Who gets cancer?

Anyone can get cancer at any age; however, middle and older aged people are most likely to develop cancer. In Indiana, during 2017, 74.2 percent of all cancer cases occurred among people aged 55-84 (25 percent among people aged 55-64, 30.3 percent among people aged 65-74, and 18.9 percent among people aged 75-84).1 Individuals who have been exposed to certain external and internal risk factors have an increased risk of developing cancer. As an external example, male smokers are approximately 25 times more likely to develop lung cancer than people who have never smoked.2 Smoking accounts for approximately 80 percent of all lung cancer deaths. Lung cancer is the leading cause of cancer death in both men and women.2 As an internal example, 55 to 72 percent of women who inherit the BRCA-1 gene mutation will develop breast cancer by 70-80 years of age.3

What are the risk factors?

Tobacco

The ACS estimates that 30 percent of all cancer deaths are caused by tobacco use.2 Each of those deaths could have been prevented by not using tobacco products. During 2019, 19.2 percent of Indiana adults were current smokers.4 Men and women who smoke cigarettes are about 25 times more likely to develop lung cancer than people who never smoke.2

Bodyweight, Diet, and Physical Activity

According to the CDC, overweight and obesity are associated with 13 types of cancer, which make up approximately 40 percent of all diagnosed cancers.5 During 2019, 35.3 percent of Indiana adults were considered obese.4 Additionally, during 2019, 53.7 percent of Indiana adults did not get the recommended 150 minutes of exercise per week (recommendations available at https://www.cdc.gov/physicalactivity/basics/index.htm).4 During 2019, 41.3 percent did not consume fruit one or more times per day and 21.1 percent did not consume vegetables one or more times per day.4 Diets low in animal fat and high in fruits and vegetables could help prevent certain cancers.

Infection with Human Papillomavirus (HPV) and Other Infectious Diseases

HPV is the single greatest risk factor for cervical cancer.6 The CDC estimates that HPV vaccination could prevent more than 90 percent of cancers caused by HPV—estimated to be 33,000 cases every year—from ever developing.7 In all, an estimated 13 percent of cancers worldwide are related to infectious exposures, such as the hepatitis B virus (HBV), HPV, human immunodeficiency virus (HIV), Helicobacter pylori bacteria, and others.8 Many of these infections can be prevented through behavioral changes or the use of vaccines or antibiotics.9

Sun Exposure

Excessive exposure to ultraviolet radiation from the sun or other sources, such as tanning beds, is the greatest risk factor for developing skin cancer. The US Department of Health and Human Services and the International Agency of Research on Cancer have found that exposure to sun lamps or sunbeds is classified as a known human carcinogen, the same classification as tobacco.10

Healthcare Coverage

Uninsured and underinsured patients are substantially more likely to be diagnosed with cancer at a later stage, when treatment can be more extensive and costly. According to the US Census Bureau, approximately 26.1 million Americans, 8.0 percent, were uninsured in 2019.11 For Indiana, in 2019, 13.6 percent of Indiana residents were uninsured.4

Screening

Early diagnosis through regular screening examinations saves lives by identifying cancers when they are most curable and treatment is more successful. Cancers that can be detected by screening include breast, cervix, colon, lung, oral cavity, prostate, rectum, skin, and testicular cancers.

What are the most common cancers?

Indiana mirrors the nation when it comes to the top four most common cancers. Excluding skin cancers, breast and prostate are the most prevalent cancers among females and males, respectively. Lung, including bronchus, and colon cancers are the next most common cancers among both sexes.12 Annually, lung cancer is responsible for the most cancer-related deaths among both sexes.12

How many people alive today will get cancer?

About 2.4 million Hoosiers, or approximately two in five people now living in Indiana, will eventually develop cancer. Nationally, 4.1 in 10 men will develop cancer in their lifetime; while 3.9 in 10 women will develop cancer in their lifetime.2

How many cases are expected to occur this year?

The ACS estimates that approximately 39,010 Indiana residents will be diagnosed with cancer in 2021, amounting to more than four new cases of cancer diagnosed every hour of every day.2 Nationally, an estimated 1.9 million new cancer cases are expected in 2021.2 These estimates did not include cases of non-melanoma skin cancer and carcinoma in situ (except for in situ urinary bladder cancer cases).

How many people are expected to die from cancer this year?

Approximately 13,460 Indiana residents are expected to die of cancer in 2021, which translates to approximately 37 people every day.2 Cancer is the second leading cause of death in Indiana following heart disease. Among children aged five to 14 years, cancer is the second leading cause of death following accidental injury.2

What are the costs of cancer?

During 2014, $1.83 billion was the estimated direct cost of treating Indiana residents with cancer. The estimated indirect costs totaled $11.12 billion for the same year.13 The Milken Institute estimated that, should current trends continue, Indiana residents would spend $2.76 billion on direct costs for cancer care in 2023.13

Is the cancer burden in Indiana lessening?

In Indiana, from 2008 to 2017, the age-adjusted incidence rates for all cancers combined decreased 2.6 percent from 474.6 to 462.9 cases per 100,000 people. Likewise, the age-adjusted mortality rates decreased 10 percent from 230.3 to 208.5 deaths per 100,000 people. However, trends varied among the different cancer types.12

These statistics indicate that progress continues to be made in the early detection and treatment of certain cancers, and that the incidence and mortality of some cancers is declining. However, a significant cancer burden still exists among Indiana residents that requires continued and increasingly targeted cancer control efforts.

Resources

  • Cancer Factsheet 2017 — Use this fact sheet to educate your partners and communities. The fact sheet provides information and statistics on the cancer burden in Indiana.
  • Sample Press Release for Cancer Control Month (April) — This press release is designed to be customized and sent to local media outlets.
  • Indiana Facts and Figures 2020 — Provides current statistics and information on cancer in Indiana in convenient PDF form. This can be linked to documents, websites, presentations, or through social media.
  • Indiana Cancer Control Plan 2018-2020 – Provides a roadmap for cancer control in Indiana. The ICCP includes six focus areas: primary prevention, early detection, treatment, quality of life, data, and advocacy. This can be linked to documents, websites, presentations, or through social media.

Additional and online resources:

 

References

  1. National Cancer Institute. Genetic Testing for Hereditary Cancer Syndromes [Online]. Accessed at https://www. cancer.gov/about-cancer/causes-prevention/genetics/genetic-testing-fact-sheet on July 1, 2021.
  2. American Cancer Society. Cancer Facts & Figures 2021. Atlanta, GA. 2021.
  3. National Cancer Institute. BRCA Gene Mutations: Cancer Risk and Genetic Testing [Online]. Accessed at https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet on July 1, 2021.
  4. Indiana Department of Health. Indiana Behavioral Risk Factor Surveillance System, 2018. Accessed at www. in.gov/isdh/25194.htm on July 1 1, 2021.
  5. Centers for Disease Control and Prevention. Obesity and Cancer. [Online] Last reviewed February 18, 2021. Accessed at https://www.cdc.gov/cancer/obesity/index.htm on July 1, 2021.
  6. Centers for Disease Control and Prevention. Basic Information About Cervical Cancer. [Online] Last reviewed February 13, 2021. Accessed at https://www.cdc.gov/cancer/cervical/basic_info/index.htm on July 1, 2021.
  7. Centers for Disease Control and Prevention. Cancers Caused by HPV are Preventable. [Online] Last reviewed September 14, 2020. Accessed at https://www.cdc.gov/hpv/hcp/protecting-patients.html on July 1, 2021.
  8. World Health Organization. Cancer [Online]. Last reviewed March 3, 2021. Accessed at https://www.who.int/news-room/fact-sheets/detail/cancer on July 1, 2021.
  9. American Cancer Society. Infections that Can Lead to Cancer [Online]. Revised July 11, 2016. Accessed at www.cancer.org/Cancer/CancerCauses/OtherCarcinogens/InfectiousAgents/InfectiousAgentsandCancer/infectious-agents-and-cancer-intro on July 1, 2021.
  10. U.S. Department of Health and Human Services, Public Health Services, National Toxicology Program. 14th Report on Carcinogens 2016. Accessed at http://ntp.niehs.nih.gov/pubhealth/roc/roc13/index.html on July 1, 2021.
  11. Keisler-Starkey, Katherine & Bunch Lisa N. Health Insurance Coverage in the United States: 2019. United States Census Bureau, U.S. Government Printing Office, Washington, DC, 2020.
  12. Indiana State Cancer Registry, 2021.
  13. DeVol R, Bedroussian A. An Unhealthy America: The Economic Burden of Chronic Disease. Milken Institute. Oct 2007.