Cancer Statistics, 2013 Rebecca Siegel, MPH 1 ; Deepa Naishadham, MA, MS 2 ; Ahmedin Jemal, DVM, PhD 3 Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. A total of 1,660,290 new cancer cases and 580,350 cancer deaths are projected to occur in the United States in 2013. During the most recent 5 years for which there are data (2005-2009), delay- adjusted cancer incidence rates declined slightly in men (by 0.6% per year) and were stable in women, while cancer death rates decreased by 1.8% per year in men and by 1.5% per year in women. Overall, cancer death rates have declined 20% from their peak in 1991 (215.1 per 100,000 population) to 2009 (173.1 per 100,000 population). Death rates continue to decline for all 4 major cancer sites (lung, colorectum, breast, and prostate). Over the past 10 years of data (2000-2009), the largest annual declines in death rates were for chronic myeloid leukemia (8.4%), cancers of the stomach (3.1%) and colorectum (3.0%), and non-Hodgkin lymphoma (3.0%). The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of approximately 1.18 million deaths from cancer, with 152,900 of these deaths averted in 2009 alone. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population, with an emphasis on those groups in the lowest socioeconomic bracket and other underserved populations. CA Cancer J Clin 2013;63:11-30. V C 2013 American Cancer Society. Keywords: cancer, incidence, mortality, survival, trends, deaths averted Introduction Cancer is a major public health problem in the United States and many other parts of the world. One in 4 deaths in the United States is due to cancer. In this article, we provide the expected numbers of new cancer cases and deaths in 2013 nationally and by state, as well as an overview of current cancer statistics using data through 2009, including incidence, mortality, and survival rates and trends. We also estimate the total number of deaths averted as a result of the decline in cancer death rates since the early 1990s, and provide the actual reported numbers of deaths in 2009 by age for the 10 leading causes of death and the 5 leading cancer types. Materials and Methods Incidence and Mortality Data Mortality data from 1930 to 2009 in the United States were obtained from the National Center for Health Statistics (NCHS). 1,2 There are several sources for cancer incidence data. The Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute reports long-term (beginning in 1973), high-quality, population-based incidence data covering up to 26% of the US population. Cancer incidence rates for long-term trends (1975-2009), 5-year relative and cause- specific survival rates (2002-2008), and estimations of the lifetime probability of developing cancer (2007-2009) were obtained from SEER registries. 3-6 The North American Association of Central Cancer Registries (NAACCR) compiles and reports incidence data from 1995 onward for cancer registries that participate in the SEER program or the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR). Incidence data for state-level rates (2005-2009), trends by race/ethnicity (2000-2009), and estimated new cancer cases in 2013 were obtained from NAACCR. 7 Cancer cases were classi- fied according to the International Classification of Diseases for Oncology. 8 All incidence and death rates are age-standardized to the 2000 US standard population and expressed per 100,000 persons. Cancer incidence rates in this report are delay-adjusted whenever possible in order to account for anticipated future corrections to registry data due to inherent delays and errors in case reporting. Delay-adjusted rates primarily affect the most recent years of data for cancers that are frequently diagnosed in outpatient settings (eg, melanoma, leukemia, and prostate) and provide a more 1 Director, Surveillance Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA; 2 Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA; 3 Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA. Corresponding author: Rebecca Siegel, MPH, Surveillance and Health Services Research, American Cancer Society, 250 Williams St, NW, Atlanta, GA 30303-1002; Rebecca.siegel@cancer.org DISCLOSURES: The authors report no conflicts of interest. V C 2013 American Cancer Society, Inc. doi:10.3322/caac.21166. Available online at cacancerjournal.com VOLUME 63 _ NUMBER 1 _ JANUARY/FEBRUARY 2013 11 CA CANCER J CLIN 2013;63:11–30