Questions and Answers About USCS

The U.S. Cancer Statistics Incidence and Mortality Web-based Report contains the official federal statistics on cancer incidence (newly diagnosed cases) from each registry that met data quality criteria. The Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) have combined their cancer incidence data sources to produce these statistics. Mortality data from the National Vital Statistics System (NVSS) of CDC’s National Center for Health Statistics (NCHS) are included for each state.

This Web site provides state-specific and regional data for cancer cases diagnosed and cancer deaths that occurred from 1999 to 2014 and for 2010 to 2014 combined. The data from 2014 are the most recent year for which incidence data are available.

The report includes incidence data on more than 1 million cases of invasive cancer (including approximately 15,000 cases among children younger than 20 years) diagnosed in each of the individual years. The population coverage varies by diagnosis year. Population coverage may be affected by the suppression of state incidence data if 16 or fewer cases were reported or if the state requested that the data be suppressed.

The report also includes mortality data from malignant neoplasms (cancers) as recorded in the National Vital Statistics System from the 50 states and the District of Columbia. With regard to mortality data, 100% of the U.S. population is covered.

Medical facilities that diagnose cancers report information to central cancer registries in metropolitan areas, regions or states. State registries then report these data to two federal registry programs, CDC’s National Program of Cancer Registries (NPCR) and NCI’s Surveillance, Epidemiology, and End Results (SEER) Program, which together collect cancer incidence data for the entire U.S. population. These data can be used to monitor cancer trends over time, determine cancer patterns in various populations, guide planning and evaluation of cancer control programs, help set priorities for allocating health resources, and provide information for a national database of cancer incidence.

Information on cancer deaths comes from death certificates that are sent to the state vital statistics office, and is then collected by the National Vital Statistics System (NVSS) of CDC’s National Center for Health Statistics (NCHS).

Differences in rates among racial and ethnicity (Hispanic origin) populations should be interpreted with caution. A study using SEER data suggests that the quality of race data in cancer registries is considered excellent for whites, blacks, and Asians/Pacific Islanders and substantial for Hispanics, but cancers among American Indians/Alaska Natives have are considerably underreported. A study involving cancer mortality data shows that death rates for whites and blacks are generally reliable, whereas death rates for Asians/Pacific Islanders, American Indians/Alaska Natives, and Hispanics are underestimated. Therefore, incidence and/or mortality data published in this report may be underestimated for Asians/Pacific Islanders, American Indians/Alaska Natives, and Hispanics, possibly due to racial and Hispanic origin misclassification. NCHS is working with states to improve the reporting of race and ethnicity on death certificates.

Grouping racial or Hispanic origin subpopulations into one racial or Hispanic origin population can mask differences in subpopulations. Asians/Pacific Islanders, American Indians/Alaska Natives, and Hispanics are not homogeneous groups. The subpopulations are grouped into single populations because of small numbers or concerns regarding the possible misclassification of race and Hispanic origin among the subpopulations. Cancer rates by more detailed categories of race have been published in scientific journals.

Both NPCR and SEER provide training and technical assistance to cancer registries. Examples of this assistance include—

• Providing on-site technical assistance to registry personnel to help ensure data completeness, timeliness, and quality. For example, software has been developed to facilitate data transmission and improve the quality of data that hospitals transmit electronically to cancer registries.
• Coordinating and convening meetings of registry personnel for information sharing, problem solving, and training.
• Helping states and national organizations use cancer data to describe regional, state, and national disease burdens; to evaluate cancer control activities; and to identify populations or geographic regions at high risk for certain cancers.
• Collaborating with academic, federal, state, and private organizations to design and conduct research using data collected through population-based state and regional registries and to report the findings.
• Promoting specialty training in epidemiology, biostatistics, surveillance research, and tumor registry methods, operations, and management.
• Developing new statistical methods, models, and software for the analysis and presentation of national, state, and small-area cancer statistics.

All 50 states, the District of Columbia, and Puerto Rico all have the surveillance capacity and infrastructure upon which to build and improve a national cancer data system. The USCS report data illustrate the major progress made in cancer surveillance for our nation in the last decade alone. All cancer registries continually strive to meet USCS publication criteria; thus, we aim to provide data for more regions, states, and metropolitan areas. Mortality statistics for all racial and ethnic populations in all states, the District of Columbia, and Puerto Rico will continue to be published. NCHS is working with the states to improve reporting of race and ethnicity on death certificates. In future years, we will be able to present information on other advanced surveillance activities.