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Cancer Sourcebook, 9th Ed.
Cancer Sourcebook, 9th Ed.
Cancer Sourcebook, 9th Ed.
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Cancer Sourcebook, 9th Ed.

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Consumer health information about risks, prevention, and treatment of major forms of cancer. Includes index, glossary of related terms, and other resources.
LanguageEnglish
PublisherOmnigraphics
Release dateOct 1, 2021
ISBN9780780819207
Cancer Sourcebook, 9th Ed.

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    Cancer Sourcebook, 9th Ed. - Omnigraphics

    Preface

    About This Book

    Every year, nearly 1.6 million Americans are diagnosed with cancer. Cancer is not a single disease, however. There are many different diseases that all share one common characteristic. Some of the body’s cells do not die when they should. Instead they continue to grow and divide. Through this process, cancer cells can damage the body’s tissues and organs, leading to a broad array of symptoms and even death. The cellular changes that lead to the development of cancer are sometimes inherited but they may also result from environmental or lifestyle factors. Although the survival rates for many types of cancer have improved in recent years and innovative treatment protocols are being developed, cancer remains one of the leading causes of death in the United States.

    Cancer Sourcebook, Ninth Edition provides updated information about common types of cancer affecting the head, neck, central nervous system (CNS), endocrine system, lungs, digestive and urinary tracts, blood cells, immune system, skin, bones, and other body systems. It explains how people can reduce their risk of cancer by adopting a healthy lifestyle, addressing issues related to cancer risk, and taking advantage of screening exams. Various treatment choices, including surgery, chemotherapy, radiation therapy, bone marrow transplantation, and biological therapies are discussed, and facts are provided about cancer clinical trials and other ongoing research. And also it talks about life after cancer treatment and healthy food choices. The book concludes with a glossary of terms related to cancer, a directory of national cancer organizations, and awareness of online cancer fraud.

    How to Use This Book

    This book is divided into parts and chapters. Parts focus on broad areas of interest. Chapters are devoted to single topics within a part.

    Part 1: Cancer Risk Factors: An Overview introduces cancer and discusses hereditary, lifestyle, and environmental factors that can sometimes set the stage for the growth of cancer. It explains which factors can be prevented and which factors are unavoidable. Statistical information about cancer prevalence, mortality, and survival is also provided, along with facts about specific population groups that suffer disproportionately from cancer. It concludes with myths and misconceptions regarding cancer.

    Part 2: Common Types of Cancer includes a head-to-toe list of the most frequently occurring types of cancer. Individual chapters describe the development, identification, and treatment of cancers that affect the various components of the body, including the brain and central nervous system, endocrine system, respiratory system, blood and immune system, digestive and urinary tracts, and reproductive organs, as well as the bones and skin.

    Part 3: Cancer-Related Tests and Treatments describes the screening methods used to find cancers at their earliest stages and the procedures most commonly used in cancer diagnosis and treatment. It also provides information on how to find healthcare services. These include medical imaging tests, surgical procedures, chemotherapy, radiation therapy, precision medicine, stem cell transplantation, and various complementary and alternative medicine (CAM) practices used in cancer care.

    Part 4: Recurrent and Advanced Cancer explains the factors that cause cancer to spread to distant parts of the body and return again after a time of remission. It also describes end-of-life care, decisions to be taken by cancer patients and their families, and offers suggestions regarding ways to make wishes known.

    Part 5: Clinical Trials and Cancer Research discusses cancer treatment trials and various researches related to cancer. Emerging therapies, including gene therapy, oncolytic virus therapy, and liquid biopsy, for cancer treatment and prevention are also described.

    Part 6: Recovering from Cancer discusses how to adjust with cancer, self-image after cancer and the life after cancer treatment, and how to care for yourself with physical health and dietary guidelines.

    Part 7: Additional Help and Information includes a glossary of terms, a directory of national cancer organizations, and suggestions for finding local resources. A chapter offering cautionary guidance about cancer-related health fraud, especially on the Internet, is also provided.

    Bibliographic Note

    This volume contains documents and excerpts from publications issued by the following U.S. government agencies: Cancer Imaging Program (CIP); Centers for Disease Control and Prevention (CDC); MedlinePlus; National Cancer Institute (NCI); National Human Genome Research Institute (NHGRI); National Institute for Occupational Safety and Health (NIOSH); National Institute of Environmental Health Sciences (NIEHS); Office of Disease Prevention and Health Promotion (ODPHP); Surveillance, Epidemiology, and End Results (SEER) Program; U.S. Department of Veterans Affairs (VA); U.S. Environmental Protection Agency (EPA); and U.S. Food and Drug Administration (FDA).

    It also contains original material produced by Omnigraphics and reviewed by medical consultants.

    About the Health Reference Series

    The Health Reference Series is designed to provide basic medical information for patients, families, caregivers, and the general public. Each volume provides comprehensive coverage on a particular topic. This is especially important for people who may be dealing with a newly diagnosed disease or a chronic disorder in themselves or in a family member. People looking for preventive guidance, information about disease warning signs, medical statistics, and risk factors for health problems will also find answers to their questions in the Health Reference Series. The Series, however, is not intended to serve as a tool for diagnosing illness, in prescribing treatments, or as a substitute for the physician–patient relationship. All people concerned about medical symptoms or the possibility of disease are encouraged to seek professional care from an appropriate healthcare provider.

    A Note about Spelling and Style

    Health Reference Series editors use Stedman’s Medical Dictionary as an authority for questions related to the spelling of medical terms and The Chicago Manual of Style for questions related to grammatical structures, punctuation, and other editorial concerns. Consistent adherence is not always possible, however, because the individual volumes within the Series include many documents from a wide variety of different producers, and the editor’s primary goal is to present material from each source as accurately as is possible. This sometimes means that information in different chapters or sections may follow other guidelines and alternate spelling authorities. For example, occasionally a copyright holder may require that eponymous terms be shown in possessive forms (Crohn’s disease vs. Crohn disease) or that British spelling norms be retained (leukaemia vs. leukemia).

    Medical Review

    Omnigraphics contracts with a team of qualified, senior medical professionals who serve as medical consultants for the Health Reference Series. As necessary, medical consultants review reprinted and originally written material for currency and accuracy. Citations including the phrase Reviewed (month, year) indicate material reviewed by this team. Medical consultation services are provided to the Health Reference Series editors by:

    Dr. Vijayalakshmi, MBBS, DGO, MD

    Dr. Senthil Selvan, MBBS, DCH, MD

    Dr. K. Sivanandham, MBBS, DCH, MS (Research), PhD

    Health Reference Series Update Policy

    The inaugural book in the Health Reference Series was the first edition of Cancer Sourcebook published in 1989. Since then, the Series has been enthusiastically received by librarians and in the medical community. In order to maintain the standard of providing high-quality health information for the layperson the editorial staff at Omnigraphics felt it was necessary to implement a policy of updating volumes when warranted.

    Medical researchers have been making tremendous strides, and it is the purpose of the Health Reference Series to stay current with the most recent advances. Each decision to update a volume is made on an individual basis. Some of the considerations include how much new information is available and the feedback we receive from people who use the books. If there is a topic you would like to see added to the update list, or an area of medical concern you feel has not been adequately addressed, please write to:

    Managing Editor

    Health Reference Series

    Omnigraphics

    615 Griswold St., Ste. 520

    Detroit, MI 48226

    Part 1 | Cancer Risk Factors: An Overview

    Chapter 1 | What Is Cancer?

    Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.

    Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and multiply (through a process called cell division) to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

    Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply when they should not. These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous (benign).

    Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis). Cancerous tumors may also be called malignant tumors. Many cancers form solid tumors, but cancers of the blood, such as leukemias, generally do not.

    Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually do not grow back, whereas cancerous tumors sometimes do. Benign tumors can sometimes be quite large, however. Some can cause serious symptoms or be life-threatening, such as benign tumors in the brain.

    Differences Between Cancer Cells and Normal Cells

    Cancer cells differ from normal cells in many ways. For instance, cancer cells:

    Grow in the absence of signals telling them to grow. Normal cells only grow when they receive such signals.

    Ignore signals that normally tell cells to stop dividing or to die (a process known as programmed cell death, or apoptosis).

    Invade into nearby areas and spread to other areas of the body. Normal cells stop growing when they encounter other cells, and most normal cells do not move around the body.

    Tell blood vessels to grow toward tumors. These blood vessels supply tumors with oxygen and nutrients and remove waste products from tumors.

    Hide from the immune system. The immune system normally eliminates damaged or abnormal cells.

    Trick the immune system into helping cancer cells stay alive and grow. For instance, some cancer cells convince immune cells to protect the tumor instead of attacking it.

    Accumulate multiple changes in their chromosomes, such as duplications and deletions of chromosome parts. Some cancer cells have double the normal number of chromosomes.

    Rely on different kinds of nutrients than normal cells. In addition, some cancer cells make energy from nutrients in a different way than most normal cells. This lets cancer cells grow more quickly.

    Many times, cancer cells rely so heavily on these abnormal behaviors that they cannot survive without them. Researchers have taken advantage of this fact, developing therapies that target the abnormal features of cancer cells. For example, some cancer therapies prevent blood vessels from growing toward tumors, essentially starving the tumor of needed nutrients.

    Figure 1.1. Cancer Cells and Normal Cells

    How Does Cancer Develop?

    Cancer is a genetic disease – that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.

    Genetic changes that cause cancer can happen because:

    Of errors that occur as cells divide.

    Damage to deoxyribonucleic acid (DNA) caused by harmful substances in the environment, such as the chemicals in tobacco smoke and ultraviolet rays from the sun.

    They were inherited from our parents.

    The body normally eliminates cells with damaged DNA before they turn cancerous. But the body’s ability to do so goes down as we age. This is part of the reason why there is a higher risk of cancer later in life.

    Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.

    Types of Genes That Cause Cancer

    The genetic changes that contribute to cancer tend to affect three main types of genes – proto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called drivers of cancer.

    Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes), allowing cells to grow and survive when they should not.

    Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.

    Deoxyribonucleic acid (DNA) repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes and changes in their chromosomes, such as duplications and deletions of chromosome parts. Together, these mutations may cause the cells to become cancerous.

    As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Now there are many cancer treatments available that target gene mutations found in cancer. A few of these treatments can be used by anyone with a cancer that has the targeted mutation, no matter where the cancer started growing.

    When Cancer Spreads

    A cancer that has spread from the place where it first formed to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

    Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.

    Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

    In some cases, treatment may help prolong the lives of people with metastatic cancer. In other cases, the primary goal of treatment for metastatic cancer is to control the growth of the cancer or to relieve symptoms it is causing. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.

    Tissue Changes That Are Not Cancer

    Not every change in the body’s tissues is cancer. Some tissue changes may develop into cancer if they are not treated, however. Here are some examples of tissue changes that are not cancer but, in some cases, are monitored because they could become cancer:

    Hyperplasia occurs when cells within a tissue multiply faster than normal and extra cells build up. However, the cells and the way the tissue is organized still look normal under a microscope. Hyperplasia can be caused by several factors or conditions, including chronic irritation.

    Dysplasia is a more advanced condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form. Some types of dysplasia may need to be monitored or treated, but others do not. An example of dysplasia is an abnormal mole (called a dysplastic nevus) that forms on the skin. A dysplastic nevus can turn into melanoma, although most do not.

    Carcinoma in situ is an even more advanced condition. Although it is sometimes called stage 0 cancer, it is not cancer because the abnormal cells do not invade nearby tissue the way that cancer cells do. But because some carcinomas in situ may become cancer, they are usually treated.

    Types of Cancer

    There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in the lung, and brain cancer starts in the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

    Here are some categories of cancers that begin in specific types of cells:

    Carcinoma

    Carcinomas are the most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. There are many types of epithelial cells, which often have a column-like shape when viewed under a microscope.

    Carcinomas that begin in different epithelial cell types have specific names:

    Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas.

    Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin.

    Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.

    Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.

    Sarcoma

    Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).

    Osteosarcoma is the most common cancer of bone. The most common types of soft tissue sarcoma are leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, liposarcoma, and dermatofibrosarcoma protuberans.

    Leukemia

    Cancers that begin in the blood-forming tissue of the bone marrow are called leukemias. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (WBCs) (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to its tissues, control bleeding, or fight infections.

    There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid). Acute forms of leukemia grow quickly and chronic forms grow more slowly.

    Lymphoma

    Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting WBCs that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.

    There are two main types of lymphoma:

    Hodgkin lymphoma. People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells.

    Non-Hodgkin lymphoma. This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

    Multiple Myeloma

    Multiple myeloma is cancer that begins in plasma cells, another type of immune cell. The abnormal plasma cells, called myeloma cells, build up in the bone marrow and form tumors in bones all through the body. Multiple myeloma is also called plasma cell myeloma and Kahler disease.

    Melanoma

    Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.

    Brain and Spinal Cord Tumors

    There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system (CNS). For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

    Other Types of Tumors

    Germ Cell Tumors

    Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.

    Neuroendocrine Tumors

    Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.

    Carcinoid Tumors

    Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine). Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

    _____________

    This chapter includes text excerpted from What Is Cancer? National Cancer Institute (NCI), May 5, 2021.

    Chapter 2 | Cancer Statistics

    Chapter Contents

    Section 2.1—Understanding Statistics on Incidence, Prevalence, and Mortality

    Section 2.2—Statistics for Different Kinds of Cancer

    Section 2.1 | Understanding Statistics on Incidence, Prevalence, and Mortality

    This section contains text excerpted from the following sources: Text in this section begins with excerpts from Cancer Statistics, National Cancer Institute (NCI), September 25, 2020; Text beginning with the heading Incidence and Death Rates is excerpted from United States Cancer Statistics (USCS) – Statistical Methods, Centers for Disease Control and Prevention (CDC), June 8, 2021.

    Cancer has a major impact on society in the United States and across the world. Cancer statistics describe what happens in large groups of people and provide a picture in time of the burden of cancer on society.

    Statistics tell us things such as how many people are diagnosed with and die from cancer each year, the number of people who are currently living after a cancer diagnosis, the average age at diagnosis, and the numbers of people who are still alive at a given time after diagnosis. They also tell us about differences among groups defined by age, sex, racial/ethnic group, geographic location, and other categories.

    Cancer statistics also help us see trends. By looking at cancer rates over time, we can track changes in the risk of developing and dying from specific cancers as well as cancer overall.

    Although statistical trends are usually not directly applicable to individual patients, they are essential for governments, policy makers, health professionals, and researchers to understand the impact of cancer on the population and to develop strategies to address the challenges that cancer poses to the society at large. Statistical trends are also important for measuring the success of efforts to control and manage cancer.

    Statistics at a Glance: The Burden of Cancer in the United States

    In 2020, an estimated 1,806,590 new cases of cancer will be diagnosed in the United States and 606,520 people will die from the disease.

    The most common cancers (listed in descending order according to estimated new cases in 2020) are breast cancer, lung and bronchus cancer, prostate cancer, colon and rectum cancer, melanoma of the skin, bladder cancer, non-Hodgkin lymphoma, kidney and renal pelvis cancer, endometrial cancer, leukemia, pancreatic cancer, thyroid cancer, and liver cancer.

    Prostate, lung, and colorectal cancers account for an estimated 43 percent of all cancers diagnosed in men in 2020. For women, the three most common cancers are breast, lung, and colorectal, and they will account for an estimated 50 percent of all new cancer diagnoses in women in 2020.

    The rate of new cases of cancer (cancer incidence) is 442.4 per 100,000 men and women per year (based on 2013–2017 cases).

    The cancer death rate (cancer mortality) is 158.3 per 100,000 men and women per year (based on 2013–2017 deaths).

    The cancer mortality rate is higher among men than women (189.5 per 100,000 men and 135.7 per 100,000 women). When comparing groups based on race/ethnicity and sex, cancer mortality is highest in African-American men (227.3 per 100,000) and lowest in Asian/Pacific Islander women (85.6 per 100,000).

    As of January 2019, there were an estimated 16.9 million cancer survivors in the United States. The number of cancer survivors is projected to increase to 22.2 million by 2030.

    Approximately 39.5 percent of men and women will be diagnosed with cancer at some point during their lifetimes (based on 2015–2017 data).

    In 2020, an estimated 16,850 children and adolescents ages 0 to 19 will be diagnosed with cancer and 1,730 will die of the disease.

    Estimated national expenditures for cancer care in the United States in 2018 were $150.8 billion. In future years, costs are likely to increase as the population ages and more people have cancer. Costs are also likely to increase as new, and often more expensive, treatments are adopted as standards of care.

    The U.S. Cancer Mortality Trends

    The best indicator of progress against cancer is a change in age-adjusted mortality (death) rates, although other measures, such as quality of life (QOL), are also important. Incidence is also important, but it is not always straightforward to interpret changes in incidence. A rise in incidence can reflect a real increase in disease occurrence, such as when an increase in exposure to a risk factor causes more cases of cancer. In such a scenario the increased incidence would likely lead to a rise in deaths from cancer. On the other hand, the incidence of cancer may rise due to a new screening test that detects many cancer cases that would not have caused a problem during someone’s life (called overdiagnosis). In this example, the incidence of cancer would increase, but death rates would not change.

    Mortality trends, when compared with incidence trends, can also provide evidence of improved treatments. If death rates drop faster than incidence (or if death rates drop while incidence is rising), this may reflect the availability of better treatments. For example, statistical evidence suggests that improved treatments have likely made a substantial contribution to recent sharp declines in the lung cancer mortality rate.

    In the United States, the overall cancer death rate has declined since the early 1990s. The most recent Annual Report to the Nation, released in March 2020, shows that overall cancer death rates decreased by:

    1.8 percent per year among men from 2001 to 2017

    1.4 percent per year among women from 2001 to 2017

    1.4 percent per year among children ages 0–14 from 2013 to 2017

    Although death rates for many individual cancer types have also declined, rates for a few cancers have not changed or even increased.

    As the overall cancer death rate has declined, the number of cancer survivors has increased. These trends show that progress is being made against the disease, but much work remains. Although rates of smoking, a major cause of cancer, have declined, the rates of other risk factors, such as obesity, have increased in the United States. Also, the U.S. population is aging, and cancer rates increase with age.

    Incidence and Death Rates

    Crude rates are helpful in determining the cancer burden and specific needs for services for a given population, compared with another population, regardless of size. Crude rates are calculated as follows:

    Crude and age-specific incidence rates equal the total number of new cancer cases diagnosed in a specific year in the population category of interest, divided by the at-risk population for that category and multiplied by 100,000 (cancers by primary site) or by 1 million (International Classification of Childhood Cancer [ICCC] groupings of childhood cancers).

    Crude and age-specific death rates equal the total number of cancer deaths during a specific year in the population category of interest, divided by the at-risk population for that category and multiplied by 100,000.

    Crude Rates versus Age-Adjusted Rates

    Crude rates are influenced by the underlying age distribution of the state’s population. Even if two states have the same age-adjusted rates, the state with the relatively older population generally will have higher crude rates because incidence or death rates for most cancers increase with increasing age. The age distribution of a population (the number of people in particular age categories) can change over time and can be different in different geographic areas. Age-adjusting the rates ensures that differences in incidence or deaths from one year to another, or between one geographic area and another, are not due to differences in the age distribution of the populations being compared.

    2000 U.S. Standard Population Age Groups

    The population used to age-adjust the rates in this report is the 2000 U.S. standard population. In the USCS Data Visualizations tool, the 2000 U.S. standard population is based on the proportion of the 2000 population in 19 specific age groups (younger than 1 year, 1–4 years, 5–9 years, 10–14 years, 15–19 years,… 85 years and older); except for Puerto Rico, where it is based on 18 specific age groups (0–4 years, 5–9 years, 10–14 years, 15–19 years, … 85 years and older); the proportions of the 2000 population in these age groups serve as weights for calculating age-adjusted incidence and death rates. Cancer death rates in the USCS Data Visualizations tool may differ slightly from those published by the National Center for Health Statistics (NCHS) because NCHS uses age groups as recommended by the U.S. Department of Health and Human Services (HHS) in its adjustment of death rates. In addition, the 2000 U.S. standard population weights are not race- or sex-specific, so they do not adjust for differences in race or sex distribution between geographic areas or populations being compared. They do, however, provide the basis for adjusting for differences in the age distributions across groups defined by sex, race, geography, or other categories.

    The 2000 U.S. standard population weights used for this report are based on single years of age from the Census P25-1130 series estimates of the 2000 U.S. population. Populations for single years of age are summed to form the age groups. These standard weights are used to compute age-adjusted incidence and death rates by the method of direct standardization as implemented in the National Cancer Institute’s (NCI) SEER*Stat software (seer.cancer.gov/seerstat).

    Ideally, crude, age-adjusted, and age-specific rates are used to plan for population-based cancer prevention and control interventions.

    Cancer Prevalence

    Definition and Calculation of Cancer Prevalence

    Prevalence is the number of people with a specific disease or condition in a given population at a specific time. This measure includes both newly diagnosed and preexisting cases of the disease. It is different from incidence, because incidence measures only the number of newly diagnosed cases in a given population at a specific time.

    There are different types of prevalence. For example:

    Annual prevalence is the number of people with the disease at any time during a year.

    Period prevalence is the number of people with the disease at any time during a specified number of years, such as the last 10 years.

    Limited-duration prevalence is the number of people alive on a certain day who were diagnosed with the disease during a specified number of years (such as the last 5 or 15 years).

    Cancer incidence data submitted to the National Program of Cancer Registries (NPCR) in the 2019 data submission period were used to create a data set in SEER*Stat for this analysis. The data set included data from 44 NPCR central cancer registries that met the United States Cancer Statistics (USCS) publication criteria for all years 2001 through 2016 and that conducted linkage with the National Death Index and/or active patient follow-up for all years 2001 through 2016. These registries include Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. These data cover 94 percent of the U.S. population.

    Cases from these registries were included in the analysis if:

    The case was an invasive cancer diagnosed from 2001 through 2016. Cases diagnosed in 2017 do not have adequate follow-up time to be included in the analysis.

    The age of the case was known and was 0 through 99 years.

    The sex of the case was known.

    The case was not identified solely on the basis of a death certificate or autopsy.

    Because the NPCR data are available from 2001, 16-year limited-duration prevalence estimates are included in addition to 5-year estimates.

    Calculation of Limited-Duration Prevalence

    Limited-duration prevalence is the number of people alive on a certain day who were diagnosed with the disease during a specified number of years (such as the last 5 or 16 years).

    In this report, the limited-duration prevalence was calculated using SEER*Stat software. It estimates, among the people diagnosed with cancer in the last 5 or 16 years, the proportion who were still alive on January 1, 2017. The date of start of follow-up (month, day, and year) was set to the date of diagnosis. The date of last follow-up (month, day, and year) was set either to the date of last contact (if the case was actively followed) or to the date of death if the case was matched to the state death files or to the National Death Index. Cases not linking to the state death files or to the National Death Index were presumed to be alive on the prevalence date.

    For patients diagnosed with multiple tumors, prevalence calculations include the first tumor of each cancer type in the previous x years (where x = 5 or 16 in this report). For example, assume a woman was diagnosed first with thyroid cancer 9 years ago and then breast cancer 3 years ago. Thyroid cancer would contribute to the 16-year limited-duration prevalence estimates for all cancer sites and for thyroid cancer. The breast cancer would contribute to the 5-year limited-duration prevalence estimate for all cancer sites and for breast cancer, but not to the 16-year limited-duration prevalence estimate for breast cancer because it was not her first tumor in the previous 16 years; she is already counted in this estimate for thyroid cancer.

    The NPCR prevalence proportions were calculated for each combination of age, sex, and race group. For this report, race was categorized as white, Black, and other races. The other races group contains Indian Health Service-linked American Indian and Alaska Native cases and Asian/Pacific Islander cases. Cases with unknown races were combined with white races. Then, cancer prevalence counts at January 1, 2017, for the U.S. population were estimated by multiplying the age-, sex-, and race-specific NPCR prevalence proportions by the corresponding U.S. population estimates based on the average of the 2016 and 2017 population estimates from the U.S. Census Bureau. U.S. cancer prevalence counts for all races combined were estimated by summing the counts for whites/unknown, Blacks, and other races.

    Section 2.2 | Statistics for Different Kinds of Cancer

    This section includes text excerpted from Cancer Stat Facts: Common Cancer Sites, Surveillance, Epidemiology, and End Results (SEER) Program, National Cancer Institute (NCI), March 21, 2018.

    Statistics at a Glance

    At a Glance

    Breast, lung and bronchus, prostate, and colorectal cancers account for almost 50 percent of all new cancer cases in the United States. Lung and bronchus, colorectal, pancreatic, and breast cancers are responsible for nearly 50 percent of all deaths.

    Figure 2.1. New Cancer Cases, 2021

    Figure 2.2. Cancer Deaths, 2021

    How Many People Are Diagnosed with Cancer Each Year?

    In 2021, roughly 1.9 million people will be diagnosed with cancer in the United States. An estimated 281,550 women and 2,650 men will be diagnosed with breast cancer, which makes it the most common cancer diagnosis. Prostate cancer is the leading cancer diagnosis among men and the second most common diagnosis overall with 248,530 expected cases. Lung and bronchus cancer is the third most common cancer diagnosis with an estimated 235,760 new cases.

    The top 12 most common cancer sites, shown below, will account for more than three quarters of all new cancer cases.

    How Many People Die of Cancer Each Year?

    In 2021, an estimated 608,570 people will die of cancer in the United States. Lung and bronchus cancer is responsible for the most deaths with 131,880 people expected to die from this disease. That is nearly three times the 52,980 deaths due to colorectal cancer, which is the second most common cause of cancer death. Pancreatic cancer is the third deadliest cancer, causing 48,220 deaths.

    The eight deadliest cancer sites, shown below, will account for almost two-thirds of all expected cancer deaths.

    New Cases, Deaths, and Survival

    How Do Cancer Rates Compare?

    For comparison purposes, new cases and deaths are generally expressed as a rate – the number per 100,000 in the total population. The rate of new cases is known as cancer incidence, and the death rate as mortality. Note that total population changes depending on what group you are looking at, so, for instance, the rate of new cases for females is the rate per 100,000 females in the United States.

    The table below gives the predicted number of new cases and deaths in 2021, the age-adjusted rate of new cases and deaths over the most recent five years of data, and the five-year relative survival rate, representing the percent surviving their cancer diagnosis 5-years after diagnosis.

    You can sort on any column by clicking the header.

    How Do the Most Common Cancers Compare by Race/Ethnicity?

    The rate and type of cancer diagnosis varies significantly by race and ethnicity. The graph below shows the age-adjusted rate of new cases, by race and ethnicity, for the four most commonly diagnosed cancers.

    Cancer death rates, or mortality rates, also vary significantly by race and ethnicity. The graph below shows the age-adjusted death rate, by race and ethnicity, for the five most commonly diagnosed cancers.

    Trends in Rates

    What Are the Recent Trends in Rates of New Cancer Cases?

    Between 2014 and 2018, the overall age-adjusted rate of new cancers remained stable among men and remained stable among women. During this period, nine of the 19 most common cancers in men and eleven of the 21 most common cancers in women

    Table 2.1. New Cases and Deaths in 2021

    Table 2.1. Continued

    Figure 2.3. Cancer by Race/Ethnicity

    aAsian & Pacific Islander, bAmerican Indian/Alaska Native Age-adjusted rates of new cases, the

    Surveillance, Epidemiology, and End Results (SEER) Program 21, 2014–2018

    Figure 2.4. Age-Adjusted Death Rate, by Race and Ethnicity

    aAsian & Pacific Islander, bAmerican Indian/Alaska Native

    Age-adjusted death rates, U.S., 2014–2018

    showed statistically significant decreases in new cases. For men, laryngeal cancer showed the greatest decrease. For women, ovarian cancer showed the greatest decrease.

    What Are the Recent Trends in Cancer Death Rates?

    Between 2014 and 2018, the overall age-adjusted death rate decreased on average 2.2 percent per year for men and 1.7 percent for women. During this period, twelve of the 19 most common cancers in men and fifteen of the 21 most common cancers in women showed statistically significant decreases in death rates. Thyroid cancer showed the greatest increase in death rates among men. Uterine cancer showed the greatest increase in death rates among women.

    Cancer in Context

    How Does Cancer Compare to Other Causes of Death?

    Cancer caused 21.1 percent of all deaths in the United States in 2018. Deaths due to heart disease and cancer caused nearly half of all deaths in the United States. Cancer is the leading cause of death for those under 65 years of age.

    Figure 2.5. Leading Causes of Death in the U.S. 2018

    Figure 2.6. Death Rate Ages <65 (Source: U.S. Mortality Files, National Center for Health

    Statistics (NCHS), Centers for Disease Control and Prevention (CDC).)

    Rates are age-adjusted

    What Are the U.S. Death Rates?

    In the United States, heart disease death rates have decreased for people of all ages. In 1975, heart disease among those less than 65 caused 26 percent of deaths, compared to 17 percent in 2018. In those over 65, heart disease caused 44 percent of deaths in 1975, compared to 25 percent in 2018.

    Figure 2.7. Death Rate Ages 65+ (Source: U.S. Mortality Files, National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC).)

    Rates are age-adjusted

    Neoplasms have slightly increased for people of all ages. In 1975, neoplasms for those less than 65 accounted for 22 percent of deaths in the United States, compared to 23 percent in 2018. In those over 65, neoplasms caused 18 percent of deaths in 1975, compared to 21 percent in 2018.

    Chapter 3 | Cancer Health Disparities

    Chapter Contents

    Section 3.1—Overview of Cancer Health Disparities

    Section 3.2—Statistics for Cancer Health Disparities

    Section 3.1 | Overview of Cancer Health Disparities

    This section includes text excerpted from Cancer Disparities, National Cancer Institute (NCI), November 17, 2020.

    Cancer affects all population groups in the United States, but due to social, environmental, and economic disadvantages, certain groups bear a disproportionate burden of cancer compared with other groups.

    Cancer disparities (sometimes called cancer health disparities) are differences in cancer measures such as:

    Incidence (new cases)

    Prevalence (all existing cases)

    Mortality (deaths)

    Survival (how long people survive after diagnosis)

    Morbidity (cancer-related health complications)

    Survivorship (including quality of life (QOL) after cancer treatment)

    Financial burden of cancer or related health conditions

    Screening rates

    Stage at diagnosis

    Cancer disparities can also be seen when outcomes are improving overall but the improvements are not seen in some groups relative to other groups.

    Population groups that may experience cancer disparities include groups defined by race/ethnicity, disability, gender identity, geographic location, income, education, age, sexual orientation, national origin, and/or other characteristics.

    Examples of Cancer Disparities

    Although cancer incidence and mortality overall are declining in all population groups in the United States, certain groups continue to be at increased risk of developing or dying from particular cancers.

    Statistics from NCI’s Surveillance, Epidemiology, and End Results (SEER) Program include information specific to racial and ethnic populations as well as populations defined by age, gender, and geography. Some key cancer incidence and mortality disparities in the United States include:

    Blacks/African Americans have higher death rates than all other racial/ethnic groups for many, although not all, cancer types.

    Despite having similar rates of breast cancer, Black/African-American women are more likely than white women to die of the disease.

    The incidence rates of colorectal, lung, and cervical cancers are much higher in rural Appalachia than in urban areas in the region.

    Although deaths from prostate cancer have dropped substantially in recent decades among all men, Black/African-American men are twice as likely as white men to die of prostate cancer and continue to have the highest prostate cancer mortality among all U.S. population groups.

    People with more education are less likely to die prematurely (before the age of 65) from colorectal cancer than those with less education, regardless of race or ethnicity.

    Hispanic/Latino and Black/African-American women have higher rates of cervical cancer than women of other racial/ethnic groups, with Black/African-American women having the highest rates of death from the disease.

    American Indians/Alaska Natives have higher death rates from kidney cancer than any other racial/ethnic group.

    The rates of smoking and alcohol drinking, which increase cancer risk, are higher among lesbian, gay, and bisexual youths than among heterosexual youths.

    American Indians/Alaska Natives have the highest rates of liver and intrahepatic bile duct cancer, followed by Hispanics/Latinos and Asian/Pacific Islanders.

    Contributing Factors

    Cancer disparities reflect the interplay among many factors, including social determinants of health, behavior, biology, and genetics – all of which can have profound effects on health, including cancer risk and outcomes.

    Certain groups in the United States experience cancer disparities because they are more likely to encounter obstacles in getting healthcare.

    For example, people with low incomes, low health literacy, long travel distances to screening sites, or who lack health insurance, transportation to a medical facility, or paid medical leave are less likely to have recommended cancer screening tests and to be treated according to guidelines than those who do not encounter these obstacles.

    People who do not have reliable access to healthcare are also more likely to be diagnosed with late-stage cancer that might have been treated more effectively if diagnosed earlier.

    Some groups are disproportionately affected by cancer due to environmental conditions. People who live in communities that lack clean water or air may be exposed to cancer-causing substances.

    The built environment can also influence behaviors that raise one’s risk of cancer. For example, people who live in neighborhoods that lack affordable healthy foods or safe areas for exercise are more likely to have poor diets, be physically inactive, and obese, all of which are risk factors for cancer.

    Even people of higher socioeconomic status and those with health insurance may experience cancer disparities. The disparities these individuals experience may reflect the health impact of institutional racism and the chronic stress it causes, conscious or unconscious bias from health providers, mistrust of the healthcare system, and/or fatalistic attitudes about cancer.

    In some cases, inherited factors or tumor biological factors may, either directly or by interacting with factors such as diet, chronic stress, or tobacco exposure, lead to cancer disparities.

    For example, some evidence suggests that there are differences in the genetics, tumor biology, and immune environment of triple-negative breast, colorectal, and prostate cancers that arise in African Americans compared with those that arise in people of other racial/ethnic groups. These differences may contribute to disparities in incidence, aggressiveness, and response to treatment of these cancers.

    Cancer disparities may also be exacerbated by the lack of diversity in clinical research participation. Because of this lack of diversity, research results may not be applicable to all populations.

    Because many different factors can influence cancer disparities, addressing them is not always simple or straightforward. Reducing or eliminating some cancer disparities in the pursuit of health equity will require policy changes to overcome systemic social, racial, and/or institutional inequalities.

    The NCI-funded researchers are working to identify other ways to improve outcomes for groups disproportionately affected by cancer. Their research efforts range in scope from designing and implementing culturally appropriate health interventions, to improving access to care and clinical trials, to examining genetic factors that may explain differences in rates of aggressive cancers.

    Section 3.2 | Statistics for Cancer Health Disparities

    This section includes text excerpted from Cancer Stat Facts: Cancer Disparities, National Cancer Institute (NCI), August 3, 2018.

    Statistics at a Glance

    At a Glance

    Cancer is a major public health concern that can affect anyone. However, in the United States, certain population groups suffer more from cancer and its effects. This is known as cancer disparities or cancer health disparities. Cancer disparities happen when there are higher rates of new cancer diagnoses and/or cancer deaths between population groups. These can include different racial/ethnic, sex, age, and socioeconomic groups.

    Figure 3.1. Rates of New Cancer Cases by Race/Ethnicity (Source: The Surveillance, Epidemiology, and End Results (SEER) Program 21 2014–2018, Age-Adjusted Rate per 100,000.)

    aAsian/Pacific Islander, bAmerican Indian/Alaska Native

    Figure 3.2. Cancer Death Rates by Race/Ethnicity (Source: U.S. Mortality 2014–2018, Age-Adjusted Rate per 100,000.)

    aAsian/Pacific Islander, bAmerican Indian/Alaska Native

    Figure 3.3. New Cancer Diagnoses by Sex and Race/Ethnicity (Source: The Surveillance,

    Epidemiology, and End Results (SEER) Program 21 2014–2018, Age-Adjusted Rate per 100,000.)

    Figure 3.4. Death Rates by Sex and Race/Ethnicity (Source: U.S. Mortality 2014–2018,

    Age-Adjusted Rate per 100,000.)

    Sex and Race/Ethnicity

    How Many People Are Diagnosed with Cancer by Sex and Race/Ethnicity?

    For all cancers combined, black men have the highest rate of new cancer diagnoses, and Asian/Pacific Islander men have the lowest rate of new cancer diagnoses. The rate of new cases for men was 489.2 per 100,000 men per year. The rate of new cases for women was 425.6 per 100,000 women per year. These rates are age-adjusted and based on 2014–2018 cases.

    How Many People Die of Cancer by Sex and Race/Ethnicity?

    Among both men and women, blacks have the highest cancer death rates, and Asian/Pacific Islander have the lowest cancer death rates. The death rate for men was 185.5 per 100,000 men per year. The death rate for women was 133.5 per 100,000 women per year. These rates are age-adjusted and based on 2014–2018 cases.

    Figure 3.5. Estimated New Cancer Cases (2021): All Races - Ethnicities

    Figure 3.6. Estimated Cancer Deaths (2021): All Races-Ethnicities

    Cancer Sites by Sex and Race/Ethnicity

    For all cancers and races/ethnicities combined, men are more likely to be diagnosed with cancer and to die from cancer than women.

    Figure 3.7. Prostate Cancer: Age-Adjusted Rate of New Cases per 100,000 Men by Race/Ethnicity

    (Source: The Surveillance, Epidemiology, and End Results (SEER) Program 21, Age-Adjusted Rate

    per 100,000.)

    How Do Rates of New Cancer Cases Compare by Cancer Site, Sex, and Race/Ethnicity?

    The rate of new cancer cases varies significantly by specific cancer site and by race/ethnicity.

    Men

    For all cancers combined, black men have the highest rate of new cancer diagnoses. The most common cancers in men are prostate, lung and bronchus, and colorectal. The graphs below show the trends in the rates of new cases by race/ethnicity for prostate cancer in men between 2009–2018.

    Women

    For all cancers combined, white women have the highest rate of new cancer diagnoses. The most common cancers in women are breast, lung and bronchus, and colorectal. The graphs below show the trends in the rates of new cases by race/ethnicity for breast cancer in women between 2009–2018.

    How Do Cancer Death Rates Compare by Cancer Site, Sex, and Race/Ethnicity?

    Cancer death rates vary significantly by specific cancer site and by race/ethnicity.

    Figure 3.8. Female Breast Cancer: Age-Adjusted Rate of New Cases per 100,000 Women by Race/Ethnicity (Source: The Surveillance, Epidemiology, and End Results (SEER) Program 21, Age-Adjusted Rate per 100,000.)

    Men

    Black men have the highest death rate for all cancer sites combined. The most common causes of cancer death in men are lung and bronchus, prostate, and colorectal cancer.

    Women

    Black women have the highest death rate for all cancer sites combined, however, rates vary significantly by specific cancer site. The most common causes of cancer death in women are lung and bronchus, breast, and colorectal cancer.

    Chapter 4 | Lifestyle Issues and Cancer Risk

    Chapter Contents

    Section 4.1—Tobacco Use and Cancer Risk

    Section 4.2—Alcohol Use and Cancer Risk

    Section 4.3—Obesity and Cancer Risk

    Section 4.4—Sun Exposure and Cancer Risk

    Section 4.5—Indoor Tanning and Cancer Risk

    Section 4.6—The Role of Physical Activity in Reducing Cancer Risk

    Section 4.1 | Tobacco Use and Cancer Risk

    This section contains text excerpted from the following sources: Text in this section begins with excerpts from Tobacco and Cancer, Centers for Disease Control and Prevention (CDC), November 16, 2020; Text under the heading Tobacco and Its Health Risks is excerpted from Tobacco, National Cancer Institute (NCI), January 23, 2017. Reviewed August 2021.

    If you were asked to describe the relationship between tobacco smoking and cancer, you might immediately think of lung cancer. It is true that smoking tobacco products (including cigarettes and cigars) causes almost nine of every 10 cases of lung cancer, but smoking can cause cancer almost anywhere in your body, including in the:

    Bladder

    Blood (acute myeloid leukemia (AML))

    Cervix

    Colon and rectum

    Esophagus

    Kidney and renal pelvis

    Liver

    Lungs, bronchi, and trachea

    Mouth and throat

    Pancreas

    Stomach

    Voice box (larynx)

    Health Advice for People Who Use Tobacco or Are Thinking of Using Tobacco

    The most important things you can do to avoid health risks from cancer are:

    If you do not smoke or use tobacco – do not start!

    If you do smoke or use tobacco – quit!

    No matter how long you have smoked, quitting can reduce your risk for cancer and other chronic diseases. Quitting smoking can be hard. Most smokers try to quit many times before they succeed.

    How Tobacco Products Cause Cancer

    Tobacco smoke has at least 70 chemicals that cause cancer, also known as carcinogens. Every time you breathe in that smoke, those chemicals get into your bloodstream, which carries the chemicals to all parts of your body. Many of these chemicals can damage your deoxyribonucleic acid (DNA), which controls how your body makes new cells and directs each kind of cell to do what it is made for. Damaged DNA can make cells grow differently from how they are supposed to. These unusual cells can turn into cancer.

    Secondhand Smoke

    Smokers are not the only people who can get cancer from tobacco smoke. People around them – their kids, partners, friends, coworkers, and others – breathe in that smoke, too, called secondhand smoke.

    Other Tobacco Products

    Smokeless tobacco products, such as dipping and chewing tobacco, can cause cancer, too, including cancers of the esophagus, mouth and throat, and pancreas. Smoking cigars causes lung cancer and increases the risk of cancers of the mouth, throat, larynx, and esophagus.

    Electronic cigarettes produce an aerosol by heating a liquid that usually contains nicotine – the addictive drug in regular cigarettes, cigars, and other tobacco products – flavorings, and other chemicals that help to make the aerosol. Users inhale this aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales into the air. E-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.

    Health Disparities

    Differences between groups of people in their level of health, quality of healthcare, how many have a particular health problem, and so on, are called health disparities. The groups of people might differ by age, race, income, rural residence, or some other characteristic. People who are poorer, less educated, or part of certain racial or ethnic groups are more likely to smoke.

    Tobacco and Its Health Risks

    Tobacco use is a leading cause of cancer and of death from cancer. People who use tobacco products or who are regularly around environmental tobacco smoke (also called secondhand smoke) have an increased risk of cancer because tobacco products and secondhand smoke have many chemicals that damage DNA.

    Tobacco use causes many types of cancer, including cancer of the lung, larynx (voice box), mouth, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon and rectum, and cervix, as well as acute myeloid leukemia. People who use smokeless tobacco (snuff or chewing tobacco) have increased risks of cancers of the mouth, esophagus, and pancreas.

    There is no safe level of tobacco use. People who use any type of tobacco product are strongly urged to quit. People who quit smoking, regardless of their age, have substantial gains in life expectancy compared with those who continue to smoke. Also, quitting smoking at the time of a cancer diagnosis reduces the risk of death.

    Harms of Cigarette Smoking and Health Benefits of Quitting

    What Harmful Chemicals Does Tobacco Smoke Contain?

    Tobacco smoke contains many chemicals that are harmful to both smokers and nonsmokers. Breathing even a little tobacco smoke can be harmful.

    Of the more than 7,000 chemicals in tobacco smoke, at least 250 are known to be harmful, including hydrogen cyanide, carbon monoxide, and ammonia.

    Among the 250 known harmful chemicals in tobacco smoke, at least 69 can cause cancer. These cancer-causing chemicals include the following:

    Acetaldehyde

    Aromatic amines

    Arsenic

    Benzene

    Beryllium (a toxic metal)

    1,3–Butadiene (a hazardous gas)

    Cadmium (a toxic metal)

    Chromium (a metallic element)

    Cumene

    Ethylene oxide

    Formaldehyde

    Nickel (a metallic element)

    Polonium-210 (a radioactive chemical element)

    Polycyclic aromatic hydrocarbons (PAHs)

    Tobacco-specific nitrosamines

    Vinyl chloride

    What Are Some of the Health Problems Caused by Cigarette Smoking?

    Smoking is the leading cause of premature, preventable death in this country. Cigarette smoking and exposure to tobacco smoke cause about 480,000 premature deaths each year in the United States. Of those premature deaths, about 36 percent are from cancer, 39 percent are from heart disease and stroke, and 24 percent are from lung disease. Mortality rates among smokers are about three times higher than among people who have never smoked.

    Smoking harms nearly every bodily organ and organ system in the body and diminishes a person’s overall health. Smoking causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukemia.

    Smoking also causes heart disease, stroke, aortic aneurysm (a balloon-like bulge in an artery in the chest), chronic obstructive pulmonary disease (COPD) (chronic bronchitis and emphysema), diabetes, osteoporosis, rheumatoid arthritis, age-related macular degeneration, and cataracts, and worsens asthma symptoms in adults. Smokers are at higher risk of developing pneumonia, tuberculosis, and other airway infections. In addition, smoking causes inflammation and impairs immune function.

    Since the 1960s, a smoker’s risk of developing lung cancer or COPD has actually increased compared with nonsmokers, even though the number of cigarettes consumed per smoker has decreased. There have also been changes over time in the type of lung cancer smokers develop – a decline in squamous cell carcinomas (SCC) but a dramatic increase in adenocarcinomas. Both of these shifts may be due to changes in cigarette design and composition, in how tobacco leaves are cured, and in how deeply smokers inhale cigarette smoke and the toxicants it contains.

    Smoking makes it harder for a woman to get pregnant. A pregnant smoker is at higher risk of miscarriage, having an ectopic pregnancy, having her baby born too early and with an abnormally low birth weight, and having her baby born with a cleft lip and/or cleft palate. A woman who smokes

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