How cancer affects Americans

October is breast cancer awareness month, which kicks off 31 days of marches, fundraisers and campaigns across the country. Breast cancer is one of the most common cancers in America, with over 230,000 new cases diagnosed in 2014. However, cancer can develop in any part of the body at any age. According to the CDC, cancer is the second-highest cause of death in the United States. In 2014, there were over 1.6 million new cases and nearly 600,000 deaths.

For the past few decades, more money has been poured into cancer research, focusing on screening, prevention, diagnosis and treatment. Over time, scientists have discovered much about what influences risk for developing certain cancers—from smoking to radiation to HPV—and as a result, we have seen rates decline in these areas. For other cancers, however, rates have been increasing with no sign of abating.

Using data from Cancer.gov, HealthGrove analyzed trends in new cases and deaths for 23 major cancers. They looked at these trends through a historical lens to see what events and behavioral changes could be influencing the cancer burden in America.

#23. Lung Cancer

Lung cancer is the second most common cancer in America, with over 200,000 new cases estimated in 2015. The vast majority of lung cancer cases are caused by smoking tobacco, which exposes the lungs to harmful carcinogens. Although we have known about the dangers of smoking since the 1964 Surgeon General’s report, cases still ramped up well into the 1970s and 1980s. Three major factors contributed to this delay: first, people were reluctant to accept the dangers of smoking; second, it typically takes years of heavy smoking for lung cancer to develop; and third, smoking is extremely addictive, so even those who wanted to quit often could not. Fortunately, with a decrease in smoking rates and widespread public health messaging, we have seen both incidence and mortality rates decline since the early 1990s.

#22. Colon Cancer

Percent change in incidence: down 35.5%
Percent change in mortality: down 47.7%

Colon cancer screening is recommended for adults over the age of 50, which is when many polyps—both cancerous and non-cancerous—start to form in the colon. Increased screening and early detection through colonoscopies, sigmoidoscopies and other techniques have reduced both the incidence and mortality rates of this common cancer. Screening can catch early signs of cancer and has been found to lower the death rate of colon cancer patients by 60 to 70 percent.

#21. Acute Myeloid Leukemia

Percent change in incidence: up 31.8%

AML is one of the two most common adult leukemias, and rates have increased in the past decade. With AML, the bone marrow produces abnormal myeloblasts, which are types of white blood cells, red blood cells, or platelets. Smoking, previous chemotherapy and exposure to radiation can increase risk for AML.

#20. Cervical Cancer

Percent change in incidence: down 55.8%
Percent change in mortality: down 58.7%

Although cervical cancer is relatively rare, it is still a major public health concern. Routine screening in the form of the Pap test has helped detect cancer at earlier stages, leading to improved survival rates. The development of the HPV vaccine, which targets nearly all cancer-causing strains of the virus, has helped drive rates even lower.

#19. Larynx Cancer

Percent change in incidence: down 40.2%
Percent change in mortality: down 39.3%

The larynx, also known as the voice box, is a part of the throat responsible for holding the vocal cords and windpipe. Cancer cells rarely develop in the larynx, causing vague symptoms such as sore throat, ear pain and other discomfort. Long-term heavy alcohol and tobacco use can increase the risk of developing larynx cancer. This cancer disproportionately affects men and the median age of diagnosis is 65 years old.

#18. Malignant Brain Tumor

Percent change in incidence: up 10.1%
Percent change in mortality: up 7%

Unlike most other cancers, which largely impact older populations, malignant brain tumors are fairly evenly distributed among all age groups. In fact, brain and central nervous system (CNS) tumors comprise about 21 percent of all childhood cancers. Rates have remained mostly stable for both incidence and mortality, and there is no clear directional change over time. This can be explained by the fact that we can’t pinpoint what exactly causes them, and that there’s no screening test for these tumors.

#17. Uterine Cancer

Percent change in incidence: down 22.5%
Percent change in mortality: down 14.4%

Like many other hormonally-linked cancers, obesity and high estrogen use can increase the risk of uterine cancer. Incidence and mortality rates are down overall, but there has been a slight uptick in both in the past decade. Uterine cancer rates vary geographically, with the northeast seeing the highest incidence.

#16. Testicular Cancer

Percent change in incidence: up 59.8%
Percent change in mortality: down 66.2%

Though a comparatively rare cancer, testicular cancer is on the rise. It most commonly affects young adults, but fortunately it is relatively curable—over 95 percent of people survive at least five years. Many cases are linked to testicular abnormalities and inherited factors, such as undescended testicles and family history of the disease.

#15. Liver Cancer

Percent change in incidence: up 220%
Percent change in mortality: up 126%

While this cancer is still relatively rare in the United States, rates have skyrocketed in the past few decades. Nationally, Asian/Pacific Islander and Native American populations are at the greatest risk. These groups also have some of the highest rates of hepatitis, which can cause liver damage and lead to an increased risk of liver cancer. Fortunately, the gap between incidence and mortality has widened, meaning the survival rate is increasing. In 2007, the five-year survival rate was 18.5 percent, compared with just 3 percent in 1975.

#14. Oral Cancer

Percent change in incidence: down 16%
Percent change in mortality: down 42.1%

Oral cancer has been on the decline for many years. It is primarily caused by tobacco use—especially chewing tobacco—and heavy alcohol use. People infected with the HPV virus also have a heightened risk.

#13. Non-Hodgkin’s Lymphoma

Percent change in incidence: up 81.1%
Percent change in mortality: up 5%

Lymphomas are the most common blood cancers in the United States, with Non-Hodgkin’s lymphoma comprising the majority of cases. Incidence rates of this cancer have increased since 1975, with a slight leveling off since the mid-1990s. Mortality has remained about the same, but fortunately, the widening gap between incidence and mortality means more people are surviving for at least five years. The risk of developing this cancer increases with age, but about 70 percent of patients will survive at least five years after diagnosis.

#12. Pancreatic Cancer

Percent change in incidence: up 9.3%
Percent change in mortality: up 3.3%

Pancreatic cancer is one of the deadliest cancers, with only 7.2 percent of patients surviving five or more years, as of 2012. Routine screening for pancreatic cancer does not exist, and by the time noticeable symptoms develop, the cancer has usually spread outside the pancreas. The pancreas is a vital and important organ, and while aggressive treatments are often recommended, palliative care is often necessary.

#11. Acute Lymphoblastic Leukemia

Percent change in incidence: up 57%

ALL, which is a blood cancer that occurs when the bone marrow makes too many immature white blood cells, is the most common childhood cancer. Nearly 60 percent of cases occur in people younger than 20. Cure rates vary widely by age; the majority of children beat the disease, but adults have significantly lower survival rates.

#10. Prostate Cancer

Percent change in incidence: up 21.4%
Percent change in mortality: down 36.8%

The prostate-specific antigen (PSA) test is one of the two ways (the other being a rectal exam) that doctors screen for prostate cancer. The PSA test was developed by a team of scientists at Roswell Park Cancer Institute. They worked on detecting the antigen, finally succeeding with a patent in 1984. You can see the huge spike in cases in the late 1980s and early 1990s—this can be attributed to the increased detection through the use of the PSA test.

#9. Ovarian Cancer

Percent change in incidence: down 27.1%
Percent change in mortality: down 24.8%

Though it only accounts for three percent of cancers in all women, ovarian cancer causes more deaths than any other female reproductive system cancer. Early symptoms are vague and hard to distinguish from regular monthly discomfort, and as a result many cases are not diagnosed until late stage symptoms surface. Certain environmental exposures and gene mutations can increase risk, including the presence of the BRCA1 and BRCA2 genes, which are linked to high risk of ovarian and breast cancers.

#8. Hodgkin’s Lymphoma

Percent change in incidence: down 12.3%
Percent change in mortality: down 74%

Hodgkin’s lymphoma is much less common than Non-Hodgkin’s lymphoma; about 9,000 new Hodgkin’s cases will be diagnosed in 2015, compared with nearly 72,000 Non-Hodgkin’s cases. Hodgkin’s lymphoma is most common in young adults and people with AIDS or Epstein-Barr virus. The survival rate has been increasing steadily—over 85 percent of patients will survive for at least five years.

#7. Kidney Cancer

Percent change in incidence: up 117%
Percent change in mortality: up 6.1%

Kidney cancer cases experienced a dramatic increase from 1975 until about 2008, when it leveled off. This increase is due to improved early-stage disease screening and detection—mortality has actually been on the decline since the early 1990s. Smoking, obesity and high blood pressure are the most significant risk factors for kidney cancer, and Native Americans have the highest rates of both incidence and mortality.

#6. Thyroid Cancer

Percent change in incidence: up 207%
Percent change in mortality: down 12.7%

Thyroid cancer is rapidly increasing in the United States, and incidence in women is nearly triple that of men. Improved detection can be credited with some of this spike, but not all of it; environmental exposures and genetic conditions are also significant risk factors. Fortunately, the death rate is very low, with nearly 98 percent of patients surviving at least five years.

#5. Stomach Cancer

Percent change in incidence: down 39.8%
Percent change in mortality: down 62.2%

Stomach cancer cases and deaths have been steadily decreasing since 1975. This condition is influenced by diet, age and stomach disease. People with H. pylori infection, chronic gastritis, gastric polyps and other stomach ailments are all at heightened risk. Early symptoms of stomach cancer are hard to pinpoint, and include general discomfort, feeling bloated, heartburn and loss of appetite. By the time more severe symptoms such as blood in the stool and jaundice develop, the cancer has often spread.

#4. Esophageal Cancer

Esophageal cancer is a less common, but very deadly cancer that forms in the tissues of the esophagus. Smoking, heavy alcohol use and Barrett esophagus, a condition caused by long-term, severe heartburn, are all risk factors. The incidence rate has remained relatively flat since 1975, but survival rates have increased from about 4 percent in 1975 to nearly 22 percent in 2010.

#3. Skin Cancer (Melanoma)

Percent change in incidence: up 190%
Percent change in mortality: up 28.5%

Skin cancer is the most common kind of cancer in the U.S., and rates of melanoma have nearly tripled over the past 40 years. This alarming trend can be traced to unhealthy sun behaviors, such as aggressive tanning, lack of sunscreen use and UV tanning bed use. CDC officials predict cases will continue to increase unless drastic measures are taken.

#2. Bladder Cancer

Percent change in incidence: up 6.6%
Percent change in mortality: down 20.4%

Often overlooked, bladder cancer is fifth on the list of cancers with the most new cases in 2015. The rate of new cases has remained relatively constant, and with the exception of a dip in the early 1980s, so has mortality. Many bladder cancer cases are linked to long-term environmental exposures to things such as tobacco smoke and harmful chemicals. Consequently, most cases are diagnosed in people 65 and older.

#1. Breast Cancer

Percent change in incidence: up 23.4%
Percent change in mortality: down 32.3%

Breast cancer will cause the largest number of new cancer cases in 2015, and approximately 12 percent of women will be diagnosed with breast cancer at some point in their lives, according to SEER. The increase in new cases might be tied to increased estrogen exposure—two out of three breast cancers are tied to hormones, and environmental exposures to estrogen are increasing (plastics, makeup, etc.). Obesity is also associated with higher levels of estrogen and other hormones tied to breast cancer.

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