CCaanncceerr iinn NNoorrtthh AAmmeerriiccaa:: 22000069--22001123 CCaanncceerr iinn NNoorrtthh AAmmeerriiccaa:: 22000099--22001133 VolumVeo Olunme:e C Foomurb: iCneadn cCear nScuerrv Iinvcaildence VVoolluummee TTwhroe:e R: eRgeigsitsrytr-ys-psepceicfiicfi cC aCnacnecre Irn Mciodretanlcitey i nfo trh eth Ue nUitneidte Sdt Satteaste asn, dC aCnaandaad,a iinn tthhee UUnniitteedd SSttaatteess aanndd CCaannaaddaa and N20o0r5th-2 A0m11e rica Seattle / Puget Sound Greater Bay Area Metro Detroit Washington D.C. Los Angeles Metro Atlanta North American Association of Central Cancer Registries, Inc. EXECUTIVE SUMMARY Members of the North American Association of Central Cancer Registries, Inc. (NAACCR) participate voluntarily in an annual call for data to develop a multi-registry, aggregated data resource for cancer surveillance and research. In June 2016, NAACCR released the four volume monograph, Cancer in North America (CINA): 2009-2013. This release of cancer incidence statistics for the United States is the 26th publication in the series and the 24th release that includes statistics for both Canada and the United States. This year’s publication includes cancer incidence data for 50 states, the District of Columbia, Puerto Rico, all 5 SEER urban registries, and 12 Canadian registries. CINA includes registry-specific data on stage at diagnosis, survival and delay adjusted estimates of counts and age-adjusted rates for selected cancers. These delay adjustment figures provide a projection of the likely volume of tardy reports of cancer for the time period and is recommended for use in assessing current cancer incidence trends. Volume One presents the aggregated cancer incidence data, including pediatric cancer and cancer by stage at diagnosis, representing North America including data from the high quality registries in the United States and Canada. Age-adjusted cancer incidence rates for the Canadian and United States populations are provided standardized to the 2000 US, 1996 Canadian, and the world population standards. Combined United States data are presented by race and for Hispanic/Latino ethnicity. New for this year are registry specific delay adjusted rates in Volume One. Volume Two contains registry-specific cancer incidence rates by cancer site, sex, race, ethnicity and stage for all NAACCR members submitting data for inclusion in the monograph. Volume Three presents the registry-specific cancer death rates by cancer site, sex, race, and ethnicity. Volume Four provides cancer survival data for the US and Canada from 45 registries on more than 7.2 million cases diagnosed among North Americans between 2006 and 2012. All four volumes are available free of charge from the NAACCR website, along with population data, supporting appendices, and cancer rates age-adjusted to the US, Canadian and World population standards. Note that this publication utilizes population estimates that are based upon the United States 2010 and Canada 2011 censuses. In addition to publication of cancer statistics for the most recent five-year period, the CINA data resource is used to create the CINA+ Online database and NAACCR FastStats (graphic and tables by cancer sites, race/sex, race/ethnicity, age at diagnosis, sex, registry, and data type) for public queries regarding cancer incidence for the most recent five years. The CINA data are also used to develop a discretionary research data set (CINA Deluxe), including data from 1995 to 2013, to facilitate analytic studies conducted by epidemiologists and other qualified researchers. The data within this report are also available as an electronic reproduction of all cancer statistics reported in the CINA monograph for use in SAS analytic software and a discretionary data set of the data in CINA+ Online (named CINA Plus in SEER*Stat) in SEER*Stat software for approved uses by NAACCR members. These preeminent cancer data resources are unparalleled in geographic scope, timeliness of statistics, and assurance of standardization of information and data quality across all contributors, with standard data quality metrics reported for all contributors. We hope that Cancer in North America: 2009-2013, with the companion CINA products and resources, facilitate studies of cancer burden, so that we are better able to identify and understand appropriate and important measures to control the myriad diseases within the cancer rubric. The cancer surveillance infrastructure in the U.S. and Canada has been orchestrated to meet these objectives. This publication is made possible by the continuing efforts of the NAACCR member registries. High quality standardized cancer incidence data aggregated across the states, provinces, territories, and regions in North America is made possible by the dedication of our members to cancer surveillance. The Editors would like to acknowledge the fine work and support of the National Cancer Institute, the National Center for Health Statistics and Statistics Canada for their assistance in developing this publication. The Editors June 2016 EXECUTIVE SUMMARY i CANCER IN NORTH AMERICA: 2009-2013 VOLUME ONE: COMBINED CANCER INCIDENCE FOR THE UNITED STATES, CANADA AND NORTH AMERICA A Publication of the North American Association of Central Cancer Registries, Inc. (NAACCR) Editors: Glenn Copeland, Michigan Cancer Surveillance Program Andrew Lake, Information Management Services, Inc. Rick Firth, Information Management Services, Inc. Brad Wohler, Florida Cancer Data System Xiao-Cheng Wu, Louisiana Tumor Registry Maria J. Schymura, New York State Cancer Registry Jim Hofferkamp, NAACCR, Inc. Recinda Sherman, NAACCR Inc. Betsy Kohler, NAACCR, Inc. June 2016 The Editorial Subcommittee of the NAACCR Standing Committee, Data Use and Research Committee publishes this monograph. We are grateful to the National Cancer Institute, National Institutes of Health (NCI/NIH) for providing support for the production under Contract No. HHSN261200444001C/ADB Contract No. PC-44401. We acknowledge partial support of NAACCR staff by cooperative agreement U75/CCU52346-05 from the Centers for Disease Control and Prevention (CDC) and by the NCI/NIH Contract No. HHSN261200444001C/ADB Contract No. PC-44401. Its contents are solely the responsibility of the editors and do not necessarily represent the official view of CDC. iii CINA PARTICIPANTS 2009-2013 Seattle Puget Sound Metro Detroit Greater Bay Area Washington D.C. Los Angeles Metro Atlanta Participating Registries SUGGESTED CITATION: Copeland G, Lake A, Firth R, Wohler B, Wu XC, Schymura M, Hofferkamp J, Sherman R, Kohler B (eds). Cancer in North America: 2009-2013. Volume One: Combined Cancer Incidence for the United States, Canada and North America. Springfield, IL: North American Association of Central Cancer Registries, Inc. June 2016. v TABLE OF CONTENTS SECTION I: Introduction and Technical Notes ..................................................................................................... I-1 SECTION II: Top Five Most Commonly Diagnosed Cancers in North America Top Five Most Commonly Diagnosed Cancers in North America...............................................................II-1 Top Five Most Commonly Diagnosed Cancers in the U.S. by Race/Ethnicity Males ...............................................................................................................................................II-2 Females ............................................................................................................................................II-3 SECTION III: Average-annual Age-adjusted NAACCR Combined Cancer Incidence Rates for the United States, Canada and North America Data Quality Indicators for the United States............................................................................................. III-1 Map: Registries included in U.S. Combined Incidence for All Races......................................................... III-3 Combined Registries, All Races (2000 U.S. and 1996 Canadian populations).......................................... III-4 Five Most Commonly Diagnosed Cancers,Incidence Rates by Registry, All Races, Males (2000 U.S. population) ..................................................................................... III-5 All Races, Males (1996 Canadian population).............................................................................. III-7 All Races, Females (2000 U.S. population)................................................................................... III-9 All Races, Females (1996 Canadian population)......................................................................... III-11 Map: Registries included in U.S. Combined Incidence for White........................................................... III-13 Combined Registries, White (2000 U.S. and 1996 Canadian populations)............................................. III-14 Five Most Commonly Diagnosed Cancers,Incidence Rates by Registry, White, Males (2000 U.S. population).......................................................................................... III-15 White, Males (1996 Canadian population).................................................................................. III-17 White, Females (2000 U.S. population)....................................................................................... III-19 White, Females (1996 Canadian population)............................................................................... III-21 Map: Registries included in U.S. Combined Incidence for Black............................................................ III-23 Combined Registries, Black (2000 U.S. and 1996 Canadian populations).............................................. III-24 Five Most Commonly Diagnosed Cancers, Incidence Rates by Registry, Black, Males (2000 U.S. population)......................................................................................... III-25 Black, Males (1996 Canadian population).................................................................................. III-27 Black, Females (2000 U.S. population)...................................................................................... III-29 Black, Females (1996 Canadian population).............................................................................. III-31 Map: Registries included in U.S. Combined Incidence for Asian/Pacific Islander................................. III-33 Combined Registries, Asian/Pacific Islander(2000 U.S. and 1996 Canadian populations) .................... III-34 Five Most Commonly Diagnosed Cancers,Incidence Rates by Registry, Asian/Pacific Islander, Males (2000 U.S. population)................................................................ III-35 Asian/Pacific Islander, Males (1996 Canadian population)........................................................ III-37 Asian/Pacific Islander, Females (2000 U.S. population)............................................................ III-39 Asian/Pacific Islander, Females (1996 Canadian population).................................................... III-41 Map: Selected CHSDA Counties included in U.S. Combined Incidence for American Indian/Alaskan Native .................................................................................................... III-43 Combined Registries, American Indian/Alaskan Native(2000 U.S. and 1996 Canadian populations) ... III-44 Five Most Commonly Diagnosed Cancers,Incidence Rates by Registry, American Indian/Alaskan Native, Males (2000 U.S. population).............................................. III-45 American Indian/Alaskan Native, Males (1996 Canadian population)....................................... III-47 American Indian/Alaskan Native, Females (2000 U.S. population)........................................... III-49 American Indian/Alaskan Native, Females (1996 Canadian population)................................... III-51 Most Frequent Cancer Sites by IHS Region, American Indian/Alaskan Native, Males (2000 U.S. population).............................................. III-53 American Indian/Alaskan Native, Females (2000 U.S. population)........................................... III-55 Map: Registries included in U.S. Combined Incidence for Hispanic/Latino, All Races.......................... III-57 Combined Registries, Hispanic/Latino, All Races (2000 U.S. and 1996 Canadian populations) ............ III-58 Commonly Diagnosed Cancers, Incidence Rates by Registry, Hispanic/Latino, All Races, Males (2000 U.S. population)........................................................ III-59 Hispanic/Latina, All Races, Females (2000 U.S. population).................................................... III-63 vi TABLE OF CONTENTS Contents Map: Registries included in U.S. Combined Incidence for Non-Hispanic White .....................................III-67 Combined Registries, Non-Hispanic White (2000 U.S. and 1996 Canadian populations).......................III-68 Commonly Diagnosed Cancers,Incidence Rates by Registry, Non-Hispanic White, Males (2000 U.S. population)...................................................................III-69 Non-Hispanic White, Females (2000 U.S. population)................................................................III-73 Map: Registries included in U.S. Combined Incidence for Non-Hispanic Black .....................................III-77 Combined Registries, Non-Hispanic Black (2000 U.S. and 1996 Canadian populations).......................III-78 Commonly Diagnosed Cancers,Incidence Ratesby Registry, Non-Hispanic Black, Males (2000 U.S. population)....................................................................III-79 Non-Hispanic Black, Females (2000 U.S. population)................................................................III-83 Data Quality Indicators for Canada..........................................................................................................III-88 Map: Registries included in CanadianCombined Incidence for All Races .............................................III-89 Combined Registries, All Races (2000 U.S. and 1996 Canadian populations) ........................................III-90 Five Most Commonly Diagnosed Cancers,Incidence Rates by Registry, All Races, Males (2000 U.S. and 1996 Canadian populations)..................................................III-91 All Races, Females (2000 U.S. and 1996 Canadian populations) ...............................................III-92 Data Quality Indicators for North America..............................................................................................III-94 Map: Registries included in North AmericaCombined Incidence for All Races .....................................III-95 Combined Registries, All Races (2000 U.S. and 1996 Canadian populations) ........................................III-96 Five Most Commonly Diagnosed Cancers,Incidence Rates by Registry, All Races, Males (2000 U.S. population)....................................................................................III-97 All Races, Males (1996 Canadian population)............................................................................III-99 All Races, Females (2000 U.S. population)..............................................................................III-101 All Races, Females (1996 Canadian population)......................................................................III-103 Map: Registries included in U.S. Pediatric Cancer Incidence...............................................................III-106 Age-specific Rates for the United States All Races, Males .......................................................................................................................III-107 All Races, Females....................................................................................................................III-108 White, Males .............................................................................................................................III-109 White, Females .........................................................................................................................III-110 Black, Males .............................................................................................................................III-111 Black, Females ..........................................................................................................................III-112 Asian/Pacific Islander, Males....................................................................................................III-113 Asian/Pacific Islander, Females................................................................................................III-114 American Indian/Alaskan Native, Males..................................................................................III-115 American Indian/Alaskan Native, Females...............................................................................III-116 Hispanic/Latino, All Races, Males............................................................................................III-117 Hispanic/Latina, All Races, Females........................................................................................III-118 Non-Hispanic White, Males ...................................................................................................... III-119 Non-Hispanic White, Females..................................................................................................III-120 Non-Hispanic Black, Males......................................................................................................III-121 Non-Hispanic Black, Females...................................................................................................III-122 Age-adjusted Rates (2000 U.S. and 1996 Canadian population) (Ages 0-14, Ages 0-19) All Races, Males .......................................................................................................................III-123 All Races, Females....................................................................................................................III-124 White, Males .............................................................................................................................III-125 White, Females .........................................................................................................................III-126 Black, Males .............................................................................................................................III-127 Black, Females ..........................................................................................................................III-128 Asian/Pacific Islander, Males....................................................................................................III-129 Asian/Pacific Islander, Females................................................................................................III-130 American Indian/Alaskan Native, Males..................................................................................III-131 American Indian/Alaskan Native, Females...............................................................................III-132 Hispanic/Latino, All Races, Males............................................................................................III-133 Hispanic/Latina, All Races, Females........................................................................................III-134 Non-Hispanic White, Males......................................................................................................III-135 Non-Hispanic White, Females..................................................................................................III-136 Non-Hispanic Black, Males......................................................................................................III-137 Non-Hispanic Black, Females...................................................................................................III-138 Map: Registries included in Canadian Pediatric Cancer Incidence......................................................III-140 Age-specific Rates for Canada All Races, Males .......................................................................................................................III-141 All Races, Females....................................................................................................................III-142 TABLE OF CONTENTS vii Contents Age-adjusted Rates (2000 U.S. and 1996 Canadian population) (Ages 0-14, Ages 0-19) All Races, Males .......................................................................................................................III-143 All Races, Females ...................................................................................................................III-144 Map: Registries included in North American Pediatric Cancer Incidence ..........................................III-146 Age-specific Rates for North America All Races, Males .......................................................................................................................III-147 All Races, Females ...................................................................................................................III-148 Age-adjusted Rates (2000 U.S. and 1996 Canadian population) (Ages 0-14, Ages 0-19) All Races, Males .......................................................................................................................III-149 All Races, Females ...................................................................................................................III-150 SECTION IV: Stage at Diagnosis by Age for Select Cancer Sites United States Combined Registries ...........................................................................................................IV-1 Canada Combined Registries .....................................................................................................................IV-3 North America Combined Registries .........................................................................................................IV-4 SECTION V: Average-annual Age-adjusted Cancer Incidence Observed and Delay Adjusted Counts and Rates by Race, Sex and Selected Sites, for the United States, Canada and North America Map: Registries included in U.S. Combined Delay Adjusted Incidence ....................................................V-1 Combined Registries, All Races (2000 U.S. population)............................................................................V-2 All Races, Males (2000 U.S. population)......................................................................................V-3 All Races, Females (2000 U.S. population)...................................................................................V-9 Combined Registries, White (2000 U.S. population)...............................................................................V-16 Combined Registries, Black (2000 U.S. population)................................................................................V-17 Combined Registries, Asian/Pacific Islander (2000 U.S. population)......................................................V-18 Map: Registries included in CanadianCombined Delay Adjusted Incidence .........................................V-19 Combined Registries, All Races (2000 U.S. population)..........................................................................V-20 All Races, Males (2000 U.S. population)....................................................................................V-21 All Races, Females (2000 U.S. population).................................................................................V-22 Map: Registries included in North AmericaCombined Delay Adjusted Incidence .................................V-23 Combined Registries, All Races (2000 U.S. population)..........................................................................V-24 All Appendices are available on the NAACCR website: http://www.naaccr.org/DataandPublications/CINAPubs.aspx viii TABLE OF CONTENTS