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CONTENTS
Introduction to the Summary of Notifiable Noninfectious
Conditions and Disease Outbreaks United States.............................1
Acute Nonoccupational Pesticide-Related Illness and Injury
United States, 20072011.................................................................................5
Acute Occupational Pesticide-Related Illness and Injury
United States, 20072011.............................................................................. 11
Surveillance for Cancer Incidence and Mortality
United States, 2012.......................................................................................... 17
Elevated Blood Lead Levels Among Employed Adults
United States, 19942013.............................................................................. 59
Blood Lead Levels in Children Aged <5 Years
United States, 20072013.............................................................................. 66
Surveillance for Silicosis Michigan and New Jersey,
20032011........................................................................................................... 73
Foodborne (19732013) and Waterborne (19712013)
Disease Outbreaks United States.......................................................... 79
The MMWR series of publications is published by the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC),
U.S. Department of Health and Human Services, Atlanta, GA 30329-4027.
Suggested citation: Centers for Disease Control and Prevention. [Summary of Noninfectious Conditions and Disease Outbreaks]. Published October 14, 2016 for MMWR
Morb Mortal Wkly Rep 2014;63(No. 55):[inclusive page numbers].
US Department of Health and Human Services/Centers for Disease Control and Prevention
Background
As with nationally notifiable infectious diseases, to prevent
and control nationally notifiable noninfectious conditions and
disease outbreaks, public health authorities require regular,
frequent, and timely information. A brief history of the
reporting of nationally notifiable conditions in the United
States is available at http://wwwn.cdc.gov/nndss/history.
html. In 1961, responsibility for collecting data on nationally
notifiable diseases and deaths in 122 U.S. cities was transferred
from the National Office of Vital Statistics to CDC.
CDCs collection of data on nationally notifiable
noninfectious conditions and disease outbreaks is based
primarily on surveillance conducted at the local, state, and
territorial levels by health departments and other agencies
on reportable conditions in each jurisdiction. Legislation,
regulation, or other rules in those jurisdictions require health
care providers, hospitals, laboratories, and others to provide
information on reportable conditions to public health
authorities or their agents. The list of reportable conditions in
each jurisdiction varies over time and across jurisdictions. More
information is available at http://www.cste.org/?SRCA. Public
health surveillance of noninfectious conditions and disease
outbreaks at the local, state, and territorial levels protects
the publics health by ensuring the proper identification of
conditions and health hazards. Public health officials use
these data to monitor trends in these conditions, identify
populations or geographic areas at high risk, plan prevention
and control policies and other interventions, allocate resources
effectively, coordinate activities, and assess the effectiveness of
their efforts. Local, state, and territorial health departments
also use these data to assist the federal government in meeting
requirements under the International Health Regulations to
identify, respond to, and share information about adverse
health events that might constitute a Public Health Emergency
of International Concern (PHEIC) (http://www.cdc.gov/
globalhealth/ihr). Health departments have agreed to report
information about a potential PHEIC to federal agencies
(including CDC) that have primary responsibility at the
national level for monitoring such events. After evaluating
whether an event constitutes a potential PHEIC, CDC notifies
the U.S. Department of Health and Human Services (HHS).
HHS, after further evaluation, reports potential PHEICs to
the World Health Organization (WHO), which might declare
the event a PHEIC. More detailed information on this process
is found in the Summary of Notifiable Infections Diseases and
Conditions (1) and from WHO (http://apps.who.int/iris/
bitstream/10665/43883/1/9789241580410_eng.pdf ).
A selected set of reportable conditions is designated as
nationally notifiable. For most of these conditions, notifications
US Department of Health and Human Services/Centers for Disease Control and Prevention
BOX. Criteria defining nationally notifiable conditions and disease outbreaks used to determine whether notifications to CDC are published
in the annual Summary of Notifiable Noninfectious Conditions and Disease Outbreaks
Condition/Outbreak
Classification
Cancer
Confirmed
Confirmed
Confirmed
Silicosis
Confirmed
Two or more cases of a similar illness linked epidemiologically by time and location to exposure to water or waterassociated chemicals volatized into the air
US Department of Health and Human Services/Centers for Disease Control and Prevention
Data Sources
References
US Department of Health and Human Services/Centers for Disease Control and Prevention
Preface
Background
US Department of Health and Human Services/Centers for Disease Control and Prevention
Data Sources
Among the 12 states that participate in the SENSORPesticides program, seven states (Florida, Louisiana, Michigan,
North Carolina, New York, Oregon, and Washington) routinely
collect information on nonoccupational pesticide-related
illness and injury. This report summarizes data from these seven
SENSOR-Pesticides program states. More information on the
SENSOR-Pesticides program is available at http://www.cdc.
gov/niosh/topics/pesticides/overview.html.
State-level pesticide-related illness and injury surveillance
programs receive case reports about pesticide-related
illness and injury from hospitals and health care facilities,
laboratories, regional or state poison control centers, agriculture
departments, and affected persons or family members
(9,11,12). Case ascertainment sources and the agencies to
which cases are reported vary by state (12).
In Florida, health care practitioners and laboratories are
required to report new cases of pesticide-related illness and
injury within 24 hours of discovery (13). The Florida program
also accepts reports from exposed person(s), witnesses, legal
services, farmworker advocacy groups, other state agencies,
news media representatives, and others willing to report (14).
In Michigan, health care facilities, health care professionals,
and Michigans Poison Control Center are required to provide
reports of chemical poisonings only by request, except in cases
of intentional or medicinal poisonings (15). The Michigan
Department of Health and Human Services (previously known
as the Department of Community Health) makes routine and
broad-based requests for all unintentional pesticide-related
illness reports. Requested reports must be provided within
10 days. Data requests from the state to hospitals are made
quarterly. Washington requires that physicians and other health
professionals report pesticide-related illness and injury cases
to the state health department. Serious or fatal poisonings in
Washington must be reported immediately; all others must be
reported within 3 days (16). In Louisiana, health care providers
and poison control centers must report pesticide-related illness
to the Louisiana Department of Health and Hospitals (17).
New York operates a pesticide poisoning registry; physicians
and other health care professionals are required to report
suspected or confirmed pesticide-related illness and injury
cases within 48 hours (18). In addition, the program receives
reports from the two state poison control centers and pesticide
product registrants. In North Carolina, health care providers
must report cases of acute pesticide-related illness and injury
resulting in death immediately to the state health department
or state poison control center; other confirmed or suspicious
cases must be reported within 48 hours of diagnosis (19). In
Oregon, health care providers must report pesticide-related
illness and injury cases to their local health department within
24 hours (20).
US Department of Health and Human Services/Centers for Disease Control and Prevention
Case Definition
The SENSOR-Pesticides program case definitions for acute
pesticide-related illness and injury and reporting details are
described in detail elsewhere (9). A case of acute pesticiderelated illness and injury is characterized by an acute onset
of symptoms that are dependent on the formulation of the
pesticide product and involve one or more of the following:
1) systemic signs or symptoms (including respiratory,
gastrointestinal, allergic, and neurologic), 2) dermatologic
lesions, and 3) ocular lesions (9). An illness and injury case is
considered nonoccupational if the pesticide exposure occurred
at some place other than the patients place of work (9).
State SENSOR-Pesticides programs classify pesticiderelated illness and injury cases as definite, probable, possible,
suspicious, unlikely, insufficient information, asymptomatic, or
unrelated. Only definite, probable, possible, or suspicious cases
are reportable to NIOSH (9). Cases are considered definite if
objective evidence (e.g., laboratory, clinical, or environmental
evidence) confirms the occurrence of both an exposure and
adverse health effects (9). A case is considered probable if there
is objective evidence of either exposure or adverse health effects.
A case is possible if only subjective information (e.g., selfreported information of exposure or adverse health effects) is
available. With respect to identifying cases as definite, probable,
and possible, the reported health effects must be consistent with
the known toxicology of the pesticide to which the patient was
exposed. A case is considered suspicious if available toxicologic
information is not sufficient (e.g., the pesticide is relatively new
and limited human toxicologic data are available) to confirm
a causal relationship between the exposure and the adverse
health effects (9).
The SENSOR-Pesticides program uses standardized criteria
to categorize the severity of acute pesticide-related illnesses
and injuries (21). The program has four categories of severity:
death, high severity, moderate severity, and low severity. Death
is reported if the outcome of a pesticide-related illness or injury
is fatal (21). High-severity illness and injury means that the
condition is life threatening and requires treatment, usually
hospitalization, to prevent death (21). Under this category,
time lost from work or leisure activity might exceed 5 days.
Permanent or long-term disability might result from this level
of exposure (21). Moderate severity means that the person has
systemic signs or symptoms of pesticide-related illness and
injury and might lose 35 days from work or leisure-time
activity. Although adverse effects might be prolonged, no
permanent disability or impairment results. In low-severity
illnesses and injuries, the person might have signs and
symptoms of exposure (e.g., skin, eye, or upper respiratory
Interpreting Data
For several reasons, the data provided in this report (Table 1)
(Table 2 ) are likely to be underestimates of the actual magnitude
of acute nonoccupational pesticide-related illness and injury.
First, nonoccupational exposure calls reported to poison
control centers are self-reported. State surveillance systems
rarely capture data on persons who neither call a poison control
center nor seek medical care (8,23,24). In addition, an exposed
person might not link symptoms to a pesticide exposure, and
therefore might not report it (23). Second, pesticide-related
illnesses and injuries can be difficult to diagnose. The signs
and symptoms of pesticide-related illnesses and injuries are
similar to other common illnesses (e.g., upper respiratory
illness), and some physicians might not recognize and diagnose
pesticide-related illnesses and injuries (23). Other challenges
in diagnosing pesticide-related illnesses and injuries include
lack of sufficient environmental data on the exposure and a
general lack of clinical tools to diagnose pesticide exposures
(23). Therefore, the counts and rates presented in this report
likely underestimate the magnitude of acute nonoccupational
pesticide-related illnesses and injuries.
The higher incident rates of acute nonoccupational pesticiderelated illness and injury observed in Louisiana and North
Carolina might reflect better case identification and follow-up
US Department of Health and Human Services/Centers for Disease Control and Prevention
No.
Population*
Incidence rate
1,759
741
594
1,547
346
379
429
93,477,327
22,423,404
49,600,502
47,087,962
96,552,793
19,004,910
33,254,981
1.88
3.30
1.20
3.29
0.36
1.99
1.29
2,664
3,108
176,658,988
184,742,891
1.51
1.68
1,141
1,220
1,314
1,083
1,037
71,179,083
71,762,644
72,278,541
72,804,820
73,376,791
1.60
1.70
1.82
1.49
1.41
Functional class
Insecticides
Herbicides
Insect
repellents
Fumigants
Rodenticides
Fungicides
Other
Multiple
Total
Severity
Low
Moderate
High
Death
Total
5 years
No. (%)
All
No. (%)
366 (10.0)
36 (6.0)
183 (37.3)
383 (10.5)
58 (9.7)
106 (21.6)
2,765 (75.9)
457 (76.3)
191 (39.0)
3,645 (62.9)
599 (10.3)
490 (8.5)
14 (13.9)
23 (39.0)
0
47 (11.4)
38 (8.6)
707 (12.2)
8 (7.9)
3 (5.1)
4 (8.2)
46 (11.2)
42 (9.5)
650 (11.2)
77 ((76.2)
33 (55.9)
38 (77.6)
301 (73.2)
341 (77.3)
4,203 (72.5)
101 (1.7)
59 (1.0)
49 (0.8)
411 (7.1)
441 (7.6)
5,795
632 (12.2)
61 (11.2)
14 (19.4)
0
707 (12.2)
604 (11.7)
44 (8.1)
1 (1.4)
1 (20.0)
650 (11.2)
3,716 (71.8)
428 (78.5)
55 (76.4)
4 (80.0)
4,203 (72.5)
5,173 (89.3)
545 (9.4)
72 (1.2)
5 (0.1)
5,795
* Florida, Louisiana, Michigan, North Carolina, New York, Oregon, and Washington.
Percentages might not total 100% because information on age was lacking
for 235 cases (4%) that were excluded from analyses.
Includes insect growth regulators, antifouling agents, and other pesticides
not otherwise categorized.
Publication Criteria
This report is limited to cases of unintentional
nonoccupational pesticide-related illness and injury, classified
as definite, probable, possible, or suspicious. Disinfectantrelated cases were excluded because not all state SENSORPesticides programs report these cases.
Highlights
Among the 5,795 cases of acute nonoccupational pesticiderelated illness and injury that were reported, 3,108 occurred
among females and 2,664 occurred among males (Table 1).
Most of cases (73%) occurred among persons aged 18 years,
and 12% occurred in children aged 5 years (Table 2).
Florida had the highest number of cases (1,759), followed by
North Carolina (1,547), and Louisiana (741). North Carolina
and Louisiana had the highest incidence of cases per 100,000
population (3.29 and 3.30, respectively), followed by Oregon
(1.99) (Table 1).
US Department of Health and Human Services/Centers for Disease Control and Prevention
Pesticide category
Pesticide
functional
class
Pyrethroids
Insecticide
Pyrethrins
Insecticide
Organophosphates
Insecticide
Glyphosate
Herbicide
Carbamates
Insecticide
Naphthalene
Insect repellent
Triazines
Herbicides
Imidacloprid
Insecticide
Fipronil
Insecticide
Phosphorus
Fumigant
Thiocarbamates
Fumigant
Sulfur
Insecticide/
Fungicide
Dipyridyls
Herbicide
Pyraclostrtrobin
Fungicide
Chloropicrin
Fumigant
Organochlorines
Insecticides
All other
Total
Total
1,168
322
282
171
181
135
37
0
16
8
27
38
1,541
600
280
128
84
27
18
88
95
0
5
65
2,709
922
562
299
265
162
55
88
111
8
32
103
20
1
10
13
829
3,258
65
5
5
18
661
2,537
85
6
15
31
1,490
5,795
* Florida, Louisiana, Michigan, North Carolina, New York, Oregon, and Washington
Pesticide active ingredient.
Pesticide categories are not mutually exclusive for multiple exposures. Case
counts for persons exposed to multiple substances are included in the totals
of more than one pesticide category. Therefore, the sum of all case counts
(6,943) exceeds the total number of exposed persons (5,795).
US Department of Health and Human Services/Centers for Disease Control and Prevention
10
US Department of Health and Human Services/Centers for Disease Control and Prevention
Preface
Background
US Department of Health and Human Services/Centers for Disease Control and Prevention
11
Data Sources
Acute occupational pesticide-related illness and injury is
one of several conditions under surveillance by NIOSH. In
1987, NIOSH established the Sentinel Event Notification
System for Occupational Risks (SENSOR)Pesticides program
to track pesticide-related illness and injury in the United
States. Detailed information on this program is available at
http://www.cdc.gov/niosh/topics/pesticides/overview.html.
During 20072011, a total of 12 states (California, Florida,
Iowa, Louisiana, Michigan, Nebraska [2011 only], North
Carolina, New Mexico [20072008 only], New York, Oregon,
Texas, and Washington) participated in the SENSORPesticides program. All 12 states that participate in the
SENSOR-Pesticides program require physicians to report
confirmed and suspected cases of pesticide-related illness
and injury to state health authorities. Besides identifying,
classifying, and tabulating pesticide poisoning cases, states
periodically perform in-depth investigations of pesticiderelated events, and develop interventions aimed at particular
industries or pesticide hazards.
Case ascertainment sources used by the state programs include
poison control centers, specific government agencies (e.g., a
states Department of Agriculture), workers compensation
documents, and physician reports. In some states, there are
other sources that infrequently identify cases (e.g., medical
12
US Department of Health and Human Services/Centers for Disease Control and Prevention
Interpreting Data
For multiple reasons, the data provided in this report
(Table 1) (Table 2) are likely to be underestimates of the actual
magnitude of acute occupational pesticide-related illness and
injury (14). Many cases of pesticide-related illness or injury
never are ascertained because affected persons neither seek
medical care, nor call appropriate authorities. Furthermore,
because the signs and symptoms of acute pesticide-related
illnesses are not pathognomonic, and because most health
care professionals are not acquainted with the recognition
and management of these illnesses, many persons who seek
medical care might not receive an accurate diagnosis (15). Even
among those who do receive an accurate diagnosis, many cases
are not reported to state surveillance systems, despite the fact
that each of the participating states has mandatory reporting
of occupational pesticide-related illness and injury (6). For
these reasons, the reported counts and rates provided in this
report must be considered minimum estimates. In contrast,
some persons might have been categorized incorrectly as having
TABLE 1. Distribution of cases of acute occupational pesticide-related illness and injury, FTE estimates, and incidence rates per 100,000 FTEs,
by industrial sector, state, sex, and year of exposure Sentinel Event Notification System for Occupational RiskPesticides program, United
States, 20072011
Industrial Sector (CIC codes)
All
Characteristic
State
California
Florida
Iowa
Louisiana
Michigan
Nebraska
New Mexico
New York
North Carolina
Oregon
Texas
Washington
Sex**
Male
Female
Year
2007
2008
2009
2010
2011
Total
No.*
Agricultural (010030)
FTE estimates
Incidence rate
No.
858
171
170
98
190
22
9
38
168
55
363
464
77,468,156
40,035,419
7,447,061
9,394,549
20,083,617
920,350
1,767,303
42,269,131
19,837,941
8,253,984
54,490,716
14,786,285
1.1
0.4
2.3
1.0
0.9
2.4
0.5
<0.1
0.8
0.7
0.7
3.1
306
13
88
14
23
6
0
5
49
8
25
296
1,734
864
169,412,691
127,351,821
1.0
0.7
637
555
431
462
521
2,606
61,979,631
61,751,566
57,059,520
57,295,585
58,678,210
296,764,512
1.0
0.9
0.8
0.8
0.9
0.9
FTE estimates
Incidence rate
No.
FTE estimates
Incidence rate
1,529,999
222,155
344,047
85,432
287,402
61,932
47,773
219,275
216,678
281,245
882,039
308,556
20.0
5.9
25.6
16.4
8.0
9.7
0
2.3
22.6
2.8
2.8
95.9
483
87
22
40
153
1
4
20
103
28
276
160
75,938,157
39,823,264
7,103,014
9,309,117
19,796,215
858,418
1,719,530
42,049,856
19,621,263
7,972,739
53,608,677
14,477,729
0.6
0.2
0.3
0.4
0.8
0.1
0.2
<0.1
0.5
0.4
0.5
1.1
631
202
3,550,759
935,774
17.8
21.5
823
550
165,861,932
126,416,047
0.5
0.4
210
202
125
139
157
833
876,815
909,306
831,358
883,451
985,603
4,486,533
24.0
22.2
15.0
15.7
15.9
18.6
334
288
261
249
245
1,377
61,102,816
60,842,260
56,228,162
56,412,134
57,692,607
292,277,979
0.5
0.5
0.5
0.4
0.4
0.5
Abbreviations: CIC codes = Bureau of the Census industry codes; FTE = full-time equivalent.
* For 396 cases (15%), information on industry was missing.
The full-time equivalent (FTE) estimates were derived from the hours worked data obtained from the Current Population Survey (CPS) and summed for the years
2007 through 2011 (9). One FTE equals 2,000 hours worked. Denominator data corresponds to the states and time periods of numerator availability.
Incidence rate per 100,000 FTEs.
All states provided data for 20072011 except Nebraska (2011 only) and New Mexico (2007 and 2008 only). The summed FTE estimates include only the years for
which there are case data.
** For eight cases, information about sex was missing.
US Department of Health and Human Services/Centers for Disease Control and Prevention
13
Characteristic
All
Agricultural
(010030)
Nonagricultural
(all other codes)
No. (%)
No. (%)
No. (%)
207 (25)
146 (18)
82 (10)
73 (9)
128 (15)
526 (38)
246 (18)
36 (3)
135 (10)
37 (3)
49 (6)
148 (18)
291 (21)
106 (8)
665 (80)
153 (18)
15 (2)
833
1,105 (80)
257 (19)
15 (1)
1,377
14
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 3. Number and percentage of acute occupational pesticide-related illness and injury, by pesticides most often implicated Sentinel
Event Notification System for Occupational RiskPesticides program, United States, 20072011
Exposed to single
substance*
Exposed to multiple
substances
Pesticide category
No. (%)
No. (%)
Pyrethroids
Organophosphorous compounds
Glyphosate
Sulfur compounds
Pyrethrins
Chloropicrin
Organochlorine compounds
N-methyl carbamates
Dipyridyls
Phosphorus
Thiocarbamates/Dithiocarbamates
Pyraclostrobin
Fipronil
Imidacloprid
Triazines
Naphthalene
All other
Total
Insecticide
Insecticide
Herbicide
Insecticide/Fungicide
Insecticide
Fumigant
Insecticide
Insecticide
Herbicide
Fumigant
Fumigant
Fungicide
Insecticide
Insecticide
Herbicide
Insect repellent/Fumigant
299 (54)
188 (56)
135 (64)
83 (39)
76 (47)
4 (5)
12 (16)
47 (64)
34 (49)
61 (95)
46 (79)
33 (67)
6 (13)
1 (2)
16 (41)
23 (70)
525 (50)
1,589 (61)
256 (46)
150 (44)
76 (36)
128 (61)
85 (53)
82 (95)
62 (84)
27 (36)
36 (51)
3 (5)
12 (21)
16 (33)
39 (87)
40 (98)
23 (59)
10 (30)
525 (50)
1,017 (39)
Total
No. (%)
555 (21)
337 (14)
211 (8)
211 (8)
161 (6)
86 (3)
74 (3)
74 (3)
70 (3)
64 (2)
58 (2)
49 (2)
45 (2)
41 (2)
39 (1)
33 (1)
1,050 (40)
2,606 (100)
Publication Criteria
References
Highlights
During 20072011, a total of 2,606 cases of acute
occupational pesticide-related illness and injury were identified
in 12 states (Table 1). Rates of illness and injury among
agricultural industry workers (18.6/100,000) were 37 times
greater than the rates for nonagricultural workers (0.5/100,000).
US Department of Health and Human Services/Centers for Disease Control and Prevention
15
16
US Department of Health and Human Services/Centers for Disease Control and Prevention
Preface
Background
Data Sources
Data about cancer incidence and mortality in the Summary of
Notifiable Noninfectious Conditions and Disease Outbreaks come
from the official federal statistics on cancer, the U.S. Cancer
Statistics (USCS) dataset (1). The USCS dataset includes
cancer incidence data from NPCR registries in 45 states and
US Department of Health and Human Services/Centers for Disease Control and Prevention
17
Incidence Data
The primary source of data on cancer incidence is medical
records. Staff at health care facilities abstract data from
patients medical records, enter it into the facilitys own cancer
registry if it has one, and then send the data to the regional
or state registry. Both NPCR and SEER registries collect data
using uniform data items and codes as documented by the
North American Association of Central Cancer Registries
(NAACCR). This uniformity ensures that data items
collected by the two federal programs are comparable (10,11).
Information on primary site and histology is coded according
to the International Classification of Diseases for Oncology,
Third Edition (ICD-O-3) and categorized according to the
revised SEER recodes dated January 27, 2003, which define
standard groupings of primary cancer sites (http://seer.cancer.
gov/siterecode) (12). Beginning with 2010 diagnoses, cases
were first classified by anatomic site using ICD-O-3; cases
with hematopoetic histologies were further classified by using
the 2008 WHO Classification of Tumours of Haematopoietic
and Lymphoid Tissues (13). Data from the NPCR registries
provided in this report were reported to CDC as of November
30, 2014. Data from SEER registries were reported to NCI as
of November 1, 2014.
NPCR and SEER cancer registries consider as reportable all
incident cases with a behavior code of 2 (in situ, noninvasive)
or 3 (malignant, primary site only) in ICD-O-3. Exceptions
include in situ cancer of the cervix and all basal and squamous
cell carcinomas of the skin, except for those on the skin of the
genital organs (12). Beginning with 2001 diagnoses, several
cancers that are coded as malignant in ICD-O-3 were not
coded as malignant in ICD-O-2 (10). Additional information
is provided in the USCS technical notes (http://www.cdc.gov/
cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#namedd
est=IncidenceDataSources).
Mortality Data
Cancer mortality statistics are based on information from all
death certificates filed in the 50 states and DC and processed
by NVSS at NCHS (14). The cancer mortality data were
compiled in accordance with World Health Organization
regulations, which specify that member nations classify and
code causes of death in accordance with the current revision
of the International Classification of Diseases (ICD) (15). For
18
Population Estimates
Population denominators are race-specific, ethnicity-specific,
and sex-specific county population estimates from the U.S.
Census, modified by SEER and aggregated to the state and
national level. Additional details about population data are
available at http://seer.cancer.gov/popdata/index.html.
Interpreting Data
Incidence Data
Each year, state cancer registries submit cancer cases for a
new diagnosis year and an updated version of the previous
years cancer cases to CDC or NCI. Therefore, each year, when
USCS data are published, updates to the previous years data
are published, using the most recent data submission and the
most recent population data. Users of cancer incidence data
published by federal agencies should be mindful of the data
submission dates for all data used in their analyses.
Mortality Data
Cancer mortality statistics in USCS are influenced by the
accuracy of information on the death certificate. Unlike
incidence data, mortality data for a calendar year are considered
complete when submitted and so are not updated after the
aggregate data file is released. Mortality data for the entire
United States refer only to deaths that occurred within the
United States; data for geographic areas are provided by the
decedents place of residence.
US Department of Health and Human Services/Centers for Disease Control and Prevention
Publication Criteria
Cancer incidence data that appear in this report are derived
from state cancer registries that have high-quality cancer
incidence data for individual (e.g., 2012) and combined
(e.g., 19992012) years as demonstrated by meeting all of the
following criteria on data quality for all cancer sites combined:
case ascertainment is 90% (margin of error +5%)
complete,
5% of cases are ascertained solely on the basis of a death
certificate,
3% of cases are missing information on sex,
3% of cases are missing information on age,
5% of cases are missing information on race, and
97% of the registrys records passed a set of single-field
and inter-field computerized edits that test the validity
and logic of data components.
Additional information about USCS is available at
http://www.cdc.gov/uscs/.
Population Coverage
The population coverage for incidence data varies by
diagnosis year. Population coverage might be affected by the
suppression of state incidence data, if a state did not meet the
publication criteria or did not submit data. In addition, state
incidence data might be suppressed if <16 cases were reported
or if the state requested that the data be suppressed. Additional
Highlights
Incidence and Death Rates
In 2012, approximately 1.5 million invasive cancers were
diagnosed in the United States, an annual incidence rate of
440 cases per 100,000 persons (Table 1). In the same year,
US Department of Health and Human Services/Centers for Disease Control and Prevention
19
20
women) (Table 13). These four sites also accounted for 48% of
cancer deaths in 2012, including 157,423 lung cancer deaths,
51,516 colon and rectum cancer deaths, 41,150 female breast
cancer deaths, and 27,244 prostate cancer deaths (Table 14).
US Department of Health and Human Services/Centers for Disease Control and Prevention
References
1. US Cancer Statistics Working Group. United States cancer statistics:
19992012. Incidence and mortality web-based report. Atlanta, GA:
US Department of Health and Human Services, CDC, National Cancer
Institute; 2015. http://www.cdc.gov/uscs.index.htm
2. CDC. Summary of notifiable noninfectious conditions and disease
outbreaksUnited States. MMWR Morb Mortal Wkly Rep 2014;63(55).
3. CDC. Summary of notifiable infectious diseases and conditionsUnited
States, 2014. MMWR Morb Mortal Wkly Rep 2014;63(54).
4. Heron M. Deaths: leading causes for 2012. Natl Vital Stat Rep 2015;64:1
93. http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_10.pdf
5. Colditz GA, Wolin KY, Gehlert S. Applying what we know to accelerate
cancer prevention. Sci Transl Med 2012;4:127rv4. http://dx.doi.
org/10.1126/scitranslmed.3003218
6. Weir HK, Thun MJ, Hankey BF, et al. Annual report to the nation on
the status of cancer, 19752000, featuring the uses of surveillance data
for cancer prevention and control. J Natl Cancer Inst 2003;95:127699.
http://dx.doi.org/10.1093/jnci/djg040
7. US Department of Health and Human Services. Healthy people 2020.
Washington, DC: US Department of Health and Human Services; 2011.
http://www.healthypeople.gov/2020/topicsobjectives2020/default.aspx
8. Fisher R, Haenlein M. Legislative authorizations for cancer registries.
In: National Cancer Institute, National Institutes of Health. State cancer
legislative database update. Bethesda, MD: US Department of Health
and Human Services, Public Health Service, National Institutes of
Health. National Cancer Institute; 1991:815.
9. CDC. State cancer registries: status of authorizing legislation and
enabling regulationsUnited States, October 1993. MMWR Morb
Mortal Wkly Rep 1994;43:715.
10. Fritz ARL. The SEER program code manual. Bethesda, MD: National
Cancer Institute; 1998.
11. Havener LTM, editor. Standards for cancer registries. Volume II: data
standards and data dictionary. 13th ed. Version 11.3. Springfield, IL:
North American Association of Central Cancer Registries; 2008.
US Department of Health and Human Services/Centers for Disease Control and Prevention
21
FIGURE 1. Age-adjusted rate* of invasive cancer cases for most common sites, by sex and race/ethnicity United States, 2012
Age-adjusted rate per 100,000 men
50
100
Prostate
Lung and bronchus
Colon and rectum
150
200
White
White
Black
Black
Hispanic
Breast
Lung and bronchus
AI/AN
Breast
Lung and bronchus
Colon and rectum
Prostate
Breast
Prostate
Lung and bronchus
Colon and rectum
A/PI
200
Hispanic
AI/AN
A/PI
150
Breast
100
Prostate
Lung and bronchus
50
22
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE 2. Age-adjusted rate* of invasive cancer cases, by primary cancer site and state United States, 2012
All cancer sites combined
Breast (female)
DC
371.4431.3
431.4448.4
448.5463.0
463.1515.1
DC
107.2118.3
118.4123.6
Lung
123.7126.8
126.9141.4
Prostate
DC
29.055.5
55.661.2
61.367.9
68.092.4
DC
69.995.1
95.2106.3
Cervix uteri
106.4114.8
114.9157.1
6.57.0
7.18.1
DC
DC
4.36.4
8.29.6
30.236.4
36.539.0
39.142.3
42.449.2
* Rates are the number of cases per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Invasive cancer excludes basal and squamous cell carcinomas of the skin except when these occur on the skin of the genital organs, and in situ cancers except
urinary bladder. Urinary bladder cancer includes invasive and in situ.
Data are compiled from cancer registries that meet the data quality criteria for all invasive cancer sites combined (covering approximately 99% of the U.S. population).
Registry-specific data quality information is available at http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#nameddest=RegistriesPubCriteria.
Caution should be used when comparing incidence and death rates because of potential differences in population coverage.
US Department of Health and Human Services/Centers for Disease Control and Prevention
23
FIGURE 3. Age-adjusted rate* of cancer deaths, by primary cancer site and state United States, 2012
All cancer sites combined
Breast (female)
DC
128.7158.6
158.7166.1
166.2178.7
178.8201.2
DC
15.519.1
Lung
19.221.1
21.222.6
22.731.1
Prostate
DC
20.440.5
40.646.1
46.252.1
52.268.8
DC
13.018.6
Cervix uteri
18.720.0
20.121.3
21.431.8
DC
1.11.9
2.02.2
2.32.7
2.85.3
DC
10.613.6
13.714.4
14.515.9
16.019.2
* Rates are the number of deaths per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS Technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Data are from the National Vital Statistics System (NVSS). Data for death rates cover 100% of the U.S. population. Caution should be used when comparing incidence
and death rates because of potential differences in population coverage.
24
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE 4. Age-adjusted rate* of invasive cancer cases, by primary cancer site, race, and sex United States, 19992012
700
80
70
600
60
500
50
400
Rate
Rate
300
40
30
200
Black
AI/AN
White
A/PI
All races combined
100
10
0
0
1999
2001
2003
2005
2007
Black
AI/AN
White
A/PI
All races combined
20
2009
2011
1999
2001
2003
70
500
60
300
2011
40
30
200
Black
AI/AN
White
A/PI
All races combined
100
1999
2001
2003
2005
2007
Black
AI/AN
White
A/PI
All races combined
20
10
0
2009
2011
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
Year of diagnosis
Incidence rates by race, all cancer sites combined,
female United States, 19992012
80
600
70
500
60
50
400
Rate
Rate
2009
50
400
700
2007
80
600
Rate
Rate
700
2005
Year of diagnosis
Year of diagnosis
300
40
30
200
Black
AI/AN
White
A/PI
All races combined
100
10
0
1999
2001
2003
2005
2007
Black
AI/AN
White
A/PI
All races combined
20
2009
2011
Year of diagnosis
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
US Department of Health and Human Services/Centers for Disease Control and Prevention
25
FIGURE 4. (Continued) Age-adjusted rate* of invasive cancer cases, by primary cancer site, race, and sex United States, 19992012
Incidence rates by race, lung and bronchus cancer,
male and female United States, 19992012
140
100
140
120
100
80
Rate
Rate
160
Black
AI/AN
White
A/PI
All races combined
120
60
40
20
Black
AI/AN
White
A/PI
All races combined
20
0
1999
140
2001
2003
2005
2007
2009
1999
2011
2001
2003
2005
2007
2009
Year of diagnosis
Year of diagnosis
300
120
2011
250
100
200
80
Rate
Rate
80
60
40
60
150
100
40
Black
AI/AN
White
A/PI
All races combined
20
0
1999
2001
2003
2005
2007
50
2009
2011
Year of diagnosis
Black
White
0
1999
2001
AI/AN
A/PI
2003
2005
2007
2009
2011
Year of diagnosis
140
Black
AI/AN
White
A/PI
All races combined
120
100
Rate
80
60
40
20
0
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
Abbreviations: AI/AN = American Indian/Alaska Native; A/PI = Asian/Pacific Islander.
* Rates are the number of cases per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Invasive cancer excludes basal and squamous cell carcinomas of the skin except when these occur on the skin of the genital organs, and in situ cancers except
urinary bladder. Urinary bladder cancer includes invasive and in situ.
Rates are not presented for persons of unknown or other race. Data for specified racial populations other than white and black should be interpreted with caution.
For more information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#nameddest=IntRaceEthnicityData).
Data are compiled from cancer registries that meet the data quality criteria for all invasive cancer sites combined for all years, 19992012 (covering approximately 92% of the
U.S. population). See registry-specific data quality information for all years, 19992012 (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#nameddest
=RegistriesPubCriteria). Caution should be used when comparing incidence and death rates because of potential differences in population coverage.
26
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE 5. Age-adjusted rate* of invasive cancer cases, by primary cancer site, ethnicity, and sex United States, 19992012
700
80
70
600
60
500
50
400
Rate
Rate
300
40
30
200
20
Hispanics
Non-Hispanics
100
Hispanics
Non-Hispanics
10
0
0
1999
2001
2003
2005
2007
2009
1999
2011
2001
2003
Year of diagnosis
700
2011
60
50
400
Rate
Rate
2009
70
500
300
40
30
200
20
Hispanics
Non-Hispanics
100
Hispanics
Non-Hispanics
10
0
0
1999
2001
2003
2005
2007
2009
1999
2011
2001
2003
Year of diagnosis
2005
2007
2009
2011
Year of diagnosis
80
70
600
60
500
50
400
Rate
Rate
2007
80
600
700
2005
Year of diagnosis
300
40
30
200
20
Hispanics
Non-Hispanics
100
Hispanics
Non-Hispanics
10
0
0
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
US Department of Health and Human Services/Centers for Disease Control and Prevention
27
FIGURE 5. (Continued) Age-adjusted rate* of invasive cancer cases, by primary cancer site, ethnicity, and sex United States, 19992012
140
160
Hispanics
Non-Hispanics
120
140
120
100
100
80
Rate
Rate
60
80
60
40
40
20
Hispanics
Non-Hispanics
20
0
1999
2001
2003
2005
2007
2009
2011
1999
2001
Year of diagnosis
140
2009
2011
Hispanics
Non-Hispanics
250
200
80
Rate
Rate
2007
300
Hispanics
Non-Hispanics
100
60
150
100
40
50
20
0
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
140
2005
Year of diagnosis
120
2003
0
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
120
Rate
100
80
60
40
20
0
1999
2001
2003
2005
2007
2009
2011
Year of diagnosis
* Rates are the number of cases per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Invasive cancer excludes basal and squamous cell carcinomas of the skin except when these occur on the skin of the genital organs, and in situ cancers except urinary
bladder. Urinary bladder cancer includes invasive and in situ.
Data for specified ethnical populations should be interpreted with caution. For more information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/
pdf/uscs-2012-technical-notes.pdf#nameddest=IntRaceEthnicityData).
Data are compiled from cancer registries that meet the data quality criteria for all invasive cancer sites combined for all years, 19992012 (covering approximately 92% of
the U.S. population). See registry-specific data quality information for all years, 1999-2012 (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#na
meddest=RegistriesPubCriteria). Caution should be used when comparing incidence and death rates because of potential differences in population coverage.
28
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE 6. Age-adjusted rate* of cancer deaths, by primary cancer site, race, and sex United States, 19992012
Death rates by race, all cancer sites combined,
male and female United States, 19992012
400
80
Black
AI/AN
White
A/PI
All races combined
350
300
Black
AI/AN
White
A/PI
All races combined
70
60
50
Rate
Rate
250
200
40
150
30
100
20
50
10
1999
2001
2003
2005
2007
2009
2011
1999
2001
2003
400
300
60
250
50
Rate
Rate
70
200
150
2009
2011
Black
AI/AN
White
A/PI
All races combined
40
30
100
20
Black
AI/AN
White
A/PI
All races combined
50
1999
2001
2003
2005
2007
10
2009
2011
1999
2001
2003
Year of death
300
2007
2009
2011
80
Black
AI/AN
White
A/PI
All races combined
350
2005
Year of death
400
Black
AI/AN
White
A/PI
All races combined
70
60
250
Rate
Rate
50
200
40
150
30
100
20
50
10
2007
80
350
2005
Year of death
Year of death
1999
2001
2003
2005
2007
2009
2011
Year of death
1999
2001
2003
2005
2007
2009
2011
Year of death
US Department of Health and Human Services/Centers for Disease Control and Prevention
29
FIGURE 6. (Continued) Age-adjusted rate* of cancer deaths, by primary cancer site, race, and sex United States, 19992012
Death rates by race, lung and bronchus cancer,
male and female United States, 19992012
140
100
200
80
150
60
100
40
50
20
0
Black
AI/AN
White
A/PI
All races combined
250
Rate
Rate
300
Black
AI/AN
White
A/PI
All races combined
120
1999
2001
2003
2005
2007
2009
2011
1999
2001
2003
Year of death
Death rates by race, lung and bronchus cancer,
male United States, 19992012
140
120
60
80
60
40
40
20
20
1999
2001
2003
2005
2007
2009
2011
Year of death
0
1999
2001
2003
2005
2007
2009
2011
Year of death
140
Black
AI/AN
White
A/PI
All races combined
120
100
Rate
2011
100
80
2009
Black
AI/AN
White
A/PI
All races combined
140
Rate
Rate
100
2007
160
Black
AI/AN
White
A/PI
All races combined
120
2005
Year of death
80
60
40
20
0
1999
2001
2003
2005
2007
2009
2011
Year of death
Abbreviations: AI/AN = American Indian/Alaska Native; A/PI = Asian/Pacific Islander.
* Rates are the number of deaths per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Rates are not presented for persons of unknown or other race. Data for specified racial populations other than white and black should be interpreted with caution.
For more information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#nameddest=IntRaceEthnicityData).
Data are from the National Vital Statistics System (NVSS). Data for death rates cover 100% of the U.S. population. Caution should be used when comparing incidence
and death rates because of potential differences in population coverage.
30
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE 7. Age-adjusted rate* of cancer deaths, by primary cancer site, ethnicity, and sex United States, 19992012
700
80
Hispanics
Non-Hispanics
600
Hispanics
Non-Hispanics
70
60
500
50
400
Rate
Rate
300
40
30
200
20
100
10
0
0
1999
2001
2003
2005
2007
2009
1999
2011
2001
2003
Year of death
700
60
Rate
Rate
2011
50
400
300
40
30
200
20
100
10
0
0
1999
2001
2003
2005
2007
2009
1999
2011
2001
2003
Year of death
2005
2007
2009
2011
Year of death
80
Hispanics
Non-Hispanics
600
Hispanics
Non-Hispanics
70
60
500
50
400
Rate
Rate
2009
Hispanics
Non-Hispanics
70
500
700
2007
80
Hispanics
Non-Hispanics
600
2005
Year of death
300
40
30
200
20
100
10
0
0
1999
2001
2003
2005
2007
2009
2011
Year of death
1999
2001
2003
2005
2007
2009
2011
Year of death
US Department of Health and Human Services/Centers for Disease Control and Prevention
31
FIGURE 7. (Continued) Age-adjusted rate* of cancer deaths, by primary cancer site, ethnicity, and sex United States, 19992012
140
160
Hispanics
Non-Hispanics
120
Hispanics
Non-Hispanics
140
120
100
100
80
Rate
Rate
60
80
60
40
40
20
20
0
1999
2001
2003
2005
2007
2009
2011
1999
2001
2003
Year of death
140
2011
200
80
Rate
Rate
2009
Hispanics
Non-Hispanics
250
100
60
150
100
40
50
20
0
1999
2001
2003
2005
2007
2009
2011
Year of death
140
2007
300
Hispanics
Non-Hispanics
120
2005
Year of death
0
1999
2001
2003
2005
2007
2009
2011
Year of death
120
Rate
100
80
60
40
20
0
1999
2001
2003
2005
2007
2009
2011
Year of death
* Rates are the number of deaths per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Data for specified ethnic populations should be interpreted with caution. For more information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/
pdf/uscs-2012-technical-notes.pdf#nameddest=IntRaceEthnicityData).
Data are from the National Vital Statistics System (NVSS). Data for death rates cover 100% of the U.S. population. Caution should be used when comparing incidence
and death rates because of potential differences in population coverage.
32
US Department of Health and Human Services/Centers for Disease Control and Prevention
All races/ethnicities
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and Intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and mesentery
Other digestive organs
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
Bones and joints
Soft tissue including heart
Skin excluding basal and squamous
Melanoma of the skin
Other nonepithelial skin
Male and female breast
Female breast
Male breast
Female genital system
Cervix
Corpus and uterus, NOS
Corpus
Uterus, NOS
Ovary
Vagina
Vulva
Other female genital organs
No.
All races/ethnicities
Rate
Cancer site
1,529,078
39,879
1,842
12,374
4,254
1,936
5,331
1,758
7,330
1,733
2,281
1,040
273,535
15,993
22,623
7,894
134,784
95,962
38,822
6,338
28,012
3,835
5,963
43,213
1,321
1,924
1,635
225,933
2,274
12,152
210,828
105
574
440.3
11.2
0.5
3.4
1.3
0.5
1.5
0.5
2.0
0.5
0.6
0.3
78.3
4.5
6.6
2.3
38.9
27.8
11.1
1.8
7.7
1.1
1.7
12.3
0.4
0.5
0.5
64.7
0.7
3.4
60.4
0
0.2
2,951
10,728
73,181
67,753
5,428
226,272
224,147
2,125
90,303
12,042
49,154
47,570
1,584
20,785
1,296
4,851
2,175
0.9
3.2
21.5
19.9
1.6
65.6
122.2
1.4
48.8
7.4
25.7
24.9
0.8
11.3
0.7
2.6
1.2
No.
187,308
177,489
8,189
1,283
347
128,103
69,974
55,231
1,918
980
2,733
21,490
20,151
1,339
48,594
46,279
2,315
71,692
8,273
63,419
21,829
44,396
4,846
14,821
13,820
5,543
5,366
3,199
1,076
55,876
Rate
111.8
105.3
5.5
0.8
0.2
37.0
20.2
15.9
0.6
0.3
0.8
6.5
6.0
0.4
15.0
14.3
0.7
21.1
2.6
18.5
6.3
13.2
1.6
4.2
4.1
1.7
1.6
0.9
0.3
16.3
US Department of Health and Human Services/Centers for Disease Control and Prevention
33
All races/ethnicities
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and mesentery
Other digestive organs
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
Bones and joints
Soft tissue including heart
Skin excluding basal and squamous
Melanoma of the skin
Other nonepithelial skin
Male and female breast
Female breast
Male breast
34
No.
Rate
Cancer site
582,607
8,924
71
2,224
869
75
1,275
666
879
891
356
1,618
147,024
14,649
11,191
1,293
51,516
41,867
9,649
889
22,972
2,102
1,519
38,797
207
750
1,139
161,851
458
3,662
157,423
82
226
166.4
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.4
41.6
4.1
3.2
0.4
14.7
12.0
2.7
0.3
6.3
0.6
0.4
11.0
0.1
0.2
0.3
46.2
0.1
1.0
45.0
0
0.1
1,399
4,559
12,463
9,251
3,212
41,555
41,150
405
0.4
1.3
3.6
2.7
0.9
11.8
21.3
0.3
No.
Rate
29,405
4,074
8,911
3,812
5,099
14,404
429
1,034
553
27,955
27,244
386
273
52
29,594
15,245
13,518
378
453
279
15,276
2,660
1,690
970
21,518
1,130
20,388
11,821
23,309
1,408
4,598
9,484
1,017
6,802
2,686
40,276
15.2
2.3
4.5
1.9
2.6
7.4
0.2
0.5
0.3
20.0
19.6
0.3
0.2
0
8.5
4.4
3.8
0.1
0.1
0.1
4.4
0.8
0.5
0.3
6.2
0.3
5.9
3.4
6.8
0.4
1.3
2.8
0.3
2.0
0.8
11.5
US Department of Health and Human Services/Centers for Disease Control and Prevention
All races/ethnicities
No.
Rate
Area
311,842
474.3
New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont
81,778
20,371
8,417
35,774
7,576
6,095
3,545
469.6
477.1
475.1
463.1
473.5
484.0
449.0
Middle Atlantic
New Jersey
New York
Pennsylvania
Midwest
230,064
48,545
105,941
75,578
345,611
476.1
477.7
475.8
476.1
448.8
237,817
64,402
31,852
51,809
59,848
29,906
446.2
459.0
439.4
444.5
438.0
447.7
107,794
17,000
14,614
27,833
31,643
8,953
3,577
4,174
454.7
463.4
460.3
462.8
450.6
432.6
450.5
434.3
South
South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia
566,112
307,360
5,306
2,954
105,651
45,623
27,870
48,367
24,737
35,743
11,109
434.9
430.4
483.5
474.9
414.2
459.6
430.8
443.0
447.7
403.1
461.3
Area
Northeast
No.
Rate
100,201
25,225
25,845
15,084
34,047
470.0
451.0
515.1
457.4
459.4
158,551
15,259
24,062
18,785
100,445
424.0
442.8
483.4
442.8
406.2
West
Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming
27,680
21,614
7,452
5,424
8,726
9,582
2,516
373.4
405.5
437.0
434.4
371.4
404.0
396.0
Pacific
Alaska
California
Hawaii
Oregon
Washington
222,519
2,601
158,944
6,802
19,531
34,641
418.1
401.8
410.1
415.6
422.2
460.1
* Rates are the number of cases per 100,000 persons and are age-adjusted to
the 2000 U.S. standard population (19 age groups Census P251130). For
more information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/
uscs/pdf/uscs-2012-technical-notes.pdf ).
Invasive cancer excludes basal and squamous cell carcinomas of the skin except
when these occur on the skin of the genital organs, and in situ cancers except
urinary bladder. Urinary bladder cancer includes invasive and in situ.
Data are compiled from cancer registries that meet the data quality criteria
for all invasive cancer sites combined (covering approximately 99% of the U.S.
population). Registry-specific data quality information is available at http://
www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#namedd
est=RegistriesPubCriteria.
Rates and counts are not presented for the West Census Region, the Mountain
Census Division, or Nevada because data from Nevada are not included in
this analysis.
US Department of Health and Human Services/Centers for Disease Control and Prevention
35
All races/ethnicities
Area
No.
United States
Northeast
New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont
Middle Atlantic
New Jersey
New York
Pennsylvania
Midwest
East North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin
West North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota
South
South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia
36
582,607
110,175
28,904
6,681
3,226
12,864
2,660
2,148
1,325
81,271
16,483
35,881
28,907
135,511
94,939
24,562
13,368
20,496
25,261
11,252
40,572
6,438
5,429
9,424
12,919
3,479
1,253
1,630
221,435
118,858
1,935
1,081
42,187
16,020
10,524
18,405
9,728
14,294
4,684
Rate
Area
166.4
164.1
162.6
152.0
179.0
163.3
167.7
163.6
164.8
164.7
160.3
159.5
174.8
174.1
176.9
175.5
184.2
174.3
182.1
166.1
167.8
167.9
167.7
155.6
182.0
164.6
150.7
162.0
171.4
165.8
176.1
178.4
157.8
169.6
166.0
170.5
179.0
165.3
191.1
No.
40,547
10,274
10,012
6,496
13,765
62,030
6,540
9,308
8,040
38,142
115,486
34,819
11,085
7,306
2,572
1,954
4,610
3,461
2,876
955
80,667
925
57,675
2,284
7,832
11,951
Rate
192.0
184.8
201.2
200.0
187.9
170.5
188.6
190.5
189.6
160.6
151.9
147.7
148.3
143.7
152.0
154.2
163.8
148.0
128.7
154.6
153.7
169.0
151.0
134.6
168.3
161.8
* Rates are the number of deaths per 100,000 persons and are age-adjusted to
the 2000 U.S. standard population (19 age groups Census P251130). For
more information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/
uscs/pdf/uscs-2012-technical-notes.pdf ).
Data are from the National Vital Statistics System (NVSS).
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 5. Reported number and rate* of invasive cancer cases, by primary cancer site and age group United States, 2012
Age group (yrs)
<15
1524
2539
4064
65
Total
No.
Rate
No.
Rate
No.
Rate
No.
Rate
No.
Rate
No.
Rate (crude)
9,967
84
Stomach
Colon and rectum
Liver and intrahepatic bile duct
Pancreas
Larynx
Lung and bronchus
Melanomas of the skin
Female breast
Cervix
Corpus and uterus, NOS
Ovary
Prostate
Testis
Urinary bladder
Kidney and renal pelvis
Brain and nervous system
Thyroid
Hodgkin lymphoma
Non-Hodgkin lymphoma
Myeloma
Leukemias
Mesothelioma
Kaposi Sarcoma
34
222
27
107
102
54
20
527
2,103
197
340
595
2,948
16.5
0.1
0.1
0.4
0
0.2
0.3
0.2
0
0.9
3.5
0.3
0.6
1.0
4.9
12,634
259
340
78
99
897
348
1,425
65
180
968
2,029
1,599
933
1,163
29
0.6
0.8
0.2
0.2
2.1
1.6
6.4
0.1
0.4
2.2
4.7
3.7
2.1
2.7
58,709
1,152
127
649
3,526
292
391
107
893
5,507
9,605
2,795
1,616
1,071
77
4,073
548
1,986
2,084
9,545
2,245
2,899
266
2,243
36
321
95.9
1.9
0.2
1.1
5.8
0.5
0.6
0.2
1.5
9.0
31.5
9.2
5.3
3.5
0.3
13.2
0.9
3.2
3.4
15.6
3.7
4.7
0.4
3.7
0.1
0.5
620,927
21,140
6,383
8,153
51,746
14,698
14,178
5,966
66,105
28,901
114,962
6,730
26,341
9,564
77,236
2,440
18,019
25,557
8,127
24,876
2,614
23,101
7,887
13,517
666
448
603
20.5
6.2
7.9
50.2
14.3
13.8
5.8
64.2
28.1
218.7
12.8
50.1
18.2
153.2
4.8
17.5
24.8
7.9
24.2
2.5
22.4
7.7
13.1
0.6
0.4
826,841
17,244
9,480
13,764
79,138
12,722
28,585
6,068
143,704
32,341
99,396
2,368
21,129
9,700
100,156
197
51,322
26,981
8,208
9,632
1,475
35,891
13,663
24,525
2,486
269
1,932.60
40.3
22.2
32.2
185
29.7
66.8
14.2
335.9
75.6
411.9
9.8
87.6
40.2
536.9
1.1
120.0
63.1
19.2
22.5
3.4
83.9
31.9
57.3
5.8
0.6
1,529,078
39,879
15,993
22,623
134,784
28,012
43,213
12,152
210,828
67,753
224,147
12,042
49,154
20,785
177,489
8,189
69,974
55,231
21,490
46,279
8,273
63,419
21,829
44,396
3,199
1,076
491.5
12.8
5.1
7.3
43.3
9.0
13.9
3.9
67.8
21.8
141.8
7.6
31.1
13.2
115.9
5.3
22.5
17.8
6.9
14.9
2.7
20.4
7.0
14.3
1.0
0.3
Cancer site
US Department of Health and Human Services/Centers for Disease Control and Prevention
37
TABLE 6. Reported number and rate* of cancer deaths, by primary cancer site and age group United States, 2012
Age group (yrs)
<15
Cancer site
All cancer sites combined
Oral cavity and pharynx
Esophagus
Stomach
Colon and rectum
Liver and intrahepatic bile duct
Pancreas
Larynx
Lung and bronchus
Melanomas of the skin
Female breast
Cervix
Corpus and uterus, NOS
Ovary
Prostate
Testis
Urinary bladder
Kidney and renal pelvis
Brain and nervous system
Thyroid
Hodgkin lymphoma
Non-Hodgkin lymphoma
Myeloma
Leukemias
Mesothelioma
1524
2539
4064
65
No.
Rate
No.
Rate
No.
Rate
No.
Rate
1,367
2.2
0.1
0
0.7
0.1
0.6
1,574
34
31
252
85
356
3.6
0.1
0.1
0.6
0.2
0.8
7,391
128
74
271
775
186
151
18
430
300
971
437
108
176
131
35
109
744
23
134
344
32
649
16
12
0.2
0.1
0.4
1.3
0.3
0.2
0
0.7
0.5
3.2
1.4
0.4
0.6
0.4
0.1
0.2
1.2
0
0.2
0.6
0.1
1.1
0
168,778
3,677
5,358
3,590
15,199
9,837
10,962
1,374
43,463
3,179
16,104
2,259
2,855
4,822
2,962
149
2,390
4,134
6,177
450
353
4,304
2,624
4,627
479
162.5
3.5
5.2
3.5
14.6
9.5
10.6
1.3
41.8
3.1
30.4
4.3
5.4
9.1
5.8
0.3
2.3
4.0
5.9
0.4
0.3
4.1
2.5
4.5
0.5
32
30
458
36
378
No.
403,497
5,100
9,213
7,309
35,480
12,883
27,676
2,269
113,499
5,746
24,062
1,369
5,944
9,378
24,271
51
12,814
9,214
7,645
1,212
604
15,619
9,164
17,299
2,190
No.
Rate (crude)
582,607
8,924
14,649
11,191
51,516
22,927
38,797
3,662
157,423
9,251
41,150
4,074
8,911
14,404
27,244
386
15,245
13,518
15,276
1,690
1,130
20,388
11,821
23,309
2,686
185.6
2.8
4.7
3.6
16.4
7.3
12.4
1.2
50.2
2.9
25.8
2.6
5.6
9.0
17.6
0.2
4.9
4.3
4.9
0.5
0.4
6.5
3.8
7.4
0.9
38
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 7. Reported number and age-adjusted rate* of invasive cancer cases, by primary cancer site and sex United States, 2012
Male
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and Intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and mesentery
Other digestive organs
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other respiratory organs
Bones and joints
Soft tissue including heart
Skin excluding basal and squamous
Melanoma of the skin
Other nonepithelial skin
Male and female breast
Female breast
Male breast
Female genital system
Cervix
Corpus and uterus, NOS
Corpus
Uterus, NOS
Ovary
Vagina
Vulva
Other female genital organs
No.
767,366
27,997
1,353
8,777
2,404
1,333
2,915
1,263
5,977
1,325
1,838
812
151,713
12,628
13,964
4,187
70,204
47,448
22,756
2,304
20,207
1,221
3,246
22,101
653
157
841
122,785
1,376
9,565
111,395
60
389
1,674
5,881
42,992
39,673
3,319
NA
NA
2,125
NA
NA
NA
NA
NA
NA
NA
NA
NA
Female
Rate
483.0
16.8
0.9
5.2
1.6
0.8
1.8
0.8
3.4
0.8
1.1
0.5
95.6
7.8
9.0
2.6
44.8
30.7
14.1
1.4
11.8
0.8
2.1
14.1
0.4
0.1
0.5
78.5
0.9
5.8
71.6
0
0.3
1.1
3.8
27.8
25.5
2.3
NA
NA
1.4
NA
NA
NA
NA
NA
NA
NA
NA
NA
No.
761,712
11,882
489
3,597
1,850
603
2,416
495
1,353
408
443
228
121,822
3,365
8,659
3,707
64,580
48,514
16,066
4,034
7,805
2,614
2,717
21,112
668
1,767
794
103,148
898
2,587
99,433
45
185
1,277
4,847
30,189
28,080
2,109
NA
224,147
NA
90,303
12,042
49,154
47,570
1,584
20,785
1,296
4,851
2,175
Total
Rate
411.7
6.3
0.3
1.9
1.0
0.3
1.3
0.3
0.7
0.2
0.2
0.1
63.9
1.7
4.6
2.0
34.1
25.4
8.6
2.1
4.0
1.4
1.4
10.9
0.4
0.9
0.4
54.0
0.5
1.3
52.1
0
0.1
0.8
2.8
17.0
15.9
1.1
NA
122.2
NA
48.8
7.4
25.7
24.9
0.8
11.3
0.7
2.6
1.2
No.
1,529,078
39,879
1,842
12,374
4,254
1,936
5,331
1,758
7,330
1,733
2,281
1,040
273,535
15,993
22,623
7,894
134,784
95,962
38,822
6,338
28,012
3,835
5,963
43,213
1,321
1,924
1,635
225,933
2,274
12,152
210,828
105
574
2,951
10,728
73,181
67,753
5,428
226,272
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Rate
440.3
11.2
0.5
3.4
1.3
0.5
1.5
0.5
2.0
0.5
0.6
0.3
78.3
4.5
6.6
2.3
38.9
27.8
11.1
1.8
7.7
1.1
1.7
12.3
0.4
0.5
0.5
64.7
0.7
3.4
60.4
0
0.2
0.9
3.2
21.5
19.9
1.6
65.6
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
US Department of Health and Human Services/Centers for Disease Control and Prevention
39
TABLE 7. (Continued) Reported number and age-adjusted rate* of invasive cancer cases, by primary cancer site and sex United States, 2012
Male
Cancer site
Female
Rate
187,308
177,489
8,189
1,283
347
89,322
53,006
34,459
1,195
662
111.8
105.3
5.5
0.8
0.2
58.0
35.4
21.3
0.8
0.5
NA
NA
NA
NA
NA
38,781
16,968
20,772
723
318
NA
NA
NA
NA
NA
20.5
8.7
11.2
0.4
0.2
NA
NA
NA
NA
NA
128,103
69,974
55,231
1,918
980
NA
NA
NA
NA
NA
37.0
20.2
15.9
0.6
0.3
1,494
11,951
11,263
688
1.0
7.6
7.2
0.5
1,239
9,539
8,888
651
0.7
5.5
5.1
0.4
2,733
21,490
20,151
1,339
0.8
6.5
6.0
0.4
Endocrine system
Thyroid
Other endocrine including thymus
12,497
11,313
1,184
7.9
7.1
0.8
36,097
34,966
1,131
21.9
21.3
0.7
48,594
46,279
2,315
15.0
14.3
0.7
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
Myeloma
39,074
4,569
34,505
12,199
25.3
3.0
22.3
7.8
32,618
3,704
28,914
9,630
17.8
2.3
15.5
5.0
71,692
8,273
63,419
21,829
21.1
2.6
18.5
6.3
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
25,699
2,732
9,004
7,646
3,118
3,199
16.9
1.8
5.8
5.1
2.1
2.1
18,697
2,114
5,817
6,174
2,425
2,167
10.3
1.4
3.0
3.4
1.4
1.2
44,396
4,846
14,821
13,820
5,543
5,366
13.2
1.6
4.2
4.1
1.7
1.6
Mesothelioma
Kaposi Sarcoma
Miscellaneous
2,407
951
29,297
1.7
0.6
19.6
792
125
26,579
0.4
0.1
13.7
3,199
1,076
55,876
0.9
0.3
16.3
No.
Total
No.
Rate
No.
Rate
40
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 8. Reported number and age-adjusted rate* of cancer deaths, by primary cancer site and sex United States, 2012
Male
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and mesentery
Other digestive organs
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other respiratory organs
Bones and joints
Soft tissue including heart
Skin excluding basal and squamous
Melanoma of the skin
Other nonepithelial skin
Male and female breast
Female breast
Male breast
Female
Total
No.
Rate
No.
Rate
No.
Rate
305,661
6,263
44
1,488
581
54
746
454
714
653
268
1,261
83,782
11,697
6,611
689
26,866
21,383
5,483
368
15,563
687
739
19,718
110
78
656
90,091
285
2,925
86,689
51
141
818
2,394
8,329
6,013
2,316
NA
NA
405
200.6
3.9
0
0.9
0.4
0
0.5
0.3
0.4
0.4
0.2
0.8
53.4
7.3
4.3
0.5
17.6
14.1
3.5
0.2
9.4
0.5
0.5
12.7
0.1
0
0.4
58.4
0.2
1.8
56.2
0
0.1
0.5
1.6
5.5
4.0
1.6
NA
NA
0.3
276,946
2,661
27
736
288
21
529
212
165
238
88
357
63,242
2,952
4,580
604
24,650
20,484
4,166
521
7,409
1,415
780
19,079
97
672
483
71,760
173
737
70,734
31
85
581
2,165
4,134
3,238
896
NA
41,150
NA
141.9
1.3
0
0.4
0.1
0
0.3
0.1
0.1
0.1
0
0.2
32.0
1.5
2.4
0.3
12.4
10.3
2.1
0.3
3.8
0.7
0.4
9.6
0.1
0.3
0.2
37.0
0.1
0.4
36.4
0
0
0.3
1.2
2.1
1.7
0.4
NA
21.3
NA
582,607
8,924
71
2,224
869
75
1,275
666
879
891
356
1,618
147,024
14,649
11,191
1,293
51,516
41,867
9,649
889
22,972
2,102
1,519
38,797
207
750
1,139
161,851
458
3,662
157,423
82
226
1,399
4,559
12,463
9,251
3,212
41,555
NA
NA
166.4
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.4
41.6
4.1
3.2
0.4
14.7
12.0
2.7
0.3
6.3
0.6
0.4
11.0
0.1
0.2
0.3
46.2
0.1
1.0
45.0
0
0.1
0.4
1.3
3.6
2.7
0.9
11.8
NA
NA
US Department of Health and Human Services/Centers for Disease Control and Prevention
41
TABLE 8. (Continued) Reported number and age-adjusted rate* of cancer deaths, by primary cancer site and sex United States, 2012
Male
Cancer site
Female genital system
Cervix
Corpus and uterus, NOS
Corpus
Uterus, NOS
Ovary
Vagina
Vulva
Other female genital organs
Male genital system
Prostate
Testis
Penis
Other male genital organs
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
Eye and orbit
Brain and other nervous system
Endocrine system
Thyroid
Other endocrine including thymus
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
Myeloma
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
Mesothelioma
Miscellaneous
Female
Total
No.
Rate
No.
Rate
No.
Rate
NA
NA
NA
NA
NA
NA
NA
NA
NA
27,955
27,244
386
273
52
20,136
10,886
8,772
212
266
164
8,666
1,264
775
489
11,902
638
11,264
6,338
13,466
810
2,837
5,401
546
3,872
2,112
21,538
NA
NA
NA
NA
NA
NA
NA
NA
NA
20.0
19.6
0.3
0.2
0
13.6
7.6
5.6
0.1
0.2
0.1
5.4
0.8
0.5
0.3
8.0
0.4
7.6
4.2
9.2
0.5
2.0
3.6
0.4
2.7
1.5
14.1
29,405
4,074
8,911
3,812
5,099
14,404
429
1,034
553
NA
NA
NA
NA
NA
9,458
4,359
4,746
166
187
115
6,610
1,396
915
481
9,616
492
9,124
5,483
9,843
598
1,761
4,083
471
2,930
574
18,738
15.2
2.3
4.5
1.9
2.6
7.4
0.2
0.5
0.3
NA
NA
NA
NA
NA
4.7
2.1
2.4
0.1
0.1
0.1
3.5
0.7
0.5
0.3
4.9
0.3
4.6
2.8
5.1
0.3
0.9
2.2
0.2
1.5
0.3
9.4
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
29,594
15,245
13,518
378
453
279
15,276
2,660
1,690
970
21,518
1,130
20,388
11,821
23,309
1,408
4,598
9,484
1,017
6,802
2,686
40,276
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
8.5
4.4
3.8
0.1
0.1
0.1
4.4
0.8
0.5
0.3
6.2
0.3
5.9
3.4
6.8
0.4
1.3
2.8
0.3
2.0
0.8
11.5
42
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 9. Reported number and age-adjusted rate* of invasive cancer cases, by primary cancer site and race United States, 2012
AI/AN
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
API
Black
No.
Rate
No.
Rate
8,139
269.0
45,364
285.7
6.8
1.5
0.5
0.8
0.6
1.2
0.7
0.5
1,267
288
180
26
207
384
81
20
54
7.7
1.8
1.1
0.2
1.3
2.2
0.5
0.1
0.3
58.4
2.6
6.1
0.8
28.5
19.7
8.8
0.9
8.5
1.9
0.9
7.0
11,016
303
1,571
181
4,772
3,073
1,699
81
2,008
204
363
1,340
43
70
72.1
2.0
10.5
1.1
30.8
20.3
10.5
0.5
12.7
1.4
2.5
9.3
0.3
0.4
227
**
51
18
24
21
45
21
16
No.
White
Total
Rate
No.
Rate
No.
Rate
165,559
446.1
1,282,703
440.4
1,529,078
440.3
3,574
42
786
393
206
511
263
625
241
390
117
9.1
0.1
2.0
1.0
0.5
1.4
0.7
1.5
0.6
1.0
0.3
34,263
1,718
11,082
3,597
1,666
4,500
1,064
6,512
1,449
1,796
879
11.5
0.6
3.7
1.3
0.5
1.5
0.4
2.2
0.5
0.6
0.3
39,879
1,842
12,374
4,254
1,936
5,331
1,758
7,330
1,733
2,281
1,040
11.2
0.5
3.4
1.3
0.5
1.5
0.5
2.0
0.5
0.6
0.3
34,404
1,514
3,532
1,301
16,402
12,256
4,146
703
4,097
558
506
5,293
164
135
94.8
4.1
10.2
3.5
45.5
34.6
10.9
1.8
10.0
1.6
1.5
15.1
0.4
0.4
223,154
13,963
17,056
6,300
111,041
79,012
32,029
5,450
21,223
2,979
5,023
36,001
1,088
1,698
75.7
4.7
5.8
2.2
38.0
27.1
11.0
1.8
7.0
1.0
1.7
12.1
0.4
0.6
273,535
15,993
22,623
7,894
134,784
95,962
38,822
6,338
28,012
3,835
5,963
43,213
1,321
1,924
78.3
4.5
6.6
2.3
38.9
27.8
11.1
1.8
7.7
1.1
1.7
12.3
0.4
0.5
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and Intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and
mesentery
Other digestive organs
1,722
73
167
25
835
547
288
33
280
48
28
197
80
0.5
199
0.6
1,332
0.5
1,635
0.5
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
1,167
56
1,096
42.3
1.8
40.1
5,369
94
159
5,088
26
36.8
0.6
1.0
35.0
0.2
24,484
232
1,706
22,475
61
68.6
0.6
4.4
63.3
0.2
193,417
1,908
10,123
180,823
91
472
65.2
0.7
3.3
61.0
0
0.2
225,933
2,274
12,152
210,828
105
574
64.7
0.7
3.4
60.4
0
0.2
19
72
167
141
26
0.4
2.1
5.6
4.7
0.8
109
356
315
197
118
0.6
2.1
2.0
1.2
0.8
308
1,308
664
332
332
0.7
3.4
1.8
0.9
0.9
2,458
8,809
68,552
63,875
4,677
1.0
3.2
24.2
22.6
1.6
2,951
10,728
73,181
67,753
5,428
0.9
3.2
21.5
19.9
1.6
1,145
1,143
36.1
67.8
8,416
8,357
59
49.3
89.7
0.8
25,927
25,630
297
68.5
120.1
2.0
188,474
186,726
1,748
65.5
123.3
1.3
226,272
224,147
2,125
65.6
122.2
1.4
598
119
290
281
138
24
16
33.9
6.3
15.9
15.3
8.4
1.5
1.0
3,279
576
1,704
1,648
56
810
37
66
86
34.9
6.1
17.9
17.3
0.6
8.7
0.4
0.8
1.0
10,015
1,907
5,334
4,995
339
1,959
199
413
203
46.9
9.0
24.7
23.1
1.6
9.3
1.0
2.0
1.0
75,241
9,174
41,235
40,082
1,153
17,671
1,031
4,285
1,845
49.4
7.1
26.1
25.3
0.7
11.6
0.7
2.7
1.2
90,303
12,042
49,154
47,570
1,584
20,785
1,296
4,851
2,175
48.8
7.4
25.7
24.9
0.8
11.3
0.7
2.6
1.2
US Department of Health and Human Services/Centers for Disease Control and Prevention
43
TABLE 9. (Continued) Reported number and age-adjusted rate* of invasive cancer cases, by primary cancer site and race United States, 2012
AI/AN
API
Black
White
Total
Cancer site
No.
Rate
No.
Rate
No.
Rate
No.
Rate
No.
Rate
832
750
76
60.1
56.4
3.2
3,975
3,755
164
37
19
57.1
54.5
1.8
0.6
0.3
28,484
28,003
305
142
34
172.2
169.4
1.5
1.0
0.2
146,244
137,488
7,410
1,070
276
103.0
95.6
6.3
0.8
0.2
187,308
177,489
8,189
1,283
347
111.8
105.3
5.5
0.8
0.2
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
710
222
480
23.9
8.6
15.0
2,443
1,208
1,165
53
17
16.4
8.6
7.3
0.4
0.1
10,399
3,778
6,420
80
121
28.8
11.3
16.9
0.2
0.3
112,781
63,564
46,625
1,769
823
38.4
21.5
16.0
0.6
0.3
128,103
69,974
55,231
1,918
980
37.0
20.2
15.9
0.6
0.3
114
107
3.2
3.1
36
622
576
46
0.2
3.6
3.4
0.3
93
1,615
1,465
150
0.2
4.1
3.7
0.4
2,513
18,858
17,765
1,093
0.9
6.9
6.5
0.4
2,733
21,490
20,151
1,339
0.8
6.5
6.0
0.4
Endocrine system
Thyroid
Other endocrine including thymus
285
275
7.4
7.2
2,822
2,677
145
15.6
14.8
0.8
3,893
3,529
364
9.9
8.9
0.9
40,662
38,888
1,774
15.6
14.9
0.7
48,594
46,279
2,315
15.0
14.3
0.7
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
340
32
308
11.6
0.9
10.8
2,154
212
1,942
13.7
1.1
12.5
6,185
1,096
5,089
16.1
2.6
13.5
61,671
6,787
54,884
21.7
2.7
19.0
71,692
8,273
63,419
21.1
2.6
18.5
Myeloma
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
116
252
51
51
86
36
28
4.1
7.9
1.2
1.9
2.8
1.2
0.8
491
1,200
242
172
495
177
114
3.2
7.5
1.4
1.1
3.2
1.1
0.7
4,392
3,838
440
1,066
1,294
564
474
12.4
10.5
1.0
3.1
3.6
1.5
1.3
16,480
37,968
4,011
12,921
11,808
4,631
4,597
5.6
13.5
1.7
4.3
4.2
1.7
1.6
21,829
44,396
4,846
14,821
13,820
5,543
5,366
6.3
13.2
1.6
4.2
4.1
1.7
1.6
Mesothelioma
Kaposi Sarcoma
Miscellaneous
342
12.9
0.3
0.1
10.0
162
320
5,494
0.5
0.8
16.0
2,963
648
47,547
1.0
0.3
16.2
3,199
1,076
55,876
0.9
0.3
16.3
35
27
1,432
Abbreviations: AI/AN = American Indian/Alaska Native; A/PI = Asian/Pacific Islander; NOS = not otherwise specified.
* Rates are the number of cases per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Invasive cancer excludes basal and squamous cell carcinomas of the skin except when these occur on the skin of the genital organs, and in situ cancers except
urinary bladder. Urinary bladder cancer includes invasive and in situ.
Rates are not presented for persons of unknown or other race, therefore categories do not sum to total. Data for specified racial populations other than white and
black should be interpreted with caution. For more information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.
pdf#nameddest=IntRaceEthnicityData).
Data are compiled from cancer registries that meet the data quality criteria for all invasive cancer sites combined (covering approximately 99% of the U.S. population).
Registry-specific data quality information is available at http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#nameddest=RegistriesPubCriteria.
** Counts and rates are suppressed if <16 cases were reported.
44
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 10. Reported number and age-adjusted rate* of cancer deaths, by primary cancer site and race United States, 2012
AI/AN
Cancer site
All cancer sites combined
API
Black
White
Total
No.
Rate
No.
Rate
No.
Rate
No.
Rate
No.
Rate
3,018
112.5
15,339
104.2
67,374
194.4
496,876
166.4
582,607
166.4
48
1.6
320
2.0
1,074
2.9
7,482
68
2.5
0
8,924
71
2.5
0
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
58
19
41
141
17
21
0.4
0.1
0.3
0.8
0.1
0.1
200
67
118
100
108
146
50
281
0.5
0.2
0.3
0.3
0.3
0.4
0.1
0.8
1,956
781
71
1,108
419
753
723
297
1,306
0.6
0.3
0
0.4
0.1
0.2
0.2
0.1
0.4
2,224
869
75
1,275
666
879
891
356
1,618
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.4
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and mesentery
Other digestive organs
908
67
100
301
246
55
207
24
180
33.1
2.5
3.9
11.2
9.2
2.0
7.0
1.1
6.5
5,511
241
832
32
1,578
1,270
308
1,499
86
61
1,113
18
37
37.5
1.6
5.7
0.2
10.8
8.8
2.0
9.9
0.6
0.4
7.9
0.1
0.3
18,930
1,387
2,001
199
6,861
5,727
1,134
99
3,190
285
121
4,595
16
50
126
53.9
3.7
5.9
0.5
19.9
16.8
3.2
0.3
8.3
0.8
0.4
13.4
0
0.1
0.4
121,675
12,954
8,258
1,060
42,776
34,624
8,152
778
18,076
1,707
1,327
32,909
184
679
967
40.5
4.3
2.8
0.4
14.3
11.6
2.7
0.3
5.9
0.6
0.4
10.9
0.1
0.2
0.3
147,024
14,649
11,191
1,293
51,516
41,867
9,649
889
22,972
2,102
1,519
38,797
207
750
1,139
41.6
4.1
3.2
0.4
14.7
12.0
2.7
0.3
6.3
0.6
0.4
11.0
0.1
0.2
0.3
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
818
18
796
31.1
0.6
30.4
3,528
19
56
3,441
24.6
0.1
0.4
24.0
17,484
40
628
16,780
31
50.3
0.1
1.7
48.4
0.1
140,021
397
2,960
136,406
75
183
46.9
0.1
1.0
45.7
0
0.1
161,851
458
3,662
157,423
82
226
46.2
0.1
1.0
45.0
0
0.1
35
32
19
1.1
1.3
0.8
42
147
90
58
32
0.3
0.9
0.6
0.4
0.2
165
567
273
138
135
0.4
1.5
0.8
0.4
0.4
1,186
3,810
12,068
9,036
3,032
0.4
1.3
4.1
3.1
1.0
1,399
4,559
12,463
9,251
3,212
0.4
1.3
3.6
2.7
0.9
173
172
5.9
10.8
1,036
1,032
6.3
11.3
6,246
6,186
60
17.2
29.4
0.4
34,100
33,760
340
11.4
20.7
0.3
41,555
41,150
405
11.8
21.3
0.3
US Department of Health and Human Services/Centers for Disease Control and Prevention
45
TABLE 10. (Continued) Reported number and age-adjusted rate* of cancer deaths, by primary cancer site and race United States, 2012
AI/AN
API
Black
White
Total
Cancer site
No.
Rate
No.
Rate
No.
Rate
No.
Rate
No.
Rate
171
41
47
21
26
74
11.1
2.3
3.1
1.2
1.8
5.0
858
154
280
131
149
385
16
9.6
1.7
3.2
1.5
1.7
4.3
0.2
3,984
780
1,666
646
1,020
1,359
56
64
59
19.4
3.7
8.2
3.2
5.0
6.6
0.3
0.3
0.3
24,392
3,099
6,918
3,014
3,904
12,586
360
952
477
15.0
2.1
4.1
1.8
2.3
7.7
0.2
0.6
0.3
29,405
4,074
8,911
3,812
5,099
14,404
429
1,034
553
15.2
2.3
4.5
1.9
2.6
7.4
0.2
0.5
0.3
134
127
14.4
14.0
441
429
8.6
8.4
4,655
4,595
26
27
42.1
41.8
0.1
0.2
22,725
22,093
347
241
44
18.6
18.1
0.3
0.2
0
27,955
27,244
386
273
52
20.0
19.6
0.3
0.2
0
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
148
33
107
5.5
1.3
3.9
507
232
256
3.7
1.8
1.7
2,411
1,090
1,267
41
7.2
3.5
3.6
0.1
26,528
13,890
11,888
351
399
8.8
4.6
4.0
0.1
0.1
29,594
15,245
13,518
378
453
8.5
4.4
3.8
0.1
0.1
63
75
72
2.0
3.2
3.2
336
134
90
44
587
20
567
2.1
0.9
0.6
0.3
4.1
0.1
4.0
1,009
311
165
146
1,595
133
1,462
2.7
0.9
0.5
0.4
4.6
0.3
4.3
260
13,868
2,208
1,430
778
19,261
974
18,287
0.1
4.8
0.8
0.5
0.3
6.5
0.3
6.2
279
15,276
2,660
1,690
970
21,518
1,130
20,388
0.1
4.4
0.8
0.5
0.3
6.2
0.3
5.9
Myeloma
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
48
96
44
25
2.0
3.4
1.5
1.0
241
599
53
38
323
21
164
1.7
4.1
0.3
0.3
2.2
0.1
1.2
2,085
1,965
121
365
768
108
603
6.3
5.8
0.3
1.2
2.2
0.3
1.8
9,447
20,649
1,222
4,183
8,349
885
6,010
3.2
7.1
0.5
1.4
2.9
0.3
2.0
11,821
23,309
1,408
4,598
9,484
1,017
6,802
3.4
6.8
0.4
1.3
2.8
0.3
2.0
236
8.9
28
930
0.2
6.5
125
4,471
0.4
12.9
2,519
34,639
0.9
11.5
2,686
40,276
0.8
11.5
Mesothelioma
Miscellaneous
Abbreviations: AI/AN = American Indian/Alaska Native; A/PI = Asian/Pacific Islander; NOS = not otherwise specified.
* Rates are the number of deaths per 100,000 persons and are age-adjusted to the 2000 U.S. standard population (19 age groups Census P251130). For more
information, see USCS technical notes (http://www.cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf ).
Data for specified racial populations other than white and black should be interpreted with caution. For more information, see USCS technical notes (http://www.
cdc.gov/cancer/npcr/uscs/pdf/uscs-2012-technical-notes.pdf#nameddest=IntRaceEthnicityData).
Data are from the National Vital Statistics System (NVSS).
Counts and rates are suppressed if <16 deaths were reported.
46
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 11. Reported number and age-adjusted rate* of invasive cancer cases, by primary cancer site and ethnicity United States, 2012
Hispanic
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and Intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and mesentery
Other digestive organs
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other respiratory organs
Bones and joints
Soft tissue including heart
Skin excluding basal and squamous
Melanoma of the skin
Other nonepithelial skin
Male and female breast
Female breast
Male breast
Female genital system
Cervix
Corpus and uterus, NOS
Corpus
Uterus, NOS
Ovary
Vagina
Vulva
Other female genital organs
Non-Hispanic
Total
No.
Rate
No.
Rate
No.
Rate
111,815
2,318
87
629
324
90
366
148
364
97
139
74
24,117
847
2,926
561
10,585
7,158
3,427
449
4,066
539
650
3,079
128
134
153
9,655
191
736
8,648
**
76
415
1,092
1,726
1,423
303
17,129
17,014
115
8,557
1,998
4,135
3,976
159
1,885
108
268
163
340.5
6.9
0.3
1.9
0.9
0.3
1.2
0.4
1.0
0.3
0.4
0.2
78.3
2.8
9.5
1.7
34.0
23.8
10.2
1.4
12.7
1.9
2.2
10.7
0.3
0.4
0.5
34.4
0.6
2.4
31.2
0.1
0.9
2.8
5.1
4.2
0.9
49.0
91.3
0.8
44.5
9.5
21.8
20.9
0.9
10.0
0.6
1.7
0.9
1,417,061
37,561
1,755
11,745
3,930
1,846
4,965
1,610
6,966
1,636
2,142
966
249,370
15,143
19,694
7,333
124,186
88,791
35,395
5,888
23,937
3,295
5,313
40,116
1,193
1,790
1,482
216,231
2,083
11,413
202,136
101
498
2,536
9,636
71,452
66,328
5,124
209,135
207,125
2,010
81,736
10,044
45,015
43,593
1,422
18,894
1,188
4,583
2,012
451.4
11.7
0.6
3.6
1.3
0.6
1.6
0.5
2.1
0.5
0.6
0.3
78.5
4.7
6.2
2.3
39.5
28.3
11.2
1.9
7.2
1.0
1.7
12.5
0.4
0.6
0.5
67.5
0.7
3.5
63.2
0
0.2
0.9
3.3
23.6
21.9
1.7
67.6
125.9
1.4
49.1
7.1
26.0
25.2
0.8
11.4
0.7
2.7
1.2
1,529,078
39,879
1,842
12,374
4,254
1,936
5,331
1,758
7,330
1,733
2,281
1,040
273,535
15,993
22,623
7,894
134,784
95,962
38,822
6,338
28,012
3,835
5,963
43,213
1,321
1,924
1,635
225,933
2,274
12,152
210,828
574
2,951
10,728
73,181
67,753
5,428
226,272
224,147
2,125
90,303
12,042
49,154
47,570
1,584
20,785
1,296
4,851
2,175
440.3
11.2
0.5
3.4
1.3
0.5
1.5
0.5
2.0
0.5
0.6
0.3
78.3
4.5
6.6
2.3
38.9
27.8
11.1
1.8
7.7
1.1
1.7
12.3
0.4
0.5
0.5
64.7
0.7
3.4
60.4
0
0.2
0.9
3.2
21.5
19.9
1.6
65.6
122.2
1.4
48.8
7.4
25.7
24.9
0.8
11.3
0.7
2.6
1.2
US Department of Health and Human Services/Centers for Disease Control and Prevention
47
TABLE 11. (Continued) Reported number and age-adjusted rate* of invasive cancer cases, by primary cancer site and ethnicity United
States, 2012
Hispanic
Cancer site
Male genital system
Prostate
Testis
Penis
Other male genital organs
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
Eye and orbit
Brain and other nervous system
Brain
Cranial nerves other nervous system
Endocrine system
Thyroid
Other endocrine including thymus
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
Myeloma
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
Mesothelioma
Kaposi Sarcoma
Miscellaneous
Non-Hispanic
Total
No.
Rate
No.
Rate
No.
Rate
13,653
12,121
1,311
204
17
8,518
3,041
5,350
80
47
206
1,990
1,846
144
5,806
5,555
251
6,462
1,029
5,433
1,869
3,988
1,264
542
1,272
490
420
200
198
3,916
95.7
89.8
4.4
1.4
0.1
27.4
11.1
15.9
0.3
0.2
0.5
4.9
4.6
0.3
13.7
13.1
0.6
18.9
2.3
16.6
6.2
10.3
2.2
1.9
3.6
1.4
1.2
0.7
0.5
13.6
173,628
165,342
6,877
1,079
330
119,571
66,925
49,875
1,838
933
2,527
19,497
18,302
1,195
42,783
40,722
2,061
65,222
7,244
57,978
19,955
40,403
3,582
14,278
12,546
5,051
4,946
2,997
878
51,943
113.7
107.0
5.7
0.8
0.2
37.9
21.1
15.9
0.6
0.3
0.9
6.7
6.3
0.5
15.4
14.6
0.7
21.5
2.7
18.7
6.3
13.4
1.5
4.5
4.1
1.7
1.6
1.0
0.3
16.5
187,308
177,489
8,189
1,283
347
128,103
69,974
55,231
1,918
980
2,733
21,490
20,151
1,339
48,594
46,279
2,315
71,692
8,273
63,419
21,829
44,396
4,846
14,821
13,820
5,543
5,366
3,199
1,076
55,876
111.8
105.3
5.5
0.8
0.2
37.0
20.2
15.9
0.6
0.3
0.8
6.5
6.0
0.4
15.0
14.3
0.7
21.1
2.6
18.5
6.3
13.2
1.6
4.2
4.1
1.7
1.6
0.9
0.3
16.3
48
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 12. Reported number and age-adjusted rate* of cancer deaths, by primary cancer site and ethnicity United States, 2012
Hispanic
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and mesentery
Other digestive organs
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other respiratory organs
Bones and joints
Soft tissue including heart
Skin excluding basal and squamous
Melanoma of the skin
Other nonepithelial skin
Male and female breast
Female breast
Male breast
Non-Hispanic
Total
No.
Rate
No.
Rate
No.
Rate
34,146
476
118
48
66
37
39
43
25
87
11,382
621
1,590
68
3,349
2,737
612
40
2,780
262
136
2,407
16
46
67
5,503
37
214
5,225
22
136
390
350
224
126
2,627
2,613
117.8
1.6
0.4
0.2
0.2
0.1
0.1
0.1
0.1
0.3
39.3
2.1
5.2
0.2
11.8
9.7
2.0
0.1
9.3
1.0
0.5
8.6
0
0.1
0.2
20.4
0.1
0.8
19.4
0.1
0.3
1.1
1.2
0.7
0.5
8.1
14.7
547,027
8,421
65
2,099
819
68
1,206
627
835
848
329
1,525
135,287
13,995
9,570
1,221
48,034
39,017
9,017
845
20,135
1,833
1,383
36,307
190
703
1,071
155,925
420
3,433
151,793
77
202
1,262
4,155
12,085
9,010
3,075
38,826
38,436
390
170.4
2.6
0
0.6
0.3
0
0.4
0.2
0.3
0.3
0.1
0.5
41.8
4.3
3.0
0.4
15.0
12.2
2.8
0.3
6.1
0.6
0.4
11.2
0.1
0.2
0.3
48.4
0.1
1.0
47.1
0
0.1
0.4
1.4
3.8
2.9
0.9
12.1
21.9
0.3
582,607
8,924
71
2,224
869
75
1,275
666
879
891
356
1,618
147,024
14,649
11,191
1,293
51,516
41,867
9,649
889
22,972
2,102
1,519
38,797
207
750
1,139
161,851
458
3,662
157,423
82
226
1,399
4,559
12,463
9,251
3,212
41,555
41,150
405
166.4
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.4
41.6
4.1
3.2
0.4
14.7
12.0
2.7
0.3
6.3
0.6
0.4
11.0
0.1
0.2
0.3
46.2
0.1
1.0
45.0
0
0.1
0.4
1.3
3.6
2.7
0.9
11.8
21.3
0.3
US Department of Health and Human Services/Centers for Disease Control and Prevention
49
TABLE 12. (Continued) Reported number and age-adjusted rate* of cancer deaths, by primary cancer site and ethnicity United States, 2012
Hispanic
Cancer site
Female genital system
Cervix
Corpus and uterus, NOS
Corpus
Uterus, NOS
Ovary
Vagina
Vulva
Other female genital organs
Male genital system
Prostate
Testis
Penis
Other male genital organs
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
Eye and orbit
Brain and other nervous system
Endocrine system
Thyroid
Other endocrine including thymus
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
Myeloma
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
Mesothelioma
Miscellaneous
Non-Hispanic
Total
No.
Rate
No.
Rate
No.
Rate
2,212
520
619
245
374
963
32
45
33
1,706
1,592
75
36
1,660
584
1,042
19
18
1,049
248
168
80
1,551
123
1,428
782
1,603
325
125
582
76
495
132
2,313
12.8
2.7
3.7
1.5
2.2
5.8
0.2
0.3
0.2
17.1
16.5
0.2
0.3
6.0
2.3
3.6
0.1
0.1
3.0
0.8
0.6
0.2
5.4
0.4
5.0
2.9
5.0
0.7
0.5
1.9
0.3
1.7
0.5
8.2
27,113
3,536
8,269
3,555
4,714
13,407
396
986
519
26,189
25,595
309
237
48
27,875
14,630
12,451
362
432
260
14,194
2,409
1,521
888
19,914
1,005
18,909
11,019
21,661
1,080
4,463
8,885
936
6,297
2,545
37,842
15.4
2.2
4.6
2.0
2.6
7.5
0.2
0.5
0.3
20.2
19.8
0.2
0.2
0
8.6
4.5
3.8
0.1
0.1
0.1
4.6
0.8
0.5
0.3
6.3
0.3
6.0
3.4
6.9
0.4
1.4
2.9
0.3
2.0
0.8
11.7
29,405
4,074
8,911
3,812
5,099
14,404
429
1,034
553
27,955
27,244
386
273
52
29,594
15,245
13,518
378
453
279
15,276
2,660
1,690
970
21,518
1,130
20,388
11,821
23,309
1,408
4,598
9,484
1,017
6,802
2,686
40,276
15.2
2.3
4.5
1.9
2.6
7.4
0.2
0.5
0.3
20.0
19.6
0.3
0.2
0
8.5
4.4
3.8
0.1
0.1
0.1
4.4
0.8
0.5
0.3
6.2
0.3
5.9
3.4
6.8
0.4
1.3
2.8
0.3
2.0
0.8
11.5
50
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 13. Reported number of invasive* cancer cases by primary cancer site and year United States, 19992012
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
1,227,562 1,249,559 1,273,017 1,285,618 1,279,510 1,296,877 1,318,814 1,349,590 1,387,116 1,402,567 1,414,111 1,403,565 1,424,734 1,399,978
27,491
2,444
6,640
2,982
2,074
4,357
1,471
3,409
995
2,187
932
27,954
2,393
6,859
3,147
2,053
4,197
1,527
3,584
1,060
2,153
981
28,236
2,309
7,017
3,180
2,075
4,312
1,416
3,780
1,106
2,085
956
28,904
2,333
7,478
3,220
2,018
4,236
1,535
4,032
1,110
2,066
876
29,506
2,041
7,737
3,305
1,940
4,387
1,622
4,316
1,277
2,163
718
29,980
1,961
8,091
3,357
1,916
4,348
1,559
4,570
1,295
2,131
752
30,315
1,859
8,298
3,470
1,827
4,338
1,618
4,756
1,298
2,120
731
31,314
1,880
8,725
3,599
1,944
4,372
1,565
5,068
1,404
2,034
723
32,798
1,883
9,399
3,628
1,923
4,564
1,722
5,307
1,416
2,131
825
34,214
1,867
10,100
3,754
1,934
4,759
1,713
5,730
1,479
2,082
796
34,619
1,832
10,224
3,774
1,920
4,663
1,601
6,263
1,460
2,127
755
35,395
1,952
10,282
3,762
1,924
4,846
1,660
6,348
1,666
2,074
881
36,790
1,886
11,118
3,792
1,838
4,927
1,635
6,754
1,704
2,124
1,012
36,990
1,725
11,476
3,986
1,787
4,915
1,640
6,786
1,598
2,106
971
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and Intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and
mesentery
Other digestive organs
232,437
12,691
19,350
4,312
142,816
104,182
38,634
3,467
12,470
3,102
3,356
28,024
990
1,101
235,790
12,886
19,227
4,314
144,059
105,255
38,804
3,541
13,415
2,992
3,544
28,801
963
1,188
238,113
13,082
19,184
4,614
143,905
105,235
38,670
3,626
13,502
3,149
4,221
29,421
1,033
1,391
239,050
13,105
19,418
4,882
142,685
104,439
38,246
3,801
14,451
2,980
4,401
29,804
1,062
1,472
242,294
13,606
19,689
5,038
142,037
103,760
38,277
4,198
15,221
3,122
4,565
31,085
1,038
1,646
243,671
14,152
19,653
5,379
140,094
102,098
37,996
4,314
16,460
3,140
4,624
31,922
1,057
1,818
244,545
14,058
19,392
5,593
138,690
100,503
38,187
4,506
17,381
3,231
4,677
32,985
1,125
1,813
246,111
14,522
19,400
5,974
136,944
99,464
37,480
4,503
18,426
3,279
4,862
34,137
1,094
1,751
249,358
14,535
19,827
6,179
136,405
98,772
37,633
4,967
20,097
3,314
4,874
34,961
1,114
1,895
252,542
15,092
19,674
6,502
135,443
98,055
37,388
5,230
21,264
3,330
5,141
36,519
1,136
1,981
252,284
15,220
20,036
6,706
131,492
94,444
37,048
5,614
23,130
3,550
5,349
36,950
1,135
1,838
250,837
14,598
20,925
7,124
127,515
91,344
36,171
5,442
23,862
3,538
5,437
38,112
1,151
1,808
254,183
14,998
21,054
7,188
127,219
91,134
36,085
5,694
25,028
3,607
5,635
39,242
1,227
1,835
254,508
14,884
21,168
7,336
124,944
88,810
36,134
5,876
26,279
3,614
5,603
40,229
1,257
1,791
758
860
985
989
1,049
1,058
1,094
1,219
1,190
1,230
1,264
1,325
1,456
1,527
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
193,612
1,805
11,696
179,444
104
563
194,368
1,799
11,513
180,405
101
550
196,473
1,765
11,409
182,729
77
493
198,631
1,870
11,081
185,079
97
504
201,452
1,815
11,202
187,813
92
530
202,402
1,928
11,427
188,372
98
577
206,455
1,966
11,373
192,465
93
558
207,257
1,953
11,457
193,219
83
545
208,946
2,116
11,507
194,673
102
548
211,173
2,080
11,489
196,903
99
602
211,521
2,104
11,499
197,245
104
569
208,570
2,005
11,627
194,261
103
574
207,967
2,045
11,400
193,906
92
524
207,627
2,126
11,106
193,768
100
527
2,472
2,462
2,627
2,645
2,577
2,640
2,752
2,692
2,755
2,687
2,808
2,708
2,766
2,769
7,333
7,687
7,846
8,035
8,383
8,792
9,025
8,897
9,449
9,589
9,707
9,978
9,810
10,000
42,231
45,624
49,078
50,756
51,026
54,246
58,466
58,591
60,959
63,467
65,477
65,306
67,704
68,633
38,867
3,364
41,925
3,699
45,141
3,937
46,757
3,999
46,935
4,091
50,040
4,206
54,096
4,370
54,225
4,366
56,303
4,656
58,484
4,983
60,335
5,142
60,397
4,909
62,674
5,030
63,502
5,131
187,922
186,459
1,463
187,408
185,946
1,462
189,541
188,139
1,402
188,438
186,934
1,504
181,949
180,386
1,563
182,828
181,216
1,612
185,308
183,738
1,570
189,451
187,819
1,632
194,935
193,211
1,724
200,299
198,411
1,888
205,221
203,405
1,816
201,894
199,991
1,903
208,322
206,446
1,876
210,356
208,404
1,952
71,591
12,991
33,458
32,350
1,108
19,875
1,020
3,401
846
72,193
12,984
33,501
32,366
1,135
20,339
1,088
3,348
933
72,986
12,399
34,731
33,573
1,158
20,361
1,075
3,494
926
72,698
12,079
34,927
33,763
1,164
20,075
1,100
3,515
1,002
71,893
11,726
34,388
33,224
1,164
20,187
1,052
3,551
989
72,881
11,491
35,868
34,727
1,141
19,805
1,103
3,579
1,035
74,556
11,719
36,928
35,751
1,177
20,113
1,010
3,700
1,086
75,675
11,653
37,859
36,721
1,138
20,175
1,083
3,788
1,117
77,446
11,705
39,260
38,124
1,136
20,131
1,097
3,986
1,267
79,354
11,623
40,755
39,440
1,315
20,409
1,146
4,017
1,404
81,185
11,807
42,496
41,081
1,415
20,000
1,154
4,201
1,527
81,437
11,395
43,347
41,970
1,377
19,569
1,163
4,223
1,740
83,020
11,339
44,709
43,247
1,462
19,524
1,178
4,355
1,915
84,199
11,145
45,902
44,449
1,453
19,382
1,199
4,502
2,069
US Department of Health and Human Services/Centers for Disease Control and Prevention
51
TABLE 13. Reported number of invasive* cancer cases by primary cancer site and year United States, 19992012
Cancer site
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
194,920
186,717
6,937
1,004
262
200,489
192,151
7,052
1,008
278
206,681
198,257
7,160
991
273
208,978
200,678
7,017
1,025
258
196,114
187,529
7,251
1,053
281
195,842
187,229
7,355
988
270
196,522
187,731
7,501
997
293
214,202
205,526
7,346
1,025
305
226,520
217,631
7,509
1,099
281
215,968
206,730
7,690
1,211
337
211,749
202,691
7,650
1,106
302
203,731
194,600
7,673
1,143
315
207,234
198,110
7,579
1,206
339
173,864
164,613
7,724
1,194
333
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
89,166
55,822
31,073
1,553
718
91,902
56,845
32,824
1,536
697
94,178
57,153
34,756
1,560
709
97,018
58,168
36,629
1,565
656
100,211
59,242
38,706
1,573
690
103,654
60,732
40,615
1,608
699
106,689
61,706
42,661
1,600
722
108,167
60,721
44,965
1,721
760
111,587
62,484
46,608
1,668
827
114,459
63,354
48,383
1,701
1,021
115,944
64,138
49,203
1,723
880
2,185
17,611
16,446
1,165
2,266
17,830
16,581
1,249
2,283
17,766
16,541
1,225
2,258
18,267
17,069
1,198
2,441
18,353
17,000
1,353
2,459
18,879
17,542
1,337
2,440
18,993
17,661
1,332
2,484
19,201
17,975
1,226
2,538
19,512
18,204
1,308
2,514
19,858
18,543
1,315
2,537
20,019
18,709
1,310
2,438
19,809
18,587
1,222
2,474
19,893
18,703
1,190
2,589
19,929
18,727
1,202
Endocrine system
Thyroid
Other endocrine including thymus
19,093
17,385
1,708
21,074
19,322
1,752
22,594
20,731
1,863
24,401
22,557
1,844
25,856
23,905
1,951
28,353
26,263
2,090
31,030
28,946
2,084
33,174
31,071
2,103
36,000
33,816
2,184
39,386
37,089
2,297
41,693
39,506
2,187
42,584
40,322
2,262
43,924
41,814
2,110
45,696
43,523
2,173
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
56,381
7,272
49,109
57,054
7,461
49,593
58,147
7,346
50,801
59,578
7,678
51,900
60,948
7,617
53,331
62,813
7,726
55,087
63,613
7,981
55,632
63,762
7,905
55,857
65,116
7,972
57,144
66,350
8,273
58,077
67,262
8,012
59,250
67,800
8,069
59,731
67,173
7,884
59,289
67,005
7,704
59,301
Myeloma
14,184
14,849
15,308
15,608
15,901
16,548
16,879
16,946
17,236
18,122
18,828
19,416
19,942
20,284
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
32,688
3,670
10,499
9,535
4,122
4,862
34,533
3,823
11,455
10,089
4,305
4,861
35,367
3,939
12,049
10,192
4,343
4,844
34,808
3,916
12,149
9,895
4,104
4,744
35,970
3,970
12,669
10,143
4,302
4,886
36,580
4,131
13,133
10,132
4,437
4,747
36,752
4,066
13,511
10,015
4,370
4,790
37,614
4,269
13,683
10,292
4,612
4,758
37,875
4,380
13,352
10,407
4,643
5,093
38,508
4,536
13,548
10,824
4,758
4,842
39,192
4,491
13,605
10,938
5,045
5,113
41,214
4,600
13,759
12,208
5,278
5,369
41,530
4,701
13,897
12,448
5,305
5,179
41,569
4,536
13,938
12,883
5,223
4,989
Mesothelioma
2,825
2,889
2,891
2,935
2,925
2,964
3,074
2,978
2,974
3,012
3,048
3,070
3,079
3,002
Kaposi Sarcoma
1,406
1,399
1,391
1,306
1,349
1,315
1,355
1,226
1,263
1,191
1,172
1,112
1,113
1,036
32,014
31,788
31,511
31,304
30,362
30,030
30,045
29,848
29,849
29,874
29,845
30,598
30,160
30,457
Miscellaneous
52
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 14. Reported number of cancer deaths, by primary cancer site and year United States, 19992012*
Cancer site
All cancer sites combined
Oral cavity and pharynx
Lip
Tongue
Salivary gland
Floor of mouth
Gum and other mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other oral cavity and pharynx
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
549,829 553,080 553,760 557,264 556,890 553,880 559,303 559,880 562,867 565,460 567,614 574,738 576,685 582,607
7,486
52
1,738
656
180
1,215
638
543
600
385
1,479
7,492
67
1,767
663
153
1,213
650
518
547
359
1,555
7,701
77
1,818
685
135
1,179
621
612
592
348
1,634
7,737
74
1,887
722
149
1,152
628
638
606
323
1,558
7,777
72
1,875
696
147
1,176
598
608
626
318
1,661
7,826
74
1,881
697
122
1,168
637
592
658
368
1,629
7,773
60
1,948
701
135
1,118
615
647
655
281
1,613
7,720
51
1,906
699
114
1,108
633
654
650
301
1,604
8,067
66
2,034
742
102
1,109
677
688
721
324
1,604
8,019
68
1,983
718
99
1,160
645
724
734
294
1,594
7,922
57
1,971
795
109
1,091
662
736
720
279
1,502
8,474
69
2,125
827
93
1,212
701
795
806
324
1,522
8,657
83
2,089
820
84
1,245
630
842
861
322
1,681
8,924
71
2,224
869
75
1,275
666
879
891
356
1,618
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and
mesentery
Other digestive organs
130,070 131,455 131,726 132,541 133,010 132,215 133,562 135,140 136,419 138,469 139,200 142,680 144,007 147,024
11,917
12,232
12,529
12,700
12,860
13,023
13,499
13,685
13,592
13,714
13,908
14,490
14,446
14,649
12,711
12,645
12,319
12,198
12,110
11,859
11,514
11,345
11,388
11,352
11,184
11,390
11,035
11,191
1,036
1,057
1,082
1,017
1,070
1,115
1,117
1,091
1,083
1,192
1,195
1,218
1,256
1,293
52,045
51,783
51,516
57,222
57,434
56,808
56,603
55,783
53,580
53,005
53,196
53,219
52,857
51,848
48,962
49,019
48,292
47,987
47,248
44,988
44,325
44,331
44,247
43,650
42,471
42,245
42,181
41,867
8,260
8,415
8,516
8,616
8,535
8,592
8,680
8,865
8,972
9,207
9,377
9,800
9,602
9,649
462
492
511
539
555
589
583
623
644
718
818
813
863
889
12,382
12,916
13,351
14,047
14,706
15,321
16,075
16,525
17,146
18,213
19,352
20,304
21,608
22,972
2,059
1,949
1,971
1,907
1,915
1,936
1,989
2,000
1,914
1,971
2,048
2,105
2,101
2,102
1,531
1,717
1,630
1,501
1,491
1,461
1,464
1,427
1,436
1,377
1,384
1,519
1,510
1,519
29,081
29,331
29,802
30,263
30,777
31,771
32,759
33,454
34,117
35,234
35,628
36,888
37,344
38,797
220
262
220
219
191
219
238
190
204
226
186
202
219
207
695
703
702
807
750
429
503
543
616
602
686
648
698
721
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
156,708 160,051 160,602 162,148 162,589 162,400 163,751 163,134 163,065 163,141 162,492 162,730 161,376 161,851
456
419
485
444
457
458
484
426
475
516
530
495
416
458
3,815
3,861
3,797
3,722
3,791
3,668
3,796
3,821
3,634
3,760
3,630
3,691
3,732
3,662
152,061 155,426 155,969 157,630 157,990 158,006 159,217 158,599 158,683 158,592 158,081 158,248 156,953 157,423
99
76
84
73
76
78
67
64
48
54
55
54
61
82
277
269
267
279
275
190
187
224
225
219
196
242
214
226
1,020
917
960
931
950
655
671
906
955
920
946
1,004
1,035
1,139
1,224
1,212
1,298
1,194
1,262
1,301
1,391
1,340
1,362
1,357
1,384
1,378
1,423
3,679
3,693
3,646
3,554
3,651
3,722
3,849
3,960
4,023
4,093
4,229
4,376
4,408
4,559
9,530
7,215
2,315
9,672
7,420
2,252
9,992
7,542
2,450
9,904
7,513
2,391
10,214
7,818
2,396
10,301
7,952
2,349
10,798
8,345
2,453
11,068
8,441
2,627
11,234
8,461
2,773
11,337
8,623
2,714
12,130
9,199
2,931
12,089
9,154
2,935
12,212
9,128
3,084
12,463
9,251
3,212
41,528
41,144
384
42,300
41,872
428
41,809
41,394
415
41,883
41,514
369
41,998
41,619
379
41,316
40,954
362
41,491
41,116
375
41,209
40,820
389
40,969
40,598
371
41,026
40,589
437
41,076
40,676
400
41,435
40,996
439
41,374
40,931
443
41,555
41,150
405
1,399
US Department of Health and Human Services/Centers for Disease Control and Prevention
53
TABLE 14. (Continued) Reported number of cancer deaths, by primary cancer site and year United States, 19992012*
Cancer site
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
25,881
4,204
6,468
3,121
3,347
13,627
403
762
417
26,411
4,200
6,585
3,139
3,446
14,060
405
752
409
26,838
4,092
6,783
3,185
3,598
14,414
382
765
402
27,091
3,952
6,853
3,187
3,666
14,682
378
794
432
27,011
3,919
6,899
3,261
3,638
14,657
391
775
370
27,049
3,850
6,990
3,272
3,718
14,716
416
806
271
27,259
3,924
7,096
3,259
3,837
14,787
382
809
261
27,848
3,976
7,384
3,449
3,935
14,857
396
862
373
27,739
4,021
7,456
3,377
4,079
14,621
376
865
400
27,813
4,008
7,675
3,436
4,239
14,362
417
921
430
27,817
3,909
7,713
3,333
4,380
14,436
398
946
415
28,770
3,939
8,402
3,644
4,758
14,572
423
942
492
29,027
4,092
8,641
3,714
4,927
14,346
428
1,022
498
29,405
4,074
8,911
3,812
5,099
14,404
429
1,034
553
32,349
31,728
378
202
41
31,675
31,078
338
217
42
31,300
30,719
335
205
41
31,084
30,446
393
209
36
30,176
29,554
344
250
28
29,627
29,002
357
231
37
29,514
28,905
359
217
33
29,022
28,372
358
245
47
29,703
29,093
326
246
38
29,120
28,471
358
246
45
28,744
28,088
376
234
46
29,276
28,560
399
258
59
28,630
27,970
380
239
41
27,955
27,244
386
273
52
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
23,666
11,910
11,116
345
295
24,344
12,002
11,736
302
304
24,910
12,225
12,078
294
313
25,443
12,627
12,165
297
354
25,422
12,483
12,286
323
330
25,928
13,030
12,313
334
251
26,404
13,253
12,517
347
287
26,649
13,474
12,379
361
435
27,319
13,843
12,703
340
433
27,682
14,036
12,895
354
397
27,941
14,201
12,995
371
374
28,726
14,730
13,219
350
427
29,317
15,014
13,559
338
406
29,594
15,245
13,518
378
453
227
236
226
240
231
208
252
219
249
262
278
283
280
279
12,765
12,655
12,609
12,830
12,901
12,829
13,152
12,886
13,234
13,724
14,176
14,164
14,491
15,276
2,146
1,241
905
2,210
1,328
882
2,299
1,354
945
2,231
1,367
864
2,155
1,312
843
2,272
1,409
863
2,354
1,462
892
2,404
1,518
886
2,488
1,562
926
2,555
1,649
906
2,634
1,707
927
2,641
1,686
955
2,689
1,747
942
2,660
1,690
970
24,205
1,403
22,802
24,016
1,287
22,729
23,628
1,323
22,305
23,262
1,352
21,910
22,822
1,347
21,475
22,214
1,276
20,938
22,145
1,272
20,873
21,920
1,327
20,593
21,799
1,271
20,528
21,539
1,171
20,368
21,639
1,250
20,389
21,525
1,231
20,294
21,485
1,168
20,317
21,518
1,130
20,388
Myeloma
10,508
10,639
10,714
10,913
10,809
10,578
10,758
10,712
10,872
10,606
10,690
11,022
11,411
11,821
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
21,071
1,361
4,476
6,932
1,788
6,514
21,397
1,395
4,323
7,413
1,802
6,464
21,532
1,433
4,386
7,749
1,649
6,315
21,581
1,432
4,443
7,914
1,367
6,425
21,608
1,429
4,476
8,126
1,233
6,344
21,472
1,371
4,342
8,214
1,164
6,381
21,716
1,460
4,391
8,267
1,067
6,531
22,016
1,393
4,498
8,539
1,077
6,509
21,928
1,418
4,471
8,568
984
6,487
22,431
1,424
4,395
8,962
1,000
6,650
22,688
1,423
4,557
9,223
1,003
6,482
22,673
1,436
4,486
9,150
1,019
6,582
23,194
1,432
4,608
9,491
1,091
6,572
23,309
1,408
4,598
9,484
1,017
6,802
Mesothelioma
2,343
2,384
2,371
2,430
2,476
2,504
2,553
2,452
2,432
2,538
2,606
2,574
2,651
2,686
Miscellaneous
44,401
41,176
40,519
41,144
40,723
40,070
40,534
40,140
39,920
39,700
39,926
39,886
40,002
40,276
54
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 15. Age-adjusted rate* of invasive cancer cases, by primary cancer site and year United States, 19992012
Cancer site
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
483.9
485.1
487.2
483.7
473.1
471.6
470.9
473.4
476.5
471.8
466.0
453.2
450.9
433.7
10.9
1.0
2.6
1.2
0.8
1.7
0.6
1.4
0.4
0.9
0.4
10.8
0.9
2.7
1.2
0.8
1.6
0.6
1.4
0.4
0.8
0.4
10.8
0.9
2.7
1.2
0.8
1.6
0.5
1.4
0.4
0.8
0.4
10.8
0.9
2.8
1.2
0.8
1.6
0.6
1.5
0.4
0.8
0.3
10.8
0.8
2.8
1.2
0.7
1.6
0.6
1.6
0.5
0.8
0.3
10.8
0.7
2.9
1.2
0.7
1.6
0.6
1.6
0.5
0.8
0.3
10.7
0.7
2.9
1.2
0.6
1.5
0.6
1.6
0.5
0.7
0.3
10.8
0.7
3.0
1.3
0.7
1.5
0.5
1.7
0.5
0.7
0.2
11.1
0.7
3.1
1.3
0.6
1.6
0.6
1.7
0.5
0.7
0.3
11.3
0.6
3.3
1.3
0.6
1.6
0.6
1.8
0.5
0.7
0.3
11.2
0.6
3.3
1.3
0.6
1.5
0.5
2.0
0.5
0.7
0.2
11.2
0.6
3.2
1.2
0.6
1.6
0.5
1.9
0.5
0.6
0.3
11.4
0.6
3.4
1.2
0.6
1.6
0.5
2.0
0.5
0.6
0.3
11.2
0.5
3.4
1.3
0.5
1.5
0.5
2.0
0.5
0.6
0.3
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and Intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and
mesentery
Other digestive organs
91.8
5.0
7.6
1.7
56.4
41.1
15.2
1.4
4.9
1.2
1.3
11.1
0.4
0.4
91.6
5.0
7.5
1.7
56.0
40.9
15.1
1.4
5.2
1.2
1.4
11.2
0.4
0.5
91.2
5.0
7.4
1.8
55.1
40.4
14.8
1.4
5.2
1.2
1.6
11.3
0.4
0.5
90.1
4.9
7.3
1.8
53.8
39.4
14.4
1.4
5.4
1.1
1.7
11.2
0.4
0.6
89.7
5.0
7.3
1.9
52.6
38.5
14.1
1.5
5.6
1.2
1.7
11.5
0.4
0.6
88.7
5.1
7.2
2.0
51.0
37.3
13.8
1.6
5.9
1.1
1.7
11.6
0.4
0.7
87.3
5.0
7.0
2.0
49.6
36.0
13.6
1.6
6.1
1.2
1.7
11.8
0.4
0.6
86.3
5.0
6.8
2.1
48.1
35.0
13.1
1.6
6.3
1.2
1.7
12.0
0.4
0.6
85.6
4.9
6.8
2.1
46.9
34.1
12.8
1.7
6.8
1.1
1.7
12.0
0.4
0.7
84.8
5.0
6.7
2.2
45.7
33.2
12.5
1.7
7.0
1.1
1.7
12.3
0.4
0.7
82.9
4.9
6.6
2.2
43.4
31.3
12.1
1.8
7.4
1.2
1.8
12.2
0.4
0.6
80.7
4.6
6.8
2.3
41.3
29.7
11.6
1.7
7.4
1.2
1.8
12.3
0.4
0.6
80.1
4.6
6.7
2.3
40.4
29.0
11.4
1.8
7.6
1.1
1.8
12.4
0.4
0.6
78.4
4.5
6.6
2.3
38.8
27.7
11.1
1.8
7.8
1.1
1.7
12.4
0.4
0.6
0.3
0.3
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.4
0.5
0.5
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
76.3
0.7
4.6
70.7
0
0.2
75.6
0.7
4.5
70.1
0
0.2
75.4
0.7
4.4
70.1
0
0.2
74.9
0.7
4.1
69.9
0
0.2
74.7
0.7
4.1
69.7
0
0.2
73.9
0.7
4.1
68.8
0
0.2
74.0
0.7
4.0
69.1
0
0.2
73.1
0.7
3.9
68.2
0
0.2
72.1
0.7
3.9
67.3
0
0.2
71.3
0.7
3.8
66.6
0
0.2
69.9
0.7
3.7
65.3
0
0.2
67.5
0.7
3.6
62.9
0
0.2
65.8
0.7
3.5
61.5
0
0.2
64.0
0.7
3.3
59.8
0
0.2
1.0
0.9
1.0
1.0
1.0
1.0
1.0
1.0
1.0
0.9
1.0
0.9
0.9
0.9
2.9
3.0
3.0
3.0
3.1
3.2
3.3
3.2
3.3
3.3
3.3
3.3
3.2
3.2
16.6
15.3
1.3
17.7
16.2
1.4
18.7
17.2
1.5
19.1
17.6
1.5
18.9
17.4
1.5
19.8
18.2
1.5
21.0
19.4
1.6
20.7
19.1
1.6
21.1
19.5
1.6
21.6
19.9
1.7
21.9
20.2
1.7
21.5
19.8
1.6
21.9
20.2
1.6
21.7
20.1
1.6
74.3
135.2
1.4
72.7
132.8
1.3
72.3
132.3
1.2
70.6
129.3
1.3
66.9
122.9
1.3
66.1
121.5
1.3
65.7
121.0
1.3
66.0
121.9
1.3
66.7
123.2
1.3
67.2
124.4
1.4
67.6
125.3
1.3
65.3
121.2
1.4
66.3
123.2
1.3
65.7
122.3
1.3
US Department of Health and Human Services/Centers for Disease Control and Prevention
55
TABLE 15. (Continued) Age-adjusted rate* of invasive cancer cases, by primary cancer site and year United States, 19992012
Cancer site
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
51.9
9.7
24.2
23.4
0.8
14.3
0.7
2.4
0.6
51.6
9.6
23.8
23.1
0.8
14.4
0.8
2.3
0.7
51.4
9.1
24.3
23.6
0.8
14.2
0.7
2.4
0.7
50.4
8.7
24.0
23.3
0.8
13.8
0.7
2.4
0.7
49.0
8.4
23.2
22.5
0.8
13.6
0.7
2.4
0.7
48.9
8.2
23.8
23.0
0.7
13.2
0.7
2.3
0.7
49.1
8.2
24.0
23.3
0.7
13.1
0.6
2.4
0.7
49.1
8.1
24.2
23.4
0.7
13.0
0.7
2.4
0.7
49.3
8.1
24.5
23.8
0.7
12.7
0.7
2.5
0.8
49.6
7.9
24.9
24.1
0.8
12.7
0.7
2.5
0.9
49.9
8.0
25.4
24.6
0.8
12.2
0.7
2.5
0.9
49.0
7.6
25.4
24.6
0.8
11.8
0.7
2.5
1.0
49.1
7.5
25.7
24.9
0.8
11.6
0.7
2.5
1.1
48.9
7.4
25.8
25.0
0.8
11.3
0.7
2.6
1.2
176.5
170.0
5.3
0.9
0.2
178.4
171.9
5.4
0.9
0.3
180.6
174.1
5.4
0.9
0.2
178.4
172.0
5.3
0.9
0.2
163.7
157.1
5.5
0.9
0.2
159.7
153.1
5.5
0.8
0.2
156.4
149.7
5.6
0.8
0.2
166.0
159.5
5.5
0.8
0.2
170.1
163.4
5.5
0.9
0.2
157.0
150.1
5.7
0.9
0.3
148.7
142.0
5.6
0.8
0.2
139.2
132.5
5.6
0.8
0.2
137.5
130.9
5.5
0.9
0.2
111.7
105.1
5.5
0.8
0.2
35.2
22.0
12.3
0.6
0.3
35.7
22.1
12.7
0.6
0.3
36.1
21.9
13.3
0.6
0.3
36.6
22.0
13.7
0.6
0.2
37.1
22.0
14.3
0.6
0.3
37.8
22.2
14.7
0.6
0.3
38.2
22.2
15.2
0.6
0.3
38.1
21.5
15.7
0.6
0.3
38.5
21.7
16.0
0.6
0.3
38.7
21.5
16.2
0.6
0.3
38.4
21.3
16.2
0.6
0.3
37.5
20.9
15.8
0.6
0.3
37.4
20.7
15.8
0.6
0.3
37.1
20.4
15.9
0.6
0.3
0.9
0.9
0.9
0.8
0.9
0.9
0.9
0.9
0.9
0.9
0.9
0.8
0.8
0.8
6.9
6.4
0.5
6.9
6.4
0.5
6.8
6.3
0.5
6.9
6.4
0.5
6.8
6.3
0.5
6.9
6.4
0.5
6.9
6.4
0.5
6.8
6.4
0.4
6.8
6.4
0.5
6.8
6.4
0.5
6.8
6.3
0.5
6.6
6.2
0.4
6.5
6.1
0.4
6.4
6.0
0.4
Endocrine system
Thyroid
Other endocrine including thymus
7.5
6.8
0.7
8.1
7.4
0.7
8.6
7.9
0.7
9.2
8.5
0.7
9.6
8.9
0.7
10.4
9.6
0.8
11.2
10.5
0.8
11.8
11.1
0.8
12.7
11.9
0.8
13.7
12.9
0.8
14.3
13.6
0.7
14.5
13.7
0.8
14.7
14.0
0.7
15.2
14.5
0.7
22.2
2.8
19.3
22.1
2.9
19.2
22.2
2.8
19.4
22.4
2.9
19.5
22.6
2.8
19.8
22.9
2.9
20.1
22.9
2.9
19.9
22.6
2.9
19.7
22.6
2.9
19.8
22.7
2.9
19.7
22.6
2.8
19.8
22.4
2.8
19.5
21.8
2.7
19.0
21.3
2.6
18.6
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
Myeloma
5.6
5.8
5.9
5.9
5.9
6.0
6.0
5.9
5.9
6.1
6.2
6.3
6.3
6.3
12.9
1.4
4.1
3.7
1.6
1.9
13.4
1.5
4.5
3.9
1.7
1.9
13.5
1.5
4.6
3.9
1.7
1.9
13.1
1.5
4.6
3.7
1.5
1.8
13.4
1.5
4.7
3.8
1.6
1.8
13.4
1.6
4.8
3.7
1.6
1.7
13.3
1.5
4.8
3.6
1.6
1.7
13.4
1.6
4.8
3.7
1.6
1.7
13.2
1.6
4.6
3.6
1.6
1.8
13.2
1.6
4.6
3.7
1.6
1.7
13.2
1.6
4.5
3.7
1.7
1.7
13.6
1.6
4.4
4.1
1.8
1.8
13.5
1.7
4.4
4.1
1.7
1.7
13.3
1.6
4.3
4.1
1.7
1.6
Mesothelioma
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.0
1.0
1.0
1.0
1.0
1.0
Kaposi Sarcoma
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.4
0.4
0.4
0.4
0.4
12.6
12.4
12.1
11.8
11.2
10.9
10.7
10.5
10.3
10.1
9.8
9.9
9.6
9.4
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
Miscellaneous
56
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 16. Age-adjusted rate* of cancer deaths, by primary cancer site and year United States, 19992012
Cancer site
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
200.7
198.8
196.3
194.4
190.9
186.8
185.2
182.0
179.3
176.3
173.4
171.8
168.7
166.4
2.7
0
0.6
0.2
0.1
0.4
0.2
0.2
0.2
0.1
0.5
2.7
0
0.6
0.2
0.1
0.4
0.2
0.2
0.2
0.1
0.6
2.7
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.6
2.7
0
0.7
0.3
0.1
0.4
0.2
0.2
0.2
0.1
0.5
2.6
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.6
2.6
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.5
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.5
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.5
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.5
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.5
2.4
0
0.6
0.2
0
0.3
0.2
0.2
0.2
0.1
0.4
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.4
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.5
2.5
0
0.6
0.2
0
0.4
0.2
0.2
0.2
0.1
0.4
Digestive system
Esophagus
Stomach
Small intestine
Colon and rectum
Colon excluding rectum
Rectum and rectosigmoid junction
Anus, anal canal, and anorectum
Liver and intrahepatic bile duct
Gallbladder
Other biliary
Pancreas
Retroperitoneum
Peritoneum, omentum, and
mesentery
Other digestive organs
47.5
4.3
4.6
0.4
20.9
17.9
3.0
0.2
4.5
0.8
0.6
10.6
0.1
0.2
47.3
4.4
4.5
0.4
20.7
17.6
3.0
0.2
4.6
0.7
0.6
10.5
0.1
0.2
46.7
4.4
4.4
0.4
20.2
17.1
3.0
0.2
4.7
0.7
0.6
10.6
0.1
0.2
46.2
4.4
4.3
0.4
19.8
16.8
3.0
0.2
4.9
0.7
0.5
10.6
0.1
0.2
45.6
4.4
4.2
0.4
19.1
16.2
2.9
0.2
5.0
0.7
0.5
10.5
0.1
0.2
44.5
4.4
4.0
0.4
18.1
15.2
2.9
0.2
5.1
0.7
0.5
10.7
0.1
0.2
44.1
4.4
3.8
0.4
17.6
14.7
2.9
0.2
5.3
0.7
0.5
10.8
0.1
0.2
43.8
4.4
3.7
0.4
17.3
14.4
2.9
0.2
5.3
0.7
0.5
10.9
0.1
0.2
43.3
4.3
3.6
0.3
16.9
14.1
2.8
0.2
5.4
0.6
0.5
10.8
0.1
0.2
43.0
4.2
3.5
0.4
16.5
13.6
2.9
0.2
5.6
0.6
0.4
11.0
0.1
0.2
42.3
4.2
3.4
0.4
15.8
13.0
2.8
0.2
5.8
0.6
0.4
10.8
0.1
0.2
42.3
4.3
3.4
0.4
15.5
12.6
2.9
0.2
5.9
0.6
0.5
11.0
0.1
0.2
41.8
4.2
3.3
0.4
15.1
12.3
2.8
0.2
6.1
0.6
0.4
10.9
0.1
0.2
41.6
4.1
3.2
0.4
14.7
12.0
2.7
0.3
6.3
0.6
0.4
11.0
0.1
0.2
0.4
0.3
0.3
0.3
0.3
0.2
0.2
0.3
0.3
0.3
0.3
0.3
0.3
0.3
Respiratory system
Nose, nasal cavity, and middle ear
Larynx
Lung and bronchus
Pleura
Trachea, mediastinum, and other
respiratory organs
57.1
0.2
1.4
55.4
0
0.1
57.5
0.2
1.4
55.8
0
0.1
57.0
0.2
1.3
55.3
0
0.1
56.6
0.2
1.3
55.0
0
0.1
55.8
0.2
1.3
54.2
0
0.1
54.8
0.2
1.2
53.4
0
0.1
54.3
0.2
1.2
52.9
0
0.1
53.2
0.1
1.2
51.7
0
0.1
52.1
0.2
1.1
50.7
0
0.1
51.0
0.2
1.2
49.6
0
0.1
49.7
0.2
1.1
48.4
0
0.1
48.7
0.1
1.1
47.4
0
0.1
47.3
0.1
1.1
46.0
0
0.1
46.2
0.1
1.0
45.0
0
0.1
0.4
0.4
0.5
0.4
0.4
0.4
0.5
0.4
0.4
0.4
0.4
0.4
0.4
0.4
1.3
1.3
1.3
1.2
1.2
1.3
1.3
1.3
1.3
1.3
1.3
1.3
1.3
1.3
3.5
3.5
3.5
3.4
3.5
3.5
3.6
3.6
3.6
3.5
3.7
3.6
3.6
3.6
2.6
0.8
2.7
0.8
2.7
0.9
2.6
0.8
2.7
0.8
2.7
0.8
2.8
0.8
2.7
0.8
2.7
0.9
2.7
0.8
2.8
0.9
2.7
0.9
2.7
0.9
2.7
0.9
15.2
26.6
0.3
15.2
26.6
0.4
14.8
26.0
0.4
14.5
25.6
0.3
14.3
25.3
0.3
13.8
24.5
0.3
13.6
24.1
0.3
13.2
23.6
0.3
12.9
23.0
0.3
12.7
22.6
0.3
12.4
22.2
0.3
12.3
21.9
0.3
12.0
21.5
0.3
11.8
21.3
0.3
US Department of Health and Human Services/Centers for Disease Control and Prevention
57
TABLE 16. (Continued) Age-adjusted rate* of cancer deaths, by primary cancer site and year United States, 19992012
Cancer site
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
16.7
2.8
4.1
2.0
2.1
8.8
0.2
0.5
0.3
16.7
2.8
4.1
2.0
2.1
8.9
0.2
0.4
0.3
16.8
2.7
4.2
2.0
2.2
9.0
0.2
0.5
0.3
16.7
2.6
4.2
1.9
2.2
9.0
0.2
0.5
0.3
16.4
2.5
4.1
2.0
2.2
8.9
0.2
0.4
0.2
16.2
2.4
4.1
1.9
2.2
8.8
0.2
0.5
0.2
16.0
2.4
4.1
1.9
2.2
8.7
0.2
0.5
0.2
16.1
2.4
4.2
2.0
2.2
8.6
0.2
0.5
0.2
15.8
2.4
4.2
1.9
2.3
8.3
0.2
0.5
0.2
15.5
2.4
4.2
1.9
2.3
8.0
0.2
0.5
0.2
15.2
2.3
4.2
1.8
2.4
7.9
0.2
0.5
0.2
15.5
2.3
4.5
1.9
2.5
7.8
0.2
0.5
0.3
15.3
2.3
4.5
1.9
2.6
7.5
0.2
0.5
0.3
15.2
2.3
4.5
1.9
2.6
7.4
0.2
0.5
0.3
32.1
31.6
0.3
0.2
0
30.9
30.4
0.2
0.2
0
30.0
29.5
0.2
0.2
0
29.2
28.7
0.3
0.2
0
27.7
27.2
0.2
0.2
0
26.7
26.2
0.3
0.2
0
25.8
25.4
0.2
0.2
0
24.7
24.2
0.2
0.2
0
24.7
24.2
0.2
0.2
0
23.5
23.0
0.2
0.2
0
22.6
22.1
0.3
0.2
0
22.3
21.8
0.3
0.2
0
21.2
20.8
0.3
0.2
0
20.0
19.6
0.3
0.2
0
Urinary system
Urinary bladder
Kidney and renal pelvis
Ureter
Other urinary organs
8.7
4.4
4.1
0.1
0.1
8.8
4.3
4.2
0.1
0.1
8.8
4.3
4.3
0.1
0.1
8.9
4.4
4.2
0.1
0.1
8.7
4.3
4.2
0.1
0.1
8.8
4.4
4.1
0.1
0.1
8.8
4.4
4.1
0.1
0.1
8.7
4.4
4.0
0.1
0.1
8.7
4.4
4.0
0.1
0.1
8.6
4.4
4.0
0.1
0.1
8.5
4.4
3.9
0.1
0.1
8.6
4.4
3.9
0.1
0.1
8.6
4.4
3.9
0.1
0.1
8.5
4.4
3.8
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
0.1
4.6
4.5
4.4
4.5
4.4
4.3
4.3
4.2
4.2
4.3
4.3
4.2
4.3
4.4
Endocrine system
Thyroid
Other endocrine including thymus
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.7
0.4
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
0.8
0.5
0.3
Lymphomas
Hodgkin lymphoma
Non-Hodgkin lymphoma
8.8
0.5
8.3
8.6
0.5
8.2
8.4
0.5
7.9
8.1
0.5
7.7
7.8
0.5
7.4
7.5
0.4
7.1
7.4
0.4
6.9
7.2
0.4
6.7
7.0
0.4
6.6
6.8
0.4
6.4
6.7
0.4
6.3
6.5
0.4
6.1
6.4
0.4
6.0
6.2
0.3
5.9
Myeloma
3.8
3.8
3.8
3.8
3.7
3.6
3.6
3.5
3.5
3.3
3.3
3.3
3.4
3.4
Leukemias
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Other leukemias
7.7
0.5
1.6
2.5
0.7
2.4
7.7
0.5
1.6
2.7
0.6
2.3
7.6
0.5
1.6
2.7
0.6
2.2
7.5
0.5
1.6
2.8
0.5
2.2
7.4
0.5
1.5
2.8
0.4
2.2
7.3
0.5
1.5
2.8
0.4
2.2
7.3
0.5
1.5
2.8
0.4
2.2
7.2
0.5
1.5
2.8
0.4
2.1
7.1
0.5
1.4
2.8
0.3
2.1
7.1
0.5
1.4
2.8
0.3
2.1
7.1
0.5
1.4
2.9
0.3
2.0
6.9
0.5
1.4
2.8
0.3
2.0
6.9
0.4
1.4
2.8
0.3
2.0
6.8
0.4
1.3
2.8
0.3
2.0
Mesothelioma
0.9
0.9
0.8
0.9
0.9
0.9
0.9
0.8
0.8
0.8
0.8
0.8
0.8
0.8
Miscellaneous
16.2
14.8
14.4
14.4
14.0
13.5
13.4
13.0
12.7
12.4
12.2
11.9
11.7
11.5
58
US Department of Health and Human Services/Centers for Disease Control and Prevention
Preface
CDCs National Institute for Occupational Safety and
Health (NIOSH) and state health departments collect data
on laboratory-reported adult blood lead levels (BLLs). This
report presents data on elevated BLLs among employed adults
(defined as persons aged 16 years) in the United States for
19942013. This report is a part of the Summary of Notifiable
Noninfectious Conditions and Disease Outbreaks United States,
which encompasses various surveillance years but is being
published in 2016 (1). The Summary of Notifiable Noninfectious
Conditions and Disease Outbreaks appears in the same volume of
the Morbidity Mortality Weekly Report (MMWR) as the annual
Summary of Notifiable Infectious Diseases (2).
Background
Since 1987, NIOSH and state health departments have
maintained the Adult Blood Lead Epidemiology and
Surveillance (ABLES) Program, a state-based surveillance
program of laboratory-reported adult BLLs (3). The BLL
is an often-used estimate of recent external exposure to lead
(4,5). This report summarizes data on elevated BLLs among
employed adults during January 1, 1994December 31, 2013.
Information is provided by geographic division and
reporting state, for all cases reported by a state (these include
cases among adult residents in the reporting state plus cases
identified by the reporting state but occurring among persons
who reside in another state) and state-residents only, by
exposure source, for BLLs 10 g/dL (definition of elevated
BLL from 2009 until 2014) (3,68), and for BLLs 25 g/dL
(previous definition of elevated BLL) (9). The current case
definition (BLL 5 g/dL) was adopted in 2015 and became
effective in 2016, on the basis of mounting evidence for adverse
health outcomes among adults with BLLs between 5 g/dL
and 25 g/dL (4,5). State prevalence rates of elevated BLLs
(10 g/dL) for 2013 are categorized into two groups (above
Corresponding author: Walter Alarcon, National Institute for
Occupational Safety and Health, CDC. Telephone: 513-841-4451;
E-mail: wda7@cdc.gov.
US Department of Health and Human Services/Centers for Disease Control and Prevention
59
Data Sources
The ABLES program is a state-based surveillance system
of adult BLLs. The number of cases (numerator) is currently
provided by ABLES programs in 30 states (29 states provided
data on BLLs 10 g/dL). The number of employed adults
(denominator) is obtained from the Local Area Unemployment
Statistics (LAUS), Bureau of Labor Statistics, in the U.S.
Department of Labor (http://www.bls.gov/data). A direct link
to annual averages of states employment status of the civilian
noninstitutionalized population is available (http://www.bls.
gov/lau/staadata.txt). NIOSH consolidates data from reporting
state ABLES programs, conducts data quality control, analyzes
the data, and disseminates the findings among stakeholders.
State ABLES programs 1) collect data on adult BLLs from
laboratories and physicians through mandatory reporting;
2) assign unique identifiers to each adult to account for
multiple BLL records per person, protect individual privacy,
and permit longitudinal analyses; 3) follow-up on adults with
BLLs 10 or 25 g/dL with laboratories, health care providers,
employers, or workers to ensure completeness of information
(e.g., the industry in which the adult is employed and whether
the exposure source is occupational, nonoccupational, or both);
4) provide guidance and information to workers and employers
to prevent lead exposures; and 5) submit data annually to
NIOSH. Most ABLES states submit data on all BLLs (both
occupational and nonoccupational) to NIOSH, including
records from adults whose BLLs fall below the state mandatory
reporting requirement.
Interpreting Data
The primary measure of adult lead exposure in the United
States is the national prevalence rate of elevated BLLs among
employed adults. This measure is provided by the ABLES
program and can be used to estimate the magnitude and
monitor trends of lead exposures and to target areas requiring
further investigation or interventions.
60
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE 2. National prevalence rate* of reported cases of elevated blood lead levels, by year State Adult Blood Epidemiology and
Surveillance Programs, United States, 19942013
30
25
Rate
20
15
10
1994
(17)
1995
(18)
1996
(20)
1997
(24)
1998
(24)
1999
(25)
2000
(25)
2001
(23)
2002
(35)
2003
(36)
2004
(37)
2005
(37)
2006
(38)
2007
(38)
2008
(40)
Year
(No. of reporting states)
Abbreviation: BLL = blood lead level.
* Per 100,000 employed adults aged 16 years. Denominator data extracted from 2015 U.S. Department of Labor, Bureau of labor Statistics Local Area Unemployment
Statistics (LAUS) program (http://www.bls.gov/lau/staadata.txt).
Since 2009, the case definition for an elevated blood lead level is a BLL 10 g/dL. For historical comparisons, prevalence rates at the previous case definition
(BLL 25 g/dL) are provided.
A total of 30 states submitted data in 2013 (down from 41 states in 2012): Alabama, Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois,
Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Jersey, New Mexico, New York, North Carolina, Oklahoma,
Oregon, Pennsylvania, Vermont, Washington, Wisconsin, Wyoming. Massachusetts provided data for BLLs 25 g/dL. For 2013, the first number is the number of
states reporting BLLs 25 g/dL (i.e., 30 states in 2013), and the second number is the number of states reporting BLLs 10 g/dL (i.e., 29 states in 2013).
US Department of Health and Human Services/Centers for Disease Control and Prevention
61
Publication Criteria
Cases meet the publication criteria if the employed adult
(aged 16 years) had a venous BLL 25 g/dL during 1994
2013 or a venous BLL 10 g/dL during 20102013. When
an adult had multiple blood lead tests in a given year, only the
highest BLL for that adult in that year was counted. Prevalence
rates of BLLs 25 g/dL are a subset of prevalence rates of
BLLs 10 g/dL and are included for historic comparison.
Highlights
In 2013, the prevalence rate of BLLs 10 g/dL was 20.4
adults per 100,000 employed population, calculated from
29 reporting states. In 2013, a total of 30 states submitted data
on 5,504 adults with BLLs 25 g/dL, and 29 states submitted
data on 20,880 adults with BLLs 10g/dL (Table 1). A total
of 23 states submitted individual level data, and seven states
submitted count data only. Overall, the national prevalence
rate of BLLs 10 g/dL declined from 26.6 adults per
100,000 employed in 2010 (among 37 states) to 20.4 in 2013
(among 29 reporting states). In 2013, of the 29 reporting
states, 12 had prevalence rates of BLLs 10g/dL equal to or
above the national prevalence rate (20.4/100,000) (Figure 1).
The national prevalence rate of BLLs 25 g/dL among state
residents and nonresidents declined from 14.0 adults per
62
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 1. Reported numbers of cases and prevalence rates of adults* with blood lead levels 10 g/dL and blood lead levels 25 g/dL, by
geographic division and area state Adult Blood Lead Epidemiology and Surveillance programs, United States, 2013
Division/State
Total
New England
Connecticut
Massachusetts
Vermont
Mid Atlantic
New Jersey
New York
Pennsylvania
East North Central
Illinois
Indiana
Michigan
Wisconsin
West North Central
Iowa
Minnesota
Missouri
Nebraska
South Atlantic
Florida
Georgia
Maryland
North Carolina
East South Central
Alabama
Kentucky
West South Central
Louisiana
Oklahoma
Mountain
Arizona
Colorado
New Mexico
Wyoming
Pacific
Alaska
California
Oregon
Washington
No. of employed
state-resident
adults (in 1,000s)
105,474
1,724
3,272
336
State residents**
All cases
State residents
No.
(Rate)
No.
(Rate)
No.
(Rate)
No.
(Rate)
20,880
(20.4)
19,603
(19.2)
5,504
(5.2)
5,183
(4.9)
(19.2)
()
(14.0)
313
47
(18.2)
()
(14.0)
62
126
12
(3.6)
(3.9)
(3.6)
61
105
12
(3.5)
(3.2)
(3.6)
331
47
4,164
8,891
5,964
832
1,873
2,928
(20.0)
(21.1)
(49.1)
832
1,731
2,915
(20.0)
(19.5)
(48.9)
158
295
1,533
(3.8)
(3.3)
(25.7)
158
270
1,527
(3.8)
(3.0)
(25.6)
5,961
2,947
4,306
2,877
1,279
596
596
687
(21.5)
(20.2)
(13.8)
(23.9)
1,253
596
595
686
(21.0)
(20.2)
(13.8)
(23.8)
283
113
108
105
(4.7)
(3.8)
(2.5)
(3.7)
279
113
108
105
(4.7)
(3.8)
(2.5)
(3.7)
1,594
2,819
2,814
983
856
598
3,145
195
(53.7)
(21.2)
(111.8)
(19.8)
856
598
2,835
195
(53.7)
(21.2)
(100.8)
(19.8)
202
107
690
32
(12.7)
(3.8)
(24.5)
(3.3)
202
107
613
32
(12.7)
(3.8)
(21.8)
(3.3)
8,783
4,368
2,917
4,310
888
898
275
219
(10.1)
(20.6)
(9.4)
(5.1)
863
897
234
218
(9.8)
(20.5)
(8.0)
(5.1)
270
237
75
99
(3.1)
(5.4)
(2.6)
(2.3)
266
237
62
99
(3.0)
(5.4)
(2.1)
(2.3)
2,012
1,892
928
478
(46.1)
(25.3)
548
468
(27.2)
(24.7)
433
94
(21.5)
(5.0)
299
92
(14.9)
(4.9)
1,965
1,707
380
144
(19.3)
(8.4)
380
121
(19.3)
(7.1)
92
29
(4.7)
(1.7)
92
27
(4.7)
(1.6)
2,804
2,591
859
292
178
103
48
66
(6.3)
(4.0)
(5.6)
(22.6)
178
41
48
66
(6.3)
(1.6)
(5.6)
(22.6)
20
29
13
12
(0.7)
(1.1)
(1.5)
(4.1)
20
15
13
12
(0.7)
(0.6)
(1.5)
(4.1)
340
17,003
1,761
3,217
123
1,825
92
272
(36.1)
(10.7)
(5.2)
(8.5)
62
1,790
79
158
(18.2)
(10.5)
(4.5)
(4.9)
8
192
12
63
(2.4)
(1.1)
(0.7)
(2.0)
6
191
9
51
(1.8)
(1.1)
(0.5)
(1.6)
* An employed person aged 16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level
for that adult in that year was counted. Rate per 100,000 employed adults. Data from the Adult Blood Epidemiology and Surveillance (ABLES) Program, National
Institute for Occupational Safety and Health (NIOSH/CDC). Denominators extracted from 2015 U.S. Department of Labor, Bureau of Labor Statistics, Local Area
Unemployment Statistics (LAUS) program (http://www.bls.gov/lau/staadata.txt).
A total of 30 states participated in the ABLES Program in 2013.
The numbers and rates of adults with BLLs 25 g/dL are subsets of the numbers and rates of adults with BLLs 10 g/dL.
All cases reported by a state. These include cases among adult residents in the reporting state plus cases identified by the reporting state but who reside in another state.
** Adults residing in the reporting state.
1015 g/dL BLL data were not available.
Data from Arizona were available only for January to August 2013.
US Department of Health and Human Services/Centers for Disease Control and Prevention
63
TABLE 2. Reported numbers of adults* with blood lead levels 25 g/dL, by exposure source and area state Adult Blood Lead Epidemiology
and Surveillance programs, United States, 2013
Occupational
Division/State
Total
New England
Connecticut
Massachusetts
Vermont
Mid Atlantic
New Jersey
New York
Pennsylvania
East North Central
Illinois
Indiana
Michigan
Wisconsin
West North Central
Iowa
Minnesota
Missouri
Nebraska
South Atlantic
Florida
Georgia
Maryland
North Carolina
East South Central
Alabama
Kentucky
West South Central
Louisiana
Oklahoma
Mountain
Arizona
Colorado
New Mexico
Wyoming
Pacific
Alaska
California
Oregon
Washington
Nonoccupational
Unknown
Total
No.
(%)
No.
(%)
No.
(%)
No.
4,262
(77.6)
285
(5.2)
944
(17.2)
5,491
37
71
3
(59.7)
(56.3)
(25.0)
23
24
4
(37.1)
(19.0)
(33.3)
2
31
5
(3.2)
(24.6)
(41.7)
62
126
12
105
191
1,449
(66.5)
(64.7)
(94.5)
78
()
(26.4)
()
53
26
84
(33.5)
(8.8)
(5.5)
158
295
1,533
177
67
70
88
(62.5)
(59.3)
(64.8)
(83.8)
14
28
9
(4.9)
()
(25.9)
(8.6)
92
46
10
8
(32.5)
(40.7)
(9.3)
(7.6)
283
113
108
105
200
92
682
25
(99.0)
(86.0)
(98.8)
(78.1)
2
3
8
2
(1.0)
(2.8)
(1.2)
(6.3)
12
()
(11.2)
()
(15.6)
202
107
690
32
82
100
57
89
(30.4)
(42.2)
(76.0)
(89.9)
11
4
8
(4.1)
()
(5.3)
(8.1)
177
137
14
2
(65.6)
(57.8)
(18.7)
(2.0)
270
237
75
99
353
(81.5)
()
()
()
80
94
(18.5)
(100.0)
433
94
78
7
(92.9)
(24.1)
5
2
(6.0)
(6.9)
1
20
(1.2)
(69.0)
84
29
12
4
4
12
(80.0)
(13.8)
(30.8)
(100.0)
3
3
3
(20.0)
(10.3)
(23.1)
()
22
6
()
(75.9)
(46.2)
()
15
29
13
12
5
146
7
49
(62.5)
(76.0)
(58.3)
(77.8)
45
1
5
()
(23.4)
(8.3)
(7.9)
3
1
4
9
(37.5)
(0.5)
(33.3)
(14.3)
8
192
12
63
* An employed person aged 16 years at the time of blood collection. When an adult had multiple blood lead tests in a given year, only the highest blood lead level
for that adult in that year was counted.
Among the 30 reporting states, 29 states submitted data on exposure source in 2013. These data include adult residents in the state and residents of other states
reported by the state ABLES programs.
Includes 23 cases coded with both occupational and nonoccupational exposure source.
No cases were reported.
64
US Department of Health and Human Services/Centers for Disease Control and Prevention
References
1. CDC. Summary of notifiable noninfectious conditions and disease
outbreaksUnited States. MMWR Morb Mortal Wkly Rep 2014;63(55).
2. CDC. Summary of notifiable infectious diseases and conditionsUnited
States, 2014. MMWR Morb Mortal Wkly Rep 2014;63(54).
3. CDC. Adult Blood Lead Epidemiology and Surveillance (ABLES)
Program. Cincinnati, OH: US Department of Health and Human
Services, CDC, National Institute for Occupational Safety and Health;
2015. http://www.cdc.gov/niosh/topics/ables/description.html
4. Association of Occupational and Environmental Clinics. Medical
management guidelines for lead-exposed adults. Washington, DC:
Association of Occupational and Environmental Clinics; 2013. http://
www.aoec.org/documents/positions/mmg_revision_with_cste_2013.pdf
5. Kosnett MJ, Wedeen RP, Rothenberg SJ, et al. Recommendations for
medical management of adult lead exposure. Environ Health Perspect
2007;115:46371. http://dx.doi.org/10.1289/ehp.9784
6. CDC. National Notifiable Diseases Surveillance System. Lead, elevated
blood levels. 2016 Case definition; 2015. Atlanta, GA: US Department
of Health and Human Services, CDC; 2015. https://wwwn.cdc.gov/
nndss/conditions/lead-elevated-blood-levels/case-definition/2016/
7. Council of State and Territorial Epidemiologists. Position Statement
09-OH-02. Public health reporting and national notification for elevated
blood: lead levels. Atlanta, GA: Council of State and Territorial
Epidemiologists; 2009. http://c.ymcdn.com/sites/www.cste.org/
resource/resmgr/PS/09-OH-02.pdf
State Adult Blood Lead Epidemiology and Surveillance (ABLES) Program Investigators
Sherri Davidson, MPH, Alabama Department of Public Health; Brigitte Dufour, Matthew Roach, MPH, Kaleb Tsang, MS, Arizona Department of Health
Services; Susan F. Payne, MA, California Department of Public Health; Amanda M. DeLoreto, MPH, Thomas St. Louis, MSPH, Connecticut Department of
Public Health; Sudha Rajagopalan, MPH, Sharon Watkins, PhD, Juanita Chalmers, MPH, Florida Department of Health; Tiefu Shen, Illinois Department of
Public Health; Jeffery M. Turner, Indiana State Department of Health; Kathy Leinenkugel, MPA, Iowa Department of Public Health; MaAdwoa Asamoah, MPH,
Kentucky Department for Public Health; Jocelyn Lewis, PhD, Louisiana Department of Health and Hospitals; Ezattolah Keyvan, MD, Maryland Department
of the Environment; Kenneth Roseman MD, Joanna Kica, MPA, Michigan State University; Stephanie Yendell, DVM, Minnesota Department of Health; Carol
R. Braun, Missouri Department of Health and Senior Services; Derry Stover, MPH, Nebraska Department of Health and Human Services; Marija Borjan, PhD,
Margaret E. Lumia, PhD, Devendra Singh, New Jersey Department of Health; Edward O. Irobi, PhD, Heidi Krapfl, New Mexico Department of Health; Alicia
M. Fletcher, MPH, New York State Department of Health; Sheila Higgins, MPH, North Carolina Division of Public Health; Susan J. Quigley, Christin T. Benner,
MPH, Oklahoma State Health Department; David Dreher, Oregon Health Authority; Tanecia Richardson, Pennsylvania Department of Health; Mike Sullivan,
MBA, Vermont Department of Health; Carrie Tomasallo, PhD, Wisconsin Department of Health Services; Steve Melia, MSPH, Wyoming Department of Health;
and ABLES Programs coordinators in Alaska Department of Health and Social Services; Colorado Department of Public Health and Environment; Georgia Department of Public Health; Massachusetts Department of Labor Standards; Washington Department of Labor and Industries.
US Department of Health and Human Services/Centers for Disease Control and Prevention
65
Preface
This report provides data concerning childhood blood lead
levels (BLLs) in the United States during 20072013. These
data were collected and compiled from raw data extracts sent by
state and local health departments to CDCs Childhood Blood
Lead Surveillance (CBLS) system. These raw data extracts
have been de-identified and coded into a format specifically
for childhood lead reporting. The numbers of children aged
<5 years reported to CDC for 2013 with newly confirmed
BLLs 10 g/dL are provided in tabular form by month
(Table 1) and geographic location (Table 2). The incidence
of BLLs 10 g/dL is reported by age group for 20072013
(Table 3). The numbers of children aged <5 years with BLLs
59 g/dL for 2013 are reported (Table 4). For the period
20072013, the numbers of children newly confirmed with
BLLs 70 g/dL are summarized (Figure 1) as well as the
percentage of children with BLLs 5 g/dL (Figure 2). This
report is a part of the Summary of Notifiable Noninfectious
Conditions and Disease Outbreaks United States, which
encompasses various surveillance years but is being published in
2016 (1). The Summary of Notifiable Noninfectious Conditions
and Disease Outbreaks appears in the same volume of MMWR
as the annual Summary of Notifiable Infectious Diseases (2).
Background
Permanent neurologic damage and behavioral disorders have
been found to be associated with lead exposure at blood levels
at or below 5 g/dL (36). No safe BLLs in children have been
identified (7). Studies examining children with high BLLs
(70 g/dL) have shown severe neurologic problems, including
seizures, comas, and death (8). Children aged <5 years are at
increased risk because their bodies are growing rapidly and
they tend to put their hands or other objects, which might be
contaminated with lead dust, into their mouths.
Corresponding author: Jaime Raymond, Division of Emergency and
Environmental Health Services, National Center for Environmental
Health, CDC. Telephone: 770-488-3627; E-mail: zvu0@cdc.gov.
66
Data Sources
Results of blood lead tests for children from state and local
health departments were sent to CDCs Healthy Homes and
Lead Poisoning Prevention Program (HHLPPP). When federal
funding was available, prior to 2013, states submitted data on
a quarterly basis. After funding ended in 2012, a total of 27
states, the District of Columbia, and New York City continued
* ACCLPP advised and guided the Secretary and Assistant Secretary of the U.S.
Department of Health and Human Services and the Director of CDC regarding
new scientific knowledge and technical developments and their practical
implications for childhood lead poisoning prevention efforts (http://www.cdc.
gov/nceh/lead/acclpp/acclpp_main.htm).
NHANES is a program of studies designed to assess the health and nutritional
status of adults and children in the United States (http://www.cdc.gov/nchs/
nhanes.htm).
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 1. Number and percentage of reported new cases of blood lead levels 10 g/dL among children aged <5 years, by month Childhood
Blood Lead Surveillance System, United States, 2013*
Jan
No. (%)
Feb
No. (%)
Mar
No. (%)
Apr
No. (%)
May
No. (%)
June
No. (%)
538 (6.5)
469 (5.7)
416 (5.1)
543 (6.6)
718 (8.7)
739 (9.0)
July
No. (%)
Aug
No. (%)
Sept
No. (%)
Oct
No. (%)
Nov
No. (%)
Dec
No. (%)
Total No.
823 (10.0)
566 (6.0)
453 (5.5)
8,230
* A total of 29 jurisdictions reported data to CDC (Alabama, Arizona, Connecticut, District of Columbia, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland,
Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Hampshire, New Mexico, New York City, North Carolina, Ohio, Oklahoma, Oregon,
Pennsylvania, Rhode Island, Tennessee, Vermont, West Virginia, and Wisconsin).
Region/State
Region/State
No.
269
72
49
71
77
241
120
121
83
69
14
New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont
Mid-Atlantic
New Jersey
New York
New York City
Pennsylvania
Eastern North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin
Western North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota
South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia
No.
8,230
1,003
264
*
472
75
163
29
2,472
593
639
1,240
2,997
1094
183
335
941
444
604
126
478
553
27
136
268
95
27
US Department of Health and Human Services/Centers for Disease Control and Prevention
67
2010**
2011
2012
2013
14 yrs
No.
Rate
No.
Rate
2,055
1,852
1,608
1,412
1,185
860
777
47.75
43.00
38.69
34.05
29.89
21.81
19.55
18,398
15,251
13,432
11,647
10,532
9,369
7,453
110.72
90.41
78.76
68.05
65.25
58.31
46.89
68
TABLE 4. Number of children aged <5 years with blood lead levels
59 g/dL, by sample type and age Childhood Blood Lead
Surveillance System, United States, 2013*
Capillary/Unknown (%)
Venous (%)
3,960 (61.2)
14,035 (56.4)
11,999(57.2)
6,728 (57.2)
5,609 (56.0)
42,331 (57.1)
2,510 (38.8)
10,866 (43.6)
8,967 (42.8)
5,028 (42.8)
4,408 (44.0)
31,779 (42.9)
Interpreting Data
In this report, state surveillance data are presented for
children aged <5 years who were tested for lead at least once
during 20072013 and whose tests were reported to CDC.
Having a confirmed BLL 10 g/dL is defined as having one
venous blood lead test 10 g/dL or two capillary blood lead
tests 10 g/dL drawn within 12 weeks of each other (14).
Incidence data rates are presented by the date of the confirmed
blood lead test. Date are reported by the jurisdiction of the
childs residence at the time of the confirmed blood lead test.
State health departments check for duplicate laboratory reports
for children and completeness of the laboratory report before
sending the data to CDC. After data are sent, CDC also checks
to ensure the completeness and accuracy of the data.
The data provided in this report are useful for analyzing
childhood blood lead trends and determining relative
morbidity numbers. However, reporting practices affect how
these data are interpreted. Childhood blood lead reporting
is likely incomplete, and completeness of the records might
vary depending on state, laboratory, or BLL range (e.g., BLLs
<10 g/dL might not be required to be reported in some states).
Independent of the actual incidence of disease, factors such as
changes in the methods of surveillance or introduction of new
diagnostic tests (e.g., use of a portable handheld analyzer) can
cause changes in the reported blood lead levels.
In 2007, a total of 38 states, New York City, and the District
of Columbia reported data to CDC. During 20072013, the
number of states collecting and reporting childhood blood
lead data to CDC fluctuated. Federal funding from CDC to
state and local health departments ended in September 2012.
For this reason, no states were required to report childhood
blood lead data to CDC in 2013. Nevertheless, 29 jurisdictions
(27 states, New York City, and the District of Columbia) did
collect and report data to CDC. Although the varying number
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE 1. Number of children aged <5 years with newly confirmed blood lead levels
70gL Childhood Blood Lead Surveillance System, United States, 20072013*
30
25
Number
20
15
10
5
0
2007
2008
2009
2010
2011
2012
2013
Year
* For 2007, a total of 40 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut,
Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana,
Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New
Jersey, New Hampshire, New York, New York City, North Carolina, Ohio, Oklahoma, Oregon,
Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2008, a total of 39 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut,
Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana,
Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nebraska, Nevada, New Jersey,
New Hampshire, New York, New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania,
Rhode Island, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2009, a total of 39 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut,
Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana,
Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey,
New Hampshire, New York, New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania,
Rhode Island, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2010, a total of 37 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut,
Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana,
Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey,
New Hampshire, New York, New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania,
Rhode Island, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2011, a total of 36 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut,
Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana,
Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New
Hampshire, New York, New York City, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas,
Vermont, Virginia, Washington, West Virginia, and Wisconsin).
For 2012, a total of 30 jurisdictions reported data to CDC (Alabama, Arizona, Connecticut, District of
Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts,
Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Hampshire, New York, New York City,
Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Vermont, West Virginia, and Wisconsin).
For 2013, a total of 29 jurisdictions reported data to CDC (Alabama, Arizona, Connecticut, District of
Columbia, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Michigan,
Minnesota, Mississippi, Missouri, New Jersey, New Hampshire, New Mexico, New York City, North
Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Vermont, West Virginia,
and Wisconsin).
Publication Criteria
Reports of children aged <5 years with BLLs
59g/dL and confirmed BLLs 10 g/dL
during 20072013.
Highlights
Lead exposure in children can cause
permanent neurologic damage (3). Behavioral
disorders are associated with lead exposure even
at detectable blood levels at or below 5 g/dL
(36). The most common highly concentrated
source of lead for children in the United States
is lead paint. When paint containing lead
deteriorates into flakes, chips, or fine dust, it
is easily inhaled or ingested by small children.
In 2011, the last full calendar year of federal
funding from CDC, 34 states, District of
Columbia, and New York City submitted
BLL data to CDC; however, by 2013, only
States
US Department of Health and Human Services/Centers for Disease Control and Prevention
69
FIGURE 2. Percentage of children aged <5 years with BLLs 5 g/dL, by year and blood lead level Childhood Blood Lead Surveillance System,
United States, 20072013*
100%
BLLs 59 g/dL
Confirmed BLL 10 g/dL (Prevalence)
Unconfirmed BLL 10 g/dL
10%
0
2007
2008
2009
2010
2011
2012
2013
Year
* For 2007, a total of 40 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana,
Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Hampshire,
New York, New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2008, a total of 39 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana,
Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nebraska, Nevada, New Jersey, New Hampshire, New York,
New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2009, a total of 39 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana,
Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Hampshire, New York,
New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2010, a total of 37 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana,
Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Hampshire, New York,
New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Vermont, Virginia, West Virginia, and Wisconsin).
For 2011, a total of 36 jurisdictions reported data to CDC (Alabama, Arizona, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana,
Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Hampshire, New York, New York
City, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Vermont, Virginia, Washington, West Virginia, and Wisconsin).
For 2012, a total of 30 jurisdictions reported data to CDC (Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas,
Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Hampshire, New York, New York City, Ohio, Oklahoma,
Oregon, Pennsylvania, Rhode Island, Vermont, West Virginia, and Wisconsin).
For 2013, a total of 29 jurisdictions reported data to CDC (Alabama, Arizona, Connecticut, District of Columbia, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland,
Massachusetts, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New Hampshire, New Mexico, New York City, North Carolina, Ohio, Oklahoma, Oregon,
Pennsylvania, Rhode Island, Tennessee, Vermont, West Virginia, and Wisconsin).
70
and cases in children with BLL 59 g/dL from the states that
continue to submit data to CDC.
In 2013, during the warmest weather months (July
September), 2,965 new cases were identified, more than in
any other consecutive 3-month period (Table 1). In warm
weather, windows that possibly are painted with lead-based
paint are opened and closed, creating lead dust in the air and
on the ground. Repainting and renovation activities also are
more common in warm-weather months. Increased presence
and activity of children in and around the home might lead to
US Department of Health and Human Services/Centers for Disease Control and Prevention
US Department of Health and Human Services/Centers for Disease Control and Prevention
71
72
17. Schlenker TL, Fritz CJ, Mark D, et al. Screening for pediatric lead
poisoning: comparability of simultaneously drawn capillary and venous
blood samples. JAMA 1994;271:13468. http://dx.doi.org/10.1001/
jama.1994.03510410058033
18. Meyer PA, Pivetz T, Dignam TA, Homa DM, Schoonover J, Brody D.
Surveillance for elevated blood lead levels among childrenUnited States,
19972001. MMWR Surveill Summ 2003;52(No. SS-10):121.
US Department of Health and Human Services/Centers for Disease Control and Prevention
Preface
CDCs National Institute for Occupational Safety and Health
(NIOSH), state health departments, and other state entities
maintain a state-based surveillance program of confirmed
silicosis cases. Data on confirmed cases are collected and
compiled by state entities and submitted to CDC. This report
summarizes information for cases of silicosis that were reported
to CDC for 20032011 by Michigan and New Jersey, the only
states that continue to provide data voluntarily to NIOSH.
The data for this report were final as of January 8, 2015. Data
are presented in tabular form on the number and distribution
of cases of silicosis by year (Table 1), duration of employment
in occupations with potential exposure to dust containing
respirable crystalline silica (Table 2), industry (Table 3), and
occupation (Table 4). The number of cases by year is presented
graphically (Figure). This report is a part of the Summary of
Notifiable Noninfectious Conditions and Disease Outbreaks
United States, which encompasses various surveillance years
but is being published in 2016 (1). The Summary of Notifiable
Noninfectious Conditions and Disease Outbreaks appears in the
same volume of MMWR as the annual Summary of Notifiable
Infectious Diseases (2).
Background
Silicosis, a form of pneumoconiosis, is a progressive
occupational lung disease caused by the inhalation, deposition,
and retention of respirable dust containing crystalline silica.
There is no effective specific treatment, and patients with
silicosis can be offered only supportive care. Silicosis is
preventable by using nonsilica substitution materials, effective
US Department of Health and Human Services/Centers for Disease Control and Prevention
73
Michigan
New Jersey
Total
No. (%)
No. (%)
No. (%)
34 (16.8)
28 (13.9)
30 (14.9)
19 (9.4)
22 (10.9)
23 (11.4)
14 (6.9)
21 (10.4)
11 (5.4)
202 (100.0)
7 (7.8)
16 (17.8)
8 (8.9)
10 (11.1)
11 (12.2)
16 (17.8)
7 (7.8)
8 (8.9)
7 (7.8)
90 100.0
41 (14.0)
44 (15.1)
38 (13.0)
29 (9.9)
33 (11.3)
39 (13.4)
21 (7.2)
29 (9.9)
18 (6.2)
292 (100.0)
<10
1019
2029
3039
40
Unknown
Total
Michigan
New Jersey
Total
No. (%)
No. (%)
No. (%)
20 (9.9)
19 (9.4)
54 (26.7)
57 (28.2)
25 (12.4)
27 (13.4)
202 (100.0)
28 (9.6)
36 (12.3)
64 (21.9)
67 (22.9)
34 (11.6)
63 (21.6)
292 (100.0)
8 (8.9)
17 (18.9)
10 (11.1)
10 (11.1)
9 (10.0)
36 (40.0)
90 (100.0)
TABLE 3. Number and percentage* of silicosis cases, by primary industry Michigan and New Jersey, 20032011
Industry (NAICS 2002)
Agriculture, forestry, fishing and hunting
Mining
Mining (except oil and gas) (212)
All other mining industries (213)
Construction
Specialty trade contractors (238)
Heavy and civil engineering construction (237)
All other construction industries (236)
Manufacturing
Primary metal manufacturing (331)
Nonmetallic mineral product manufacturing (327)
Transportation equipment manufacturing (336)
Miscellaneous manufacturing (339)
Fabricated metal product manufacturing (332)
All other manufacturing industries (325, 333335)
Wholesale trade
Retail trade
Transportation and warehousing
Professional, scientific, and technical services
Administrative and support and waste management and
remediation services
Health care and social assistance
Arts, entertainment, and recreation
Other services (except public administration)
Repair and maintenance (811)
Public administration
Unclassified
Total
Michigan
New Jersey
Total
No. (%)
No. (%)
No. (%)
1 (0.5)
17 (8.4)
17 (8.4)
()
34 (16.8)
32 (15.8)
2 (1.0)
()
139 (68.8)
106 (52.5)
10 (5.0)
13 (6.4)
4 (2.0)
3 (1.5)
3 (1.5)
1 (0.5)
1 (0.5)
2 (1.0)
()
()
1 (1.1)
12 (13.3)
11 (12.2)
1 (1.1)
23 (25.6)
15 (16.7)
5 (5.6)
3 (3.3)
45 (50.0)
3 (3.3)
28 (31.1)
2 (2.2)
3 (3.3)
3 (3.3)
6 (6.7)
()
()
2 (2.2)
1 (1.1)
1 (1.1)
2 (0.7)
29 (9.9)
28 (9.6)
1 (0.3)
57 (19.5)
47 (16.1)
7 (2.4)
3 (1.0)
184 (63.0)
109 (37.3)
38 (13.0)
15 (5.1)
7 (2.4)
6 (2.1)
9 (3.1)
1 (0.3)
1 (0.3)
4 (1.4)
1 (0.3)
1 (0.3)
1 (0.5)
()
4 (2.0)
4 (2.0)
(0.5)
1 (0.5)
202 (100.0)
()
1 (1.1)
3 (3.3)
3 (3.3)
()
1 (1.1)
90 (100.0)
1 (0.3)
1 (0.3)
7 (2.4)
7 (2.4)
1 (0.3)
2 (0.7)
292 (100.0)
74
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE 4. Number and percentage* of silicosis cases, by primary occupation Michigan and New Jersey, 20032011
Occupation (COC 2000)
Management (022)
Architecture and engineering (145, 150)
Healthcare practitioners and technical (313)
Protective service (374)
Building and grounds cleaning and maintenance
Janitors and building cleaners (422)
Grounds maintenance workers (425)
Office and administrative support (561, 562, 570)
Farming, forestry, and fishing (605)
Construction and extraction
Construction laborers (626)
Brickmasons, blockmasons, and stonemasons (622)
Other extraction workers (694)
All other construction and extraction occupations (620621, 623625, 632,
635636, 642, 644, 652653, 660, 673, 682684)
Installation, repair, and maintenance (712, 715, 722, 733735, 762)
Production
Production workers, all other (896)
Molders and molding machine setters, operators, and tenders, metal
and plastic (810)
Grinding, polishing, and buffing machine tool setters, operators, and
tenders, metal and plastic (800)
Metal furnace and kiln operators and tenders (804)
Crushing, grinding, polishing, mixing, and blending workers (865)
Firstline supervisors/managers of production and operating workers (770)
Molders, shapers, and casters, except metal and plastic (892)
Inspectors, testers, sorters, samplers, and weighers (874)
Painting workers (881)
Miscellaneous assemblers and fabricators (775)
All other production occupations (801, 803, 813814, 822, 831, 875876)
Transportation and material moving (913, 920, 961963)
Unclassifiable
Total
Michigan
New Jersey
Total
No. (%)
No. (%)
No. (%)
()
1 (0.5)
1 (0.5)
1 (0.5)
5 (2.5)
5 (2.5)
()
3 1.5
()
50 (24.8)
20 (9.9)
11 (5.4)
7 (3.5)
12 (5.9)
1 (1.1)
2 (2.2)
()
()
2 (2.2)
1 (1.1)
1 (1.1)
()
1 (1.1)
32 (35.6)
9 (10.0)
2 (2.2)
2 (2.2)
19 (21.1)
1 (0.3)
3 (1.0)
1 (0.3)
1 (0.3)
7 (2.4)
6 (2.1)
1 (0.3)
3 (1.0)
1 (0.3)
82 (28.1)
29 (9.9)
13 (4.5)
9 (3.1)
31 (10.6)
7 (3.5)
115 (56.9)
39 (19.3)
27 (13.4)
8 (8.9)
35 (38.9)
2 (2.2)
1 (1.1)
15 (5.1)
150 (51.4)
41 (14.0)
28 (9.6)
17 (8.4)
1 (1.1)
18 (6.2)
9 (4.5)
4 (2.0)
6 (3.0)
()
3 (1.5)
2 (1.0)
()
8 (4.0)
4 (2.0)
15 (7.4)
202 (100.0)
()
5 (5.6)
1 (1.1)
7 (7.8)
3 (3.3)
4 (4.4)
5 (5.6)
6 (6.7)
8 (8.9)
1 (1.1)
90 (100.0)
9 (3.1)
9 (3.1)
7 (2.4)
7 (2.4)
6 (2.1)
6 (2.1)
5 (1.7)
14 (4.8)
12 (4.1)
16 (5.5)
292 (100.0)
US Department of Health and Human Services/Centers for Disease Control and Prevention
75
76
Data Sources
In 1987, some states initiated active silicosis surveillance
under SENSOR and began providing data voluntarily to
NIOSH (16,17). The number of states conducting silicosis
surveillance varies by year. Two states, Michigan and New
Jersey, continue to conduct sentinel case-based silicosis
surveillance and interventions and provide data voluntarily
to NIOSH.
US Department of Health and Human Services/Centers for Disease Control and Prevention
FIGURE. Number* of silicosis cases by year Michigan and New Jersey, 20032011
40
Michigan
New Jersey
35
30
No. of cases
25
20
15
10
0
2003
2004
2005
2006
2007
2008
2009
2010
2011
Year
Source: Sentinel surveillance data as of January 8, 2015.
* N = 292 (Michigan: 202; New Jersey: 90).
Publication Criteria
De-identified confirmed cases of silicosis case data are
reported voluntarily to NIOSH on an annual basis. All
confirmed cases are published.
Highlights
Silicosis is a progressive and preventable occupational lung
disease caused by the inhalation, deposition, and retention
of respirable dust containing crystalline silica. As a sentinel
event, a case of silicosis indicates a failure to prevent exposure
to crystalline silica dust.
For the period 20032011, silicosis surveillance programs
in Michigan and New Jersey identified and confirmed 292
cases; 28 (9.6%) had <10 years of potential exposure to silica
dust. The manufacturing, construction, and mining industries
accounted for 92% (n = 270) of the cases, with the greatest
number of cases (184 [63%]) associated with manufacturing.
US Department of Health and Human Services/Centers for Disease Control and Prevention
77
References
1. CDC. Summary of notifiable noninfectious conditions and disease
outbreaksUnited States. MMWR Morb Mortal Wkly Rep 2014;63(55).
2. CDC. Summary of notifiable infectious diseases and conditionsUnited
States, 2014. MMWR Morb Mortal Wkly Rep 2014;63(54).
3. Leung CC, Yu ITS, Chen W. Silicosis. Lancet 2012;379:200818. http://
dx.doi.org/10.1016/S0140-6736(12)60235-9
4. Occupational Safety and Health Administration. OSHA Factsheet.
OSHAs Proposed Crystalline Silica Rule: construction. Washington,
DC: US Department of Labor, Occupational Safety and Health
Administration. https://www.osha.gov/silica/factsheets/OSHA_
FS-3681_Silica_Construction.v2.html
5. Occupational Safety and Health Administration. OSHA Factsheet.
OSHAs Proposed Crystalline Silica Rule: general industry and maritime.
Washington, DC: US Department of Labor, Occupational Safety and
Health Administration. https://www.osha.gov/silica/factsheets/OSHA_
FS-3682_Silica_GIM.html
6. CDC, National Institute for Occupational Safety and Health. Health
effects of occupational exposure to respirable crystalline silica. Cincinnati,
Ohio: US Department of Health and Human Services, CDC, National
Institute for Occupational Safety and Health; 2002. DHHS (NIOSH)
Pub No. 2002-129. http://www.cdc.gov/niosh/docs/2002-129/
pdfs/2002-129.pdf
7. International Agency for Research on Cancer. IARC monographs on
the evaluation of carcinogenic risks to humans. Vol. 68: silica, some
silicates, coal dust and para-aramid fibrils. Lyon, France: International
Agency for Research on Cancer, World Health Organization; 1997.
http://monographs.iarc.fr/ENG/Monographs/vol68/index.php
8. International Agency for Research on Cancer. IARC monographs on
the evaluation of carcinogenic risks to humans. Vol. 100C: a review of
human carcinogens: arsenic, metals, fibers, and dusts. Lyon, France:
International Agency for Research on Cancer, World Health
Organization; 2012. http://monographs.iarc.fr/ENG/Monographs/
vol100C/index.php
78
US Department of Health and Human Services/Centers for Disease Control and Prevention
Preface
CDC collects data on foodborne and waterborne disease
outbreaks reported by all U.S. states and territories through the
Foodborne Disease Outbreak Surveillance System (FDOSS)
(http://www.cdc.gov/foodsafety/fdoss/surveillance/index.
html) and the Waterborne Disease and Outbreak Surveillance
System (WBDOSS) http://www.cdc.gov/healthywater/
surveillance), respectively. These two systems are the primary
source of national data describing the number of reported
outbreaks; outbreak-associated illnesses, hospitalizations,
and deaths; etiologic agents; water source or implicated
foods; settings of exposure; and other factors associated with
recognized foodborne and waterborne disease outbreaks in
the United States.
FDOSS and WBDOSS share an enhanced reporting
platform, the National Outbreak Reporting System (NORS)
(http://www.cdc.gov/nors). NORS also collects information
on disease outbreaks with modes of transmission other than
food and water, including person-to-person contact, animal
contact, and environmental contamination.
This report summarizes data on foodborne disease outbreaks
reported during 19732013 and waterborne disease outbreaks
reported during 19712013; waterborne disease outbreak data
for 2013 are preliminary. This report is a part of the Summary
of Notifiable Noninfectious Conditions and Disease Outbreaks
United States, which encompasses various surveillance years
but is being published in 2016 (1). The Summary of Notifiable
Noninfectious Conditions and Disease Outbreaks appears in the
same volume of MMWR as the annual Summary of Notifiable
Infectious Diseases (2).
Background
Foodborne Disease Outbreak Surveillance
Foodborne diseases caused by known pathogens result in an
estimated 9.4 million illnesses each year in the United States
(3). Only a minority of foodborne illnesses, hospitalizations,
and deaths occur as part of recognized outbreaks (4). However,
information gathered from foodborne disease outbreak
surveillance activities provide valuable insights into the agents
that cause foodborne illness, types of implicated foods and
ingredients, and settings in which transmission occurs.
Surveillance for foodborne disease outbreaks provides insight
into the effectiveness of regulations and control measures, helps
identify new and emerging pathogens, provides information
regarding the food preparation and consumption settings in
which outbreaks occur, informs prevention and control measures
in the food industry by identifying points of contamination, and
can be used to describe trends in outbreaks over time.
Foodborne disease outbreaks have been nationally notifiable
since 2010; however, CDC has collected reports of foodborne
disease outbreaks through FDOSS since 1973. Initially a
paper-based system, FDOSS became web-based in 1998 and
was transitioned to NORS in 2009.
US Department of Health and Human Services/Centers for Disease Control and Prevention
79
Data Sources
Foodborne Disease Outbreak Surveillance
State, local, and territorial health departments use a
standard form (CDC form 52.13, http://www.cdc.gov/
nors/pdf/NORS_CDC_5213.pdf ) to report foodborne
disease outbreaks to CDC. Data requested for each outbreak
include reporting state; date of first illness onset; the number
of illnesses, hospitalizations, and deaths; the etiology; the
implicated food vehicle; the setting of food preparation and
consumption; and contributing factors. Multistate outbreaks
(i.e., those in which exposure to the implicated food occurred in
more than one state) typically are reported to FDOSS by CDC.
Only reports meeting the definition of a foodborne disease
outbreak, defined as the occurrence of two or more cases of a
similar illness resulting from the ingestion of a common food,
are included in this summary. Outbreaks occurring on cruise
ships that have both U.S. and international ports and those in
which the food was eaten outside the United States, even if the
illness occurred in the United States, are not reported to FDOSS.
Laboratory and clinical guidelines for confirming an etiology
are specific to each bacterial, chemical/toxin, parasitic, and viral
agent (http://www.cdc.gov/foodsafety/outbreaks/investigatingoutbreaks/confirming_diagnosis.html). Suspected etiologies
are those that do not meet the confirmation guidelines. The
cause of the outbreak is categorized as multiple etiologies if
more than one etiologic agent is reported.
80
Interpreting Data
Reported outbreaks represent only a small fraction of all
foodborne and waterborne illnesses that occur each year and
the outbreak data reported here are subject to limitations.
Outbreaks caused by certain pathogens or vehicles might be
more likely to be recognized, investigated, or reported. Some
illnesses reported as sporadic (i.e., not outbreak-associated)
are likely not recognized as being part of a reported outbreak
or might be part of an undetected outbreak. In addition,
all outbreak-related illnesses might not be identified during
an investigation, smaller outbreaks might not come to the
attention of public health authorities, and some outbreaks
might not be investigated or reported to CDC.
Reporting practices for foodborne and waterborne disease
outbreaks vary among states and territories, which might have
differing definitions or interpretations of which events are
reportable and unique laws related to disease outbreak reporting.
Thus, variations in reporting rates by state or territory might
reflect variations in levels of effort and funding for foodborne
and waterborne disease outbreak investigation, rather than true
differences in outbreak incidence rates by state. NORS maintains
a dynamic database; this report includes data available on May 1,
2015, for foodborne disease outbreaks and May 4, 2015, for
waterborne disease outbreaks; data published in this Summary
might differ from those published earlier or later.
US Department of Health and Human Services/Centers for Disease Control and Prevention
Publication Criteria
Foodborne disease outbreaks are defined as two or more
cases of a similar illness resulting from ingestion of a common
food. Waterborne disease outbreaks are defined as two or more
cases of a similar illness linked epidemiologically by time and
location to exposure to water or water-associated chemicals
volatized into the air.
Highlights
Foodborne Disease Outbreaks
During 19732013, CDC received reports of 30,251
foodborne disease outbreaks with 742,945 outbreak-associated
illnesses from the 50 states, Puerto Rico, the District of Columbia,
and freely associated states/territories. An average of 738 (range:
2981,404) outbreaks were reported each year (Figure 1). The
average annual number of foodborne disease outbreaks reported
to CDC increased in 1998 in comparison to previous years,
coinciding with the transition to an electronic reporting system,
FIGURE 1. Number of foodborne and waterborne disease outbreaks reported by year, United States 19712013*
1600
1400
1200
Outbreaks
1000
800
600
400
200
0
1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Year
* Waterborne disease outbreak data for 2013 are preliminary. CDC partners with state agencies and the Environmental Protection Agency to review, summarize, and
publish waterborne disease outbreak data separately from this report. CDC also reviews, summarizes, and publishes foodborne disease outbreak data separately
from this report.
US Department of Health and Human Services/Centers for Disease Control and Prevention
81
TABLE. Number of reported foodborne and waterborne disease outbreaks and outbreak-associated illnesses, by geographical division and
area United States, 2013*
Foodborne
Area
Outbreaks
United States
New England
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont
Mid-Atlantic
New Jersey
New York
Pennsylvania
Eastern North Central
Illinois
Indiana
Michigan
Ohio
Wisconsin
Western North Central
Iowa
Kansas
Minnesota
Missouri
Nebraska
North Dakota
South Dakota
Waterborne
Illnesses
818
44
13
14
4
10
3
86
10
51
25
158
39
6
27
65
21
79
8
14
35
8
6
7
1
Outbreaks
13,316
788
248
366
70
68
36
1,054
72
561
421
2,165
714
46
350
723
332
1,403
98
356
604
90
104
94
57
55
1
3
17
5
2
1
9
10
3
All
Illnesses
Outbreaks
2,824
140
140
23
23
2,139
1,445
23
597
74
64
23
41
873
45
13
14
4
11
3
89
10
51
28
175
44
8
28
74
21
89
11
14
42
8
6
7
1
Illnesses
16,140
928
248
366
70
208
36
1,077
72
561
444
4,304
2,159
69
947
797
332
1,467
121
356
645
90
104
94
57
31
6
6
94
45
31
29
4
12
6
22
11
4 6 1
9
2
10
11
29
49 7
17
10
26
63
69
4
27
2
34
28
3 19
13
13
21
13
17
16
2
30
3
5
40
2.23.4
Rate
5.415
No reports
* Incidence of outbreaks per 1 million population based on the 2012 U.S census
estimates. Cutpoints for outbreak rate categories determined by using quartiles.
N = 818 (includes 26 multistate outbreaks assigned as an outbreak to each
state involved).
82
11
0.72.1
0.040.2
0.210.26
0.300.48
0.782
* Incidence of outbreaks per 1 million population based on the 2012 U.S census
estimates. Cutpoints for outbreak rate categories determined by using quartiles.
N = 55 (data are preliminary).
US Department of Health and Human Services/Centers for Disease Control and Prevention
TABLE. (Continued) Number of reported foodborne and waterborne disease outbreaks and outbreak-associated illnesses, by geographical
division and area United States, 2013*
Foodborne
Area
South Atlantic
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
West Virginia
Eastern South Central
Alabama
Kentucky
Mississippi
Tennessee
Western South Central
Arkansas
Louisiana
Oklahoma
Texas
Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming
Pacific
Alaska
California
Hawaii
Oregon
Washington
Territories
Puerto Rico
Multistate
Waterborne
Outbreaks
Illnesses
120
36
27
23
10
11
13
30
3
2
1
24
35
7
7
5
16
67
18
27
4
5
2
7
3
1
155
10
81
8
28
28
18
18
26
1,622
323
396
228
239
182
254
433
124
20
3
286
765
65
90
238
372
1,427
438
297
19
62
430
122
31
28
1,970
66
1,069
192
368
333
159
159
1,530
Outbreaks
12
4
2
1
1
4
4
1
3
4
2
1
1
3
All
Illnesses
Outbreaks
Illnesses
88
25
10
14
5
34
64
19
45
164
144
17
3
23
20
119
119
132
40
29
24
10
12
17
34
4
2
1
27
39
7
9
6
17
70
18
28
4
7
2
7
3
1
156
10
81
8
29
28
18
18
26
1,710
348
406
242
239
187
288
497
143
20
3
331
929
65
234
255
375
1,450
438
300
19
82
430
122
31
28
2,089
66
1,069
192
487
333
159
159
1,530
* Waterborne disease outbreak data for 2013 are preliminary. CDC partners with state and territorial agencies and the Environmental Protection Agency to review,
summarize, and publish waterborne disease outbreak data separately from this report. CDC reviews, summarizes, and publishes foodborne disease outbreak data
separately from this report.
No data were reported for 2013.
No foodborne or waterborne disease outbreaks were reported for 2013.
References
1. CDC. Summary of notifiable noninfectious conditions and disease
outbreaksUnited States. MMWR Morb Mortal Wkly Rep 2014;63(55).
2. CDC. Summary of notifiable infectious diseases and conditionsUnited
States, 2014. MMWR Morb Mortal Wkly Rep 2014;63(54).
3. Scallan E, Hoekstra RM, Angulo FJ, et al. Foodborne illness acquired in
the United Statesmajor pathogens. Emerg Infect Dis 2011;17:715.
http://dx.doi.org/10.3201/eid1701.P11101
4. Crim SM, Griffin PM, Tauxe R, et al. Preliminary incidence and trends
of infection with pathogens transmitted commonly through food
Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2006
2014. MMWR Morb Mortal Wkly Rep 2015;64:4959.
US Department of Health and Human Services/Centers for Disease Control and Prevention
83
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