Americans have 40% chance of getting cancer. Who's most at risk and how can you prevent it

Americans have 40% chance of getting cancer. Who’s most at risk and how can you prevent it?

Princess Kate’s cancer diagnosis at age 42 shines a light on a dreaded disease that seems to be striking people at younger ages, though it has become more survivable.

Americans have about a 40% chance of developing cancer at some point in their lives. Just under 20% who develop it die from cancer, which is the second-leading cause of death in the U.S.

It is typically considered a disease of aging, with 88% of diagnoses coming in people age 50 and above, according to the American Cancer Society.

But colon cancer is increasing in younger people, according to the National Cancer Institute. Americans born between 1981 and 1996 are at twice the risk for colon cancer as those born in 1950.

Other cancers have also increased in younger adults, though it’s not clear why.

The lifetime risk of developing or dying from cancer refers to the chance a person has, over the course of their lifetime (from birth to death), of being diagnosed with or dying from cancer. These risk estimates are one way to measure how widespread cancer is in the United States.

The following tables list lifetime risks of developing and dying from certain cancers for men and women in the United States. The information is from the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) database, and is based on incidence data from 2017 through 2019 and mortality data from 2018 through 2020 in the US, the most recent years for which data are available.

The risk is expressed both in terms of a percentage and as odds.

  • For example, the risk that a man will develop cancer of the pancreas during his lifetime is 1.7%. This means he has about 1 chance in 58 of developing pancreatic cancer (100/1.7 = 58).
  • Put another way, 1 out of every 58 men in the United States will develop pancreatic cancer during his lifetime.

These numbers are average risks for the overall US population. Your risk may be higher or lower than these numbers, depending on your particular risk factors for each type of cancer.

Males

 

Risk of developing

Risk of dying from

 

%

1 in

%

1 in

Any cancer

41.6

2

19

5

Bladder (includes in situ)

3.6

28

0.8

119

Brain and nervous system

0.7

145

0.5

192

Breast

0.1

726

<0.1

3,476

Colon and rectum

4.3

23

1.6

61

Esophagus

0.8

127

0.7

144

Hodgkin lymphoma

0.2

431

<0.1

2,956

Kidney and renal pelvis

2.3

43

0.5

183

Larynx (voice box)

0.5

197

0.2

594

Leukemia

1.9

53

0.9

115

Liver and bile duct

1.5

65

1.0

100

Lung and bronchus

6.3

16

4.4

23

Melanoma of the skin*

3.6

28

0.4

248

Multiple myeloma

1.0

103

0.4

232

Non-Hodgkin lymphoma

2.4

42

0.7

136

Oral cavity and pharynx
(mouth and throat)

1.7

59

0.4

248

Pancreas

1.7

58

1.4

74

Prostate

12.9

8

2.3

44

Stomach

1.0

101

0.4

260

Testicles

0.4

244

<0.1

4,889

Thyroid

0.7

153

0.1

1,780

Females

 

Risk of developing

Risk of dying from

 

%

1 in

%

1 in

Any cancer

39.6

3

17

6

Bladder (includes in situ)

1.1

89

0.3

311

Brain and nervous system

0.5

186

0.4

243

Breast

13

8

2.5

41

Cervix

0.7

152

0.2

473

Colon and rectum

3.9

25

1.5

67

Esophagus

0.2

434

0.2

536

Hodgkin lymphoma

0.2

527

<0.1

4,071

Kidney and renal pelvis

1.4

73

0.3

330

Larynx (voice box)

0.1

844

<0.1

2,416

Leukemia

1.3

75

0.6

159

Liver and bile duct

0.7

143

0.5

182

Lung and bronchus

5.9

17

3.8

26

Melanoma of the skin*

2.5

41

0.2

473

Multiple myeloma

0.8

131

0.4

284

Non-Hodgkin lymphoma

1.9

52

0.6

176

Oral cavity and pharynx
(mouth and throat)

0.7

139

0.2

541

Ovary

1.1

87

0.8

130

Pancreas

1.7

60

1.3

74

Stomach

0.6

155

0.3

371

Thyroid

1.7

58

0.1

1,467

Uterus

3.1

32

0.7

153

*The risk numbers for melanoma are for non-Hispanic White individuals. The risk among people of other races/ethnicities is likely to be lower.

What is a risk factor?

A risk factor is something that raises the chance of getting a disease. Each cancer has its own risk factors. Having risk factors does not mean that someone will get cancer. Even when a person with a risk factor is found to have cancer, there’s no way to prove that the risk factor caused the cancer.

Some risk factors, like a person’s age or gene damage, can’t be changed. But some risk factors can be controlled. Tobacco use, contact with secondhand smoke, being in the sun, excess body weight, not being active, drinking alcohol, and not eating a healthy diet are risk factors that can be managed. Other risk factors include getting certain viruses and contact with certain kinds of radiation or chemicals.

Can injuries cause cancer?

Falls, bruises, broken bones, or other such injuries do not cause cancer. Sometimes a person might visit a health care provider for an injury and cancer is found. But the injury did not cause the cancer; the cancer was already there.

Can I bring cancer on myself?

Your personality and emotions cannot cause cancer and will not affect the outcome of your cancer. Research shows that there is no connection between personality types or attitude and cancer occurrence or outcomes.

Can stress cause cancer?

Researchers have done many studies to see if there’s a link between personality, attitude, stress, and cancer. It’s known that stress affects the immune system, but so do many other things. At this time, there is no clear evidence that a person’s stress level affects their risk of getting cancer.

Does sugar feed cancer?

Sugar intake has not been shown to increase the risk of getting cancer, having cancer spread, or having it get worse. Still, sugars and sugar-sweetened drinks add a lot of calories to the diet and can cause weight gain, which is linked to cancer.

Is cancer contagious?

You can’t catch cancer from someone who has it. You won’t get cancer by being around or touching someone with cancer. When family and friends stay away, people with cancer may feel isolated and alone.  They need your visits and support. To learn more, see Is Cancer Contagious?

Is cancer inherited?

Sometimes, certain types of cancer seem to run in some families. In some cases, this might be because family members share certain behaviors or exposures that increase cancer risk, such as such as smoking. Cancer risk might also be affected by other factors, like obesity, that tend to run in some families.

But in some cases the cancer is caused by an abnormal gene that is being passed along from generation to generation. Although this is often referred to as inherited cancer, what is inherited is the abnormal gene that can lead to cancer, not the cancer itself. To learn more, see Genetics and Cancer.

What Is Cancer?

Cancer affects 1 in 3 people in the United States. Chances are that you or someone you know has been affected by cancer. Here is some information to help you better understand what cancer is.

You are made up of trillions of cells that over your lifetime normally grow and divide as needed. When cells are abnormal or get old, they usually die. Cancer starts when something goes wrong in this process and your cells keep making new cells and the old or abnormal ones don’t die when they should. As the cancer cells grow out of control, they can crowd out normal cells. This makes it hard for your body to work the way it should.

For many people, cancer can be treated successfully. In fact, more people than ever before are leading full lives after cancer treatment.

Cancer is more than just one disease

There are many types of cancer. Cancer can develop anywhere in the body and is named for the part of the body where it started. For instance, breast cancer that starts in the breast is still called breast cancer even if it spreads (metastasizes) to other parts of the body.

There are two main categories of cancer:

  • Hematologic (blood) cancers are cancers of the blood cells, including leukemia, lymphoma, and multiple myeloma.
  • Solid tumor cancers are cancers of any of the other body organs or tissues. The most common solid tumors are breast, prostate, lung, and colorectal cancers.

These cancers are alike in some ways, but can be different in the ways they grow, spread, and respond to treatment. Some cancers grow and spread fast. Others grow more slowly. Some are more likely to spread to other parts of the body. Others tend to stay where they started.

Some types of cancer are best treated with surgery; others respond better to drugs such as chemotherapy. Often 2 or more treatments are used to get the best results.

What is a tumor?

A tumor is a lump or growth that can be benign or malignant (cancer).

What is the difference between a benign and a malignant tumor?

Benign tumors usually grow slowly, don’t grow into tissues around them, and don’t grow into other parts of the body. They also don’t often cause symptoms unless they grow large enough to push on other structures. If they need treatment, it is usually surgery although radiation and medications can also be used. Benign tumors are not cancer.

Malignant tumors (cancer) can grow quickly and uncontrollably. These tumors can grow and spread into areas close by. Cells from these tumors can break away, travel through blood or lymph system, and begin to grow in other parts of the body. When this happens it is called metastasis. Symptoms from malignant tumors usually vary depending on where the tumor is located. Malignant tumors are treated with surgery, radiation, and drugs such as chemotherapy.

What causes cancer?

Cancer cells develop because of multiple changes in their genes. These changes can have many possible causes. Lifestyle habits, genes you get from your parents, and being exposed to cancer-causing agents in the environment can all play a role. Many times, there is no obvious cause.

What is the cancer stage?

When a cancer is found, tests are done to see how big the cancer is and whether it has spread from where it started. This is called the cancer’s stage.

A lower stage (such as a stage 1 or 2) means that the cancer has not spread very much. A higher number (such as a stage 3 or 4) means it has spread more. Stage 4 is the highest stage.

The stage of the cancer is very important in choosing the best treatment for a person. Ask your doctor about your cancer’s stage and what it means for you.

How does cancer spread?

Cancer can spread from where it started (the primary site) to other parts of the body.

When cancer cells break away from a tumor, they can travel to other areas of the body through either the bloodstream or the lymph system. Cancer cells that travel through the bloodstream may to reach distant organs. If they travel through the lymph system, the cancer cells may end up in lymph nodes. Either way, most of the escaped cancer cells die or are killed before they can start growing somewhere else. But one or two might settle in a new area, begin to grow, and form new tumors. This spread of cancer to a new part of the body is called metastasis.

Cells that make up a metastasis are the same type of cells as in the primary cancer. They are not a new type of cancer. For instance, breast cancer cells that spread to the lungs are still breast cancer and NOT lung cancer. And colon cancer cells that spread to the liver are still colon cancer.

In order for cancer cells to spread to new parts of the body, they have to go through several changes. They first have to become able to break away from the original tumor and then attach to the outside wall of a lymph vessel or blood vessel. Then they must move through the vessel wall to flow with the blood or lymph to a new organ or lymph node.

Why is cancer staging needed?

For most types of cancer, doctors need to know how much cancer there is and where it is (among other things) to help determine the best treatment options. For example, the best treatment for an early-stage cancer may be surgery or radiation, while a more advanced-stage cancer may need treatments that reach all parts of the body, such as chemotherapytargeted drug therapy, or immunotherapy

Of course, the stage of a cancer isn’t the only factor used to decide which treatments might be best. Sometimes, cancers with different stages might be treated the same way, or cancers with the same stage might be treated in different ways. Many factors determine the best treatment options for each person.

A cancer’s stage can also be used to help predict the course it will likely take, as well as how likely it is that treatment will be successful. Although each person’s situation is different, cancers of the same type and stage tend to have similar outlooks.

The cancer stage is also a way for doctors to describe the extent of the cancer when they talk with each other about a person’s cancer.

Not all cancers are staged. For example, leukemias are cancers of the blood cells and therefore typically have spread throughout the body by the time they are found. Most types of leukemias aren’t staged the way cancers that form tumors are. 

Exams and tests to stage cancer

Different types of exams and tests can be used to figure out a cancer’s stage.

  • Depending on where the cancer is located, a physical exam may give some idea as to how much cancer there is.
  • Imaging tests like x-rays, CT scans, MRIs, ultrasound, and PET scans may also give information about how much and where cancer is in the body.
  • Endoscopy exams are sometimes used to look for cancer. For these exams, an endoscope, which is a thin, lighted tube (usually with a small video camera on the end) is put inside the body to look for cancer.
  • biopsy often is needed to confirm a cancer diagnosis. Biopsies might also be needed to find out if a lump felt on an exam or if something seen on an imaging test in another part of the body is really from the spread of cancer. During a biopsy, the doctor removes a tumor or pieces of a tumor to be looked at in the lab. Some biopsies are done during surgery. But biopsies can also be done using a thin, hollow needle or through an endoscope. For more on biopsies, see Testing Biopsy and Cytology Specimens for Cancer.
  • Lab tests of cancer cells (from a biopsy or surgery) and blood tests can also be used to help stage some types of cancer.

Cancer can be staged at different times

Typically, a cancer is staged when it is first diagnosed, before any treatment is given. But in some cases, it is staged again after treatment has started.

Clinical staging

The clinical stage is an estimate of the extent of the cancer based on results of physical exams, imaging tests (x-rays, CT scans, etc.), endoscopy exams, and any biopsies that are done before treatment starts. For some cancers, the results of other tests, such as blood tests, are also used in clinical staging.

The clinical stage is often a key part of deciding the best treatment options. It can also be used when trying to get an idea of what a person’s outlook (prognosis) might be. For example, the survival rates for most types of cancer are based mainly on the stage at the time of diagnosis (see below).

Pathological staging

If surgery to remove the cancer is the first treatment, doctors can also determine the pathological stage (also called the surgical stage). The pathological stage relies on the results of the exams and tests done before the surgery, as well as what is learned about the cancer during surgery.

Sometimes, the pathological stage is different from the clinical stage (for instance, if the surgery shows the cancer has spread more than was seen on imaging tests). The pathological stage gives more precise information, which can be used to help determine what other treatments might be needed, as well as to help predict treatment response and outcomes (prognosis).

Post-neoadjuvant therapy (or post-therapy) staging

For some cancers, some treatment other than surgery (such as chemo, targeted drug therapy, or radiation) might be done first. The goal might be to try to shrink the tumor before surgery (in which case the treatment is called neoadjuvant therapy), or it might be done as the main treatment if it’s not clear that surgery is going to be an option. 

Staging might be done after this first treatment to help measure the cancer’s response to treatment. This can be done the same way as clinical staging (if surgery hasn’t been done yet), which can help determine what type of surgery should be done. Or it can be done after surgery (the same way as pathological staging), which might give more precise information.

Recurrence or retreatment staging

Staging might also be done again at some point if the cancer comes back (recurs) or progresses (grows or spreads without ever having gone away completely). This information can be used to help guide decisions about further treatment. 

Does restaging a cancer change the original stage?

When a cancer is staged again after the initial staging, it is sometimes referred to as restaging. Often the same tests that were done when the cancer was first diagnosed (such as physical exams, imaging tests, endoscopy exams, biopsies, and maybe surgery) are done again. 

With any type of restaging, the new stage classification is added to the original stage, but it doesn’t replace it. The stage assigned at diagnosis is still the one that is most important when discussing statistics like survival rates (described below).

From a practical standpoint, however, the stage assigned to the cancer isn’t always as important as making sure everyone understands how far the cancer has spread, and what this means going forward. For example, if a person is diagnosed with a stage II cancer that later is found to have spread to other parts of the body, they (and even their health care provider) may now describe this as a ‘stage IV’ cancer, even though this isn’t technically accurate. What’s most important is that everyone understands that the cancer has spread, and that this information is used to guide future treatment decisions.

What goes into the stage: The TNM system

There are different types of systems used to stage cancer, but the most common and useful staging system for most types of cancer is the TNM system.

The American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) maintain the TNM classification system as a way for doctors to stage many different types of cancer based on certain common standards.

In the TNM system, the overall stage is determined after the cancer is assigned a letter or number to describe the tumor (T), node (N), and metastasis (M) categories.

  • T describes the original (primary) tumor.
  • N tells whether the cancer has spread to the nearby lymph nodes.
  • M tells whether the cancer has spread (metastasized) to distant parts of the body

The primary tumor (T category)

When trying to determine how much and where the cancer is in the body, doctors first look at the primary (main) tumor, which is where the cancer started. The tumor’s size, location, and whether it has grown into nearby areas can all be important. Doctors also check for other nearby tumors.

The T category can be assigned a letter or a number:

  • TX means there’s no information about the primary tumor, or it can’t be measured.
  • T0 means there is no evidence of a primary tumor (it cannot be found).
  • Tis means that the cancer cells are only growing in the layer of cells where they started, without growing into deeper layers. This may also be called in situ cancer or pre-cancer.
  • A number after the T (such as T1, T2, T3, or T4) might describe the tumor size and/or amount of spread into nearby structures. The higher the T number, the larger the tumor and/or the more it has grown into nearby tissues.

The lymph nodes (N category)

Lymph nodes near the primary tumor usually are checked to find out if cancer has spread into them. Lymph nodes are small, bean-shaped collections of immune cells. Many types of cancer often spread to nearby lymph nodes before they reach other parts of the body.

The N category can be assigned a letter or a number:

  • NX means there’s no information about the nearby lymph nodes, or they can’t be assessed.
  • N0 means nearby lymph nodes do not contain cancer.
  • A number after the N (such as N1, N2, or N3) might describe the size, location, and/or the number of nearby lymph nodes affected by cancer. The higher the N number, the greater the cancer spread to nearby lymph nodes.

Metastasis (M category)

Doctors might also look at other parts of the body to see if the cancer has spread. Cancer spread to parts of the body far from the primary tumor is known as metastasis.

The M category is assigned a number:

  • M0 means that no distant cancer spread has been found.
  • M1 means that the cancer has been found to have spread to distant organs or tissues.

Each cancer type has its own version of the TNM categories, so letters and numbers don’t mean the same thing for every type of cancer. For example, for some types of cancer, the T categories describe the size of the main tumor, while for others they describe how deeply the tumor has grown into the organ it started in, or whether the tumor has grown into nearby structures (regardless of its size).

For some cancer types, TNM categories may also have subcategories. These are noted with lowercase letters after the category. For example, T3a or T3b. 

Some cancer types may also have fewer category options than other cancer types. For instance, some cancers may not have an N3 category.

Other notations that can be part of TNM

Each of the T, N, and M categories might be written with a lowercase letter in front of it, showing if it’s a clinical or pathological classification:

  • A clinical stage is noted with “c” (for example, cT1)
  • A pathological stage is noted with “p” (for example, pN2)

For staging that is done after treatment or after cancer recurrence/progression, a category might also be given another lowercase letter in front of it:

  • For cancers that are restaged after neoadjuvant therapy (or other therapy), a “y” might be used in front of the category (for example, ycT1 or ypT2)
  • For cancers that are restaged after recurrence or progression of the cancer, an “r” might be used in front of the category (for example, rcT1 or rpT2)

Other factors that can affect a cancer’s stage

For some cancers, the values for T, N, and M aren’t the only things that determine the stage. Some other factors that may be taken into account include:

Grade: For most cancers, the grade is a measure of how abnormal the cancer cells look under the microscope. This is also called differentiation. Grade can be important because cancers with more abnormal-looking cells tend to grow and spread faster.

The grade is usually assigned a number, with lower numbers (for example, G1) used for lower grade cancers. 

  • In low-grade (well-differentiated) cancers, the cancer cells look fairly normal. In general, these cancers tend to grow slowly and often have a better outlook.
  • In high-grade (poorly differentiated) cancers, the cancer cells look more abnormal. High-grade cancers often tend to grow quickly, so they may need different treatments than low-grade cancers.

Even when the grade doesn’t affect a cancer’s stage, it might still affect a person’s outlook and/or treatment.

Cell type: Cancers in some parts of the body can start in different types of cells. Because the type of cancer cell can affect treatment and outlook, it can be a factor in staging. For example, cancers of the esophagus are mainly either squamous cell cancers or adenocarcinomas. Squamous cell esophageal cancers are staged differently from esophageal adenocarcinomas.

Tumor location: For some cancers, the main tumor’s location affects outlook and is taken into account in staging. The stage of cancer of the esophagus, for example, depends on whether the cancer starts in the upper, middle, or lower third of the esophagus.

Blood levels of tumor markers: For some cancers, the blood levels of certain substances (called tumor markers or biomarkers) can affect the stage of the cancer. For example, in prostate cancer, the level of prostate-specific antigen (PSA) in the blood is taken into account in assigning a stage.

Results of tests on the cancer cells: For some cancers, lab tests done on the cancer cells are an important part of staging. For example, in breast cancer, the stage can be affected by whether or not the cancer cells have proteins called hormone receptors on them.

A person’s age: For some types of cancer, such as thyroid cancer, a person’s age at the time of diagnosis can affect their outlook, so it is taken into account when assigning a stage.

Assigning an overall stage (stage grouping)

Once the values for T, N, and M (and any other factors that affect stage) have been determined, they are combined to assign an overall stage.

For most cancers, the stage is a Roman numeral from I (1) to IV (4). Stage I cancers are less advanced and often have a better prognosis (outlook). Higher stage cancers typically have spread farther (or have other concerning features), so they might require more intense (or different kinds of) treatment. Sometimes stages are subdivided as well, using capital letters (for example, stage III might be subdivided into stages IIIA and IIIB).

Some cancers also have a stage 0, which is often called carcinoma in situ. This means the cancer is still only in the layer of cells where it first started, and it has not spread any farther.

Other staging systems

Not all cancers are staged using the TNM system. For example:

  • Staging systems other than the TNM system are often used for Hodgkin and non-Hodgkin lymphomas, as well as for some other cancers.
  • The International Federation of Gynecologists and Obstetricians (FIGO) has a staging system for cancers of the female reproductive organs. The TNM stages closely match the FIGO stages, which makes it fairly easy to convert stages between these 2 systems.
  • Most cancers in or around the brain do not have a formal staging system, since these cancers typically don’t spread to lymph nodes or other parts of the body.

How the cancer stage might affect a person’s prognosis

Along with the type of cancer a person has, the stage of the cancer is one of the most important factors when doctors try to determine a person’s prognosis (outlook).

Stages and survival rates

For many types of cancer, prognosis is often expressed as a survival rate. This is the percentage of people with a certain type and stage of cancer who are still alive a certain amount of time (usually 5 years) after being diagnosed. For example, if the 5-year survival rate for a certain type and stage of cancer is 80%, it means that 80 out of 100 people who have that type and stage of cancer will still be expected to be alive after 5 years.

Survival rates can’t tell for sure what will happen with any particular person, because many other factors can also affect prognosis (see below). But they can give doctors and patients a general idea of how likely it is that treatment will be successful.

Survival rates are nearly always based on the stage of the cancer at the time of diagnosis. These numbers don’t apply if the cancer is restaged later on. For example, the 5-year survival rate of a cancer that is initially diagnosed as stage II and later spreads to another part of the body is not necessarily the same as that for a cancer that is initially diagnosed as a stage IV cancer (because it had already spread to another part of the body when first diagnosed).

This is important to understand because the information on our pages that discusses survival statistics refers to the stage when the cancer was first diagnosed.

Other factors can also affect prognosis

It’s also important to understand that while the stage of the cancer is important, many other factors can also affect a person’s outlook. Depending on the cancer type, other important prognostic factors might include: 

  • A person’s age and overall health
  • Whether the cancer cells have changes in certain genes, chromosomes, or proteins
  • How the cancer responds to treatment 

If you have questions about survival rates and how they might be affected by the stage of your cancer or other factors, be sure to talk to your cancer care team.

Cancer staging can be complex

Doctors are always learning more about cancer, how it grows and spreads, and how best to treat it. Over time, some of these findings are added to the staging systems for different types of cancer, which helps make them more accurate and valuable to both doctors and patients.

At the same time, adding these newer findings often makes the staging systems more complex than they were in the past, which can make it harder for people to understand them.

If you’re not sure about the stage of your cancer or what it might mean for you, ask your doctor to explain it to you in a way you understand.

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