical science. However, the stagnation in mortality declines for certain cancers, like prostate cancer, calls for renewed focus and research efforts to address these gaps. This report not only serves as a benchmark for evaluating cancer control strategies but also emphasizes the need for ongoing innovation in cancer treatment and prevention to sustain and further enhance these trends in public health.

Literatures Citing This Work ​

  1. Diagnosis and Treatment of Primary and Secondary Lung Cancers. - Francesco Petrella - Cancers (2021)
  2. Volumetric-Modulated Arc Radiotherapy with Daily Image-Guidance Carries Better Toxicity Profile for Higher Risk Prostate Cancer. - Ahmad I Ghanem;Amr A Elsaid;Mohamed A Elshaikh;Gehan A Khedr - Asian Pacific journal of cancer prevention : APJCP (2021)
  3. Targeting and Reprograming Cancer-Associated Fibroblasts and the Tumor Microenvironment in Pancreatic Cancer. - Yoshiaki Sunami;Viktoria Böker;Jörg Kleeff - Cancers (2021)
  4. The incidence of prostate cancer is increased in patients with obstructive sleep apnea: Results from the national insurance claim data 2007-2014. - Eun Jung Lee;Jeffrey D Suh;Jae Hoon Cho - Medicine (2021)
  5. Blood cancer health disparities in the United States Hispanic population. - Alfonso E Bencomo-Alvarez;Andres J Rubio;Mayra A Gonzalez;Anna M Eiring - Cold Spring Harbor molecular case studies (2021)
  6. Decoding Melanoma Development and Progression: Identification of Therapeutic Vulnerabilities. - Kevinn Eddy;Raj Shah;Suzie Chen - Frontiers in oncology (2020)
  7. Aspirin and other nonsteroidal anti-inflammatory drugs, statins and risk of non-Hodgkin lymphoma. - Mark Liebow;Melissa C Larson;Carrie A Thompson;Grzegorz S Nowakowski;Timothy G Call;William R Macon;Neil E Kay;Thomas M Habermann;Susan L Slager;James R Cerhan - International journal of cancer (2021)
  8. Overexpressed WDR3 induces the activation of Hippo pathway by interacting with GATA4 in pancreatic cancer. - Wenjie Su;Shikai Zhu;Kai Chen;Hongji Yang;Mingwu Tian;Qiang Fu;Ganggang Shi;Shijian Feng;Dianyun Ren;Xin Jin;Chong Yang - Journal of experimental & clinical cancer research : CR (2021)
  9. Bcl2l10 induces metabolic alterations in ovarian cancer cells by regulating the TCA cycle enzymes SDHD and IDH1. - Su-Yeon Lee;Jinie Kwon;Kyung-Ah Lee - Oncology reports (2021)
  10. Vitamin D regulation of energy metabolism in cancer. - Madeline P Sheeley;Chaylen Andolino;Violet A Kiesel;Dorothy Teegarden - British journal of pharmacology (2022)

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