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AL24,090AZ27,600AR14,800CA152,170CO20,340CT 20,650DE 4,690FL102,210GA39,080ID6,800IL60,960IN31,320IA16,740KS13,080KY24,060LA22,170ME9,000MD 26,650MA36,080MN23,670MS14,150MO30,090MT5,340NE8,810NV12,020NH7,630NJ 47,920NM8,830NY101,550NC42,270ND3,200OH62,420OK18,110OR19,210PA74,170RI6,250SC22,100SD4,120TN32,570TX98,200UT8,880VT3,550VA34,150WA32,290WV10,230WI27,560WY2,500DC 2,600HI6,400AK2,530MI53,550PRN/A

US1,479,350

Special Section:

Multiple Primary Cancers

see page 24

Estimated number of new cancer cases for 2009, excluding basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

Note:

State estimates are offered as a rough guide and should be interpreted with caution. State estimates may not add to US total due to rounding.

Cancer Facts& Figures

2009

Contents

Cancer: Basic Facts

1Age-adjusted Cancer Death Rates, Males by Site, US, 1930-2005* 2Age-adjusted Cancer Death Rates, Females by Site, US, 1930-2005* 3Estimated New Cancer Cases and Deaths by Sex, US, 2009* 4Estimated New Cancer Cases or Selected Cancer Sites by State, US, 2009* 5Estimated Cancer Deaths or Selected Cancer Sites by State, US, 2009* 6Cancer Incidence Rates by Site and State, US, 2001-2005* 7Cancer Death Rates by Site and State, US, 2001-2005* 8

Selected Cancers

9Leading Sites o New Cancer Cases and Deaths – 2009 Estimates* 10Probability o Developing Invasive Cancers (%) Over Selected Age Intervals by Sex, US, 2003-2005* 14Five-year Relative Survival Rates (%) by Stage at Diagnosis, 1996-2004* 17Trends in 5-year Relative Survival Rates (%) by Race and Year o Diagnosis, US, 1975-2004* 18

Special Section: Multiple Primary Cancers

Cancer Disparities

42Cancer Incidence and Mortality Rates by Site, Race, and Ethnicity, US, 2001-2005* 43Cancer Death Rates by Educational Attainment, Race, and Sex, US, 2001* 44Geographic Patterns in Colorectal Cancer Death Rates by State, US, 2001-2005* 45

Tobacco Use

47Annual Number o Cancer Deaths Attributable to Smoking, by Sex and Site, US, 2000-2004* 48

Nutrition and Physical Activity

Environmental Cancer Risks

The International Fight against Cancer

The American Cancer Society

Sources of Statistics

Factors That Influence Cancer Rates

67Screening Guidelines or the Early Detection o Cancer in Average-risk Asymptomatic People* 68

*Indicates a figure or table

National Home Ofce: American Cancer Society Inc.250 Williams Street, NW, Atlanta, GA 30303-1002(404) 320-3333

For written permission, address the Legal department of the American Cancer Society, 250 Williams Street, NW, Atlanta, GA 30303-1002.

Cancer Facts & Figures 2009

is dedicated to

Drs. Jeanne Calle

and

Carmen Rodriguez

, outstanding leaders and scientists inthe Epidemiology department at the American Cancer Society,both recently deceased. Carmen, a breast cancer survivor, diedo a second primary cancer in November 2008. Jeanne diedunexpectedly in February 2009, a short time ater retiring romher position as vice president o Epidemiology. Jeanne’s andCarmen’s research and leadership made important contributionsto understanding the causes and prevention o cancer. We dearlymiss them as riends, mentors, and colleagues.

This publication attempts to summarize current scientific information about cancer. Except when specified, it does not represent the official policy of the American Cancer Society.

Suggested citation:

American Cancer Society.

Cancer Facts

Figures 2009

. Atlanta: American Cancer Society; 2009.

Cancer: Basic Facts

What Is Cancer?

Cancer is a group of diseases characterized by uncon-trolled growth and spread of abnormal cells. If the spreadis not controlled, it can result in death. Cancer is causedby both external factors (tobacco, infectious organisms,chemicals, and radiation) and internal factors (inheritedmutations, hormones, immune conditions, and mutationsthat occur from metabolism). These causal factors may act together or in sequence to initiate or promote carcino-genesis. Ten or more years often pass between exposure toexternal factors and detectable cancer. Cancer is treated with surgery, radiation, chemotherapy, hormone therapy,biological therapy, and targeted therapy.

Can Cancer Be Prevented?

All cancers caused by cigarette smoking and heavy useof alcohol could be prevented completely. The Ameri-can Cancer Society estimates that in 2009 about 169,000cancer deaths are expected to be caused by tobacco use.Scientific evidence suggests that about one-third of the562,340 cancer deaths expected to occur in 2009 will berelated to overweight or obesity, physical inactivity, and poor nutrition and thus could also be prevented. Certaincancers are related to infectious agents, such as hepati-tis B virus (HBV), human papillomavirus (HPV), humanimmunodeficiency virus (HIV),

Helicobacter pylori (H. pylori),

and others, and could be prevented through behav-ioral changes, vaccines, or antibiotics. In addition, many of the more than 1 million skin cancers that are expectedto be diagnosed in 2009 could be prevented by protectionfrom the sun’s rays and avoiding indoor tanning.Regular screening examinations by a health care pro-fessional can result in the detection and removal of precancerous growths, as well as the diagnosis of cancersat an early stage, when they are most treatable. Cancersthat can be prevented by removal of precancerous tissueinclude cancers of the cervix, colon, and rectum. Cancersthat can be diagnosed early through screening includecancers of the breast, colon, rectum, cervix, prostate, oralcavity, and skin. For cancers of the breast, colon, rectum,and cervix, early detection has been proven to reducemortality. A heightened awareness of breast changesor skin changes may also result in detection of thesetumors at earlier stages. Cancers that can be preventedor detected earlier by screening account for at least half of all new cancer cases.

Who Is at Risk of Developing Cancer?

Anyone can develop cancer. Since the risk of being diag-nosed with cancer increases as individuals age, mostcases occur in adults who are middle-aged or older. About77% of all cancers are diagnosed in persons 55 years andolder. Cancer researchers use the word “risk” in different ways, most commonly expressing risk as lifetime risk orrelative risk.

Lifetime risk

refers to the probability that an individual,over the course of a lifetime, will develop or die from can-cer. In the US, men have slightly less than a 1 in 2 lifetimerisk of developing cancer; for women, the risk is a littlemore than 1 in 3.

Relative risk

is a measure of the strength of the relation-ship between risk factors and a particular cancer. Itcompares the risk of developing cancer in persons with acertain exposure or trait to the risk in persons who do nothave this characteristic. For example, male smokers areabout 23 times more likely to develop lung cancer thannonsmokers, so their relative risk is 23. Most relative risksare not this large. For example, women who have a first-degree relative (mother, sister, or daughter) with a history of breast cancer have about twice the risk of developingbreast cancer compared to women who do not have thisfamily history. All cancers involve the malfunction of genes that con-trol cell growth and division. About 5% of all cancers arestrongly hereditary, in that an inherited genetic altera-tion confers a very high risk of developing one or morespecific types of cancer. However, most cancers do notresult from inherited genes but from damage to genesoccurring during one’s lifetime. Genetic damage may result from internal factors, such as hormones or themetabolism of nutrients within cells, or external factors,such as tobacco, chemicals, and sunlight.

How Many People Alive Today HaveEver Had Cancer?

The National Cancer Institute estimates that approxi-mately 11.1 million Americans with a history of cancer were alive in January 2005. Some of these individuals were cancer-free, while others still had evidence of cancerand may have been undergoing treatment.

How Many New Cases Are Expected toOccur This Year?

About 1,479,350 new cancer cases are expected to be diag-nosed in 2009. This estimate does not include carcinomain situ (noninvasive cancer) of any site except urinary bladder, and does not include basal and squamous cellskin cancers. More than 1 million unreported cases of

Cancer Facts & Figures 20091