Research Article
Cancer Incidence and Survival Trends by Subtype
Using Data from the Surveillance Epidemiology
and End Results Program, 1992–2013
Anne-Michelle Noone, Kathleen A. Cronin, Sean F. Altekruse, Nadia Howlader,
Denise R. Lewis, Valentina I. Petkov, and Lynne Penberthy
Abstract
Background: Cancers are heterogeneous, comprising distinct
tumor subtypes. Therefore, presenting the burden of cancer in the
population and trends over time by these tumor subtypes is
important to identify patterns and differences in the occurrence
of these subtypes, especially to generalize findings to the U.S.
general population.
Methods: Using SEER Cancer Registry Data, we present inci-
dence rates according to subtypes for diagnosis years (1992–
2013) among men and women for five major cancer sites: breast
(female only), esophagus, kidney and renal pelvis, lung and
bronchus, and thyroid. We also describe estimates of 5-year
relative survival according to subtypes and diagnosis year
(1992–2008). We used Joinpoint models to identify years when
incidence rate trends changed slope. Finally, recent 5-year age-
adjusted incidence rates (2009–2013) are presented for each
subtype by race and age.
Results: Hormone receptor– positive and HER2-negative was
the most common subtype (about 74%) of b reast cancers.
Adenocarcinoma made up about 69% of esophagus cases
among men. Adenocarcinoma also is the most common lung
subtype (43% in men and 5 2% in women). Ninety percent of
thyroid subtype s w ere papillary. Dis tinct incidence a nd survival
patterns emerg ed by these subtypes over time amon g me n a nd
women.
Conclusions: Histologic or molecular subtype revealed
different incidence and/ or su rvival trends that are masked
when cancer is cons idered as a single disease on the basis of
anatomic site.
Impact: Presenting incidence and survival trends by subtype,
whenever possible, is critical to provide more detailed and mean-
ingful data to patients, providers, and the public.
Cancer Epidemiol
Biomarkers Prev; 26(4); 632–41. 2016 AACR.
Introduction
The conventional method of reporting pop ulatio n-based
cancer statistics, s olely by anatomic site, d oes not leverage
advances in characterizatio n of neopl asms based on their
detailed biological cha racteris tics (1). C ancer subt ypes are
increasingly de fined by detaile d anatomic site (2, 3), his tology
(4, 5), or molecula r charact eristi cs (6 ). Importa nt pa tterns of
cancer occur rence emerge when cancers ar e examined on t he
basis of these biologic characteristi cs. Thus, reporting cancer
statistics by these clinically important subtypes from popula-
tion-based registries may identif y important trends withi n the
U.S. p opulat ion or among po pulati on subgroups that would
otherwise not be evident.
Patterns of disparity can emerge when characterizing cancers
based on underlying biology, such as the elevated r ate of trip le-
negative breast ca ncer among African American women, w hich
is a more aggressive subtype than the predomi nant HR
þ
/HER
breast cancer s ubtyp e ( 6, 7). Cancer subtypes may also oft en
have distinct ris k factors associated with particular histologies.
Understanding trends over timeandriskmaybeusefulin
targeting interventions or prevent ion strategi es to specificsub-
groups ( 8– 10). Furthermore, providing data by subtypes such
as biomarker presence or geneti c test result is essential for
determining the impact of major improvements in cancer
therapy s uch as targeted therapies at the populat ion level
outside of clinical t rials (11).
The Surveillance Epidemiology and End Results (SEER) Pro-
gram has traditionally presented cancer statistics by organ site
(12); however, presenting cancer statistics by tumor subtypes is an
important contribution that reflects advances in knowledge about
the heterogeneity of cancer and to understand the differential
burden of cancer in populations. In this report, SEER cancer
incidence and survival data are presented for selected cancer
subsites. The objective of this population-based report is to
illustrate unique patterns of incidence, time trends, and survival
for breast, esophageal, thyroid, lung, kidney and renal pelvis
cancer subtypes that represent one change in how SEER data will
be presented in the future.
Materials and Methods
Population-based cancer incidence data have been collected
by the National Cancer Institute's SEER Program since 1973.
Division of Cancer Control and Population Sciences, Surveillance Research
Program, National Cancer Institute, Bethesda, Maryland.
Note: Supplementary data for this article are available at Cancer Epidemiology,
Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).
Corresponding Author: Anne-Michelle Noone, Division of Cancer Control and
Population Sciences, Surveillance Research Program, National Cancer Institute,
9609 Medical Center Drive, Bethesda, MD 20892. Phone: 240-276-6705; Fax:
240-276-7908; E-mail: noonea@mail.nih.gov
doi: 10.1158/1055-9965.EPI-16-0520
2016 American Association for Cancer Research.
Cancer
Epidemiology,
Biomarkers
& Prevention
Cancer Epidemiol Biomarkers Prev; 26(4) April 2017
632
Downloaded from http://aacrjournals.org/cebp/article-pdf/26/4/632/2283181/632.pdf by guest on 26 August 2022
Incidence and survival data included in this report are from the
SEER 13 registrie s which cover about 13% of the U.S. popu-
lation. Cancers from 5 organ sites diagnosed from 1992 to 2013
were selected t o illustrate the pot ential value in examining
tumor subtypes and include female brea st, esophag us, kidney
and renal pelvis, lung and bronchus, and thyroid. Because joint
expression of hormone receptor and HER2 stat us to classify
breast cancer subtypes was not collected until 2010, only
female breas t cancer cases diag nosed from 2010 to 2013 were
included.
The SEER site recode variable based on the World Health
Organization International Classification of Disease for Oncolo-
gy, 3rd edition (ICD-O-3), was used to define the primary site. All
cases were included in reporting by the primary site as is done in
standard reports (1, 13). Subtypes for each cancer site were
defined by histologic type and restricted to cases with microscopic
confirmation of histology (Supplementary Table S1). Two excep-
tions were that clinically relevant subtypes for breast cancer were
defined by hormone receptor and HER2 status and kidney and
renal pelvis were defined by anatomy; so these were not restricted
to cases with histologic confirmation. Although kidney and renal
pelvis tumors were defined by anatomy, each subsite had a
predominant histologic type. The vast majority of renal pelvis
tumors were transitional cell carcinomas, whereas kidney nitric
oxide synthetase (NOS) tumors were almost all adenocarcinomas
and renal cell carcinomas.
Five-year cancer incidence rates (2009–2013) and 4-year rates
(2010–2013) for breast cancer are presented for each subtype by
race and age. Race groups include white, black, Asian and Pacific
Islander (API), and American Indian/Alaska Native (AI/AN).
Differences between race and age groups were compared using
the relative rate ratio and its 95% confidence interval (14). All
incidence rates were age-adjusted to the 2000 U.S. standard
population. The population estimates used as the denominators
to calculate incidence rates were a modification of the intercensal
and Vintage 2014 (15).
Incidence rates were estimated from 1992 to 2013. In addition,
trends and changes over time were estimated using a Joinpoint
model (16). This is a technique that fits a series of joined straight
lines on a logarithm scale to the age-adjusted rates over time, a
maximum of 4 joinpoints were considered for fitting trends.
Breast cancer trends were not estimated, as data were only avail-
able from 2010. Incidence rates used to calculate trends were also
adjusted for reporting delay which may occur because of a lag in
reporting to the cancer registry or data corrections (17). Delay
adjustment factors were not available by subtype; therefore, these
rates are adjusted by the overall reporting delay for that primary
site. In this report, trends that are reported as increasing or
decreasing refer to statistically significant increasing or decreasing
trends estimated from the Joinpoint model. Nonstatistically sig-
nificant trends are referred to as stable.
Finally, we present estimates of 5-year relative survival accord-
ing to cancer subtypes and diagnosis year among men and
women. Relative survival was calculated as the ratio of observed
all-cause survival to expected survival using the actuarial method
in SEER
Stat (18, 19). It represents survival associated with a
cancer diagnosis and it is the standard method for reporting
cancer-specific survival from registry data as it does not rely on
causes of death which may be missing or misclassified (20).
Expected survival rates were calculated using life tables on the
basis of individual year 1970 to 2011, individual age 0 to 99 years,
sex, and race [white, black, other (AI/AN, API)] and were matched
on age, sex, year of diagnosis, and race (white, black, and other) to
the cancer cohort (21). Survival analyses included cases diagnosed
in 1992 to 2008 and follow-up until December 31, 2012. Cases
diagnosed in 2009 and after are not included because we do not
have complete 5 years of follow-up for them. For the same
reasons, we were unable to examine 5-year survival data for breast
cancer cases diagnosed after 2010.
Results
Female breast cancer
Hormone receptor–positive and HER2-negative (HR
þ
/HER2
)
breast cancer was the most common subtype comprising 74% of
all cases (Supplementary Fig. S1). Incidence rates for breast cancer
subtype varied by race. For example, white women had the highest
incidence rate for this subtype followed by black, API, and AI/AN
women (Table 1). In contrast, triple-negative breast cancer which
made up the second largest component at 11% of cases had the
highest rates among black women. The HR
þ
/HER2
þ
and HR
/
HER2
þ
subtypes had relatively small difference in incidence in
white compared with black women.
In addition, incidence peaked among women aged 65 to 74
years among all subtypes. The HER2-overexpressing tumors (i.e.,
HR
/HER2
þ
) were the least common subtypes with fewer
observed variations by race or age groups compared with both
the HR
þ
/HER2
and triple-negative subtypes.
Esophageal cancer
The overall trend for esophageal cancer shows a decline in
incidence for both men and women (Fig. 1). The 5-year survival is
relatively stable over time; however, there are differences between
the subtypes for both incidence and survival. Specifically, the
incidence trends by subtype, in particular for men, revealed an
increasing incidence for adenocarcinoma contrasted with a
decline for squamous cell and other histologic subtypes (Supple-
mentary Table S2). Incidence for squamous cell carcinoma is
declining for women, but incidence among the other subtypes
remains stable. Among men who have much higher rates of
esophageal cancer than women, adenocarcinoma makes up
approximately 69% of all esophageal cancers, whereas squamous
cell carcinoma makes up the second largest component at 27%
(Supplementary Fig. S1).
The incidence rates by race show that while white men have
the highest rates of adenocarcinoma (5.7 per 100,00 0), black
men have the highest rate of squamous cell carcinoma (4.5 per
100,000; Table 1). Incidence rates for squamous cell carcinoma
are also higher among AI/AN and API than white men (2.0 and
2.3 vs . 0.3, respecti vely). Incidence f or adenocarcinoma is
similar for white and black women, but black women had
higher rates of s quamous cell carcinoma than white and API
women (Table 1).
There are also differences in incidence by age for both men and
women. Incidence increased dramatically for men by age for both
adeno- and squamous cell carcinoma (Table 2). However, men
had the highest incidence of adenocarcinoma for all age groups
compared with women. There is an increased risk with advancing
age in men for both adeno- and squamous cell carcinoma com-
pared with the youngest age group. For women, the highest
incidence was squamous cell carcinoma and similar to men, the
incidence increased after the age of 55 years (Table 2).
Cancer Incidence and Survival Trends by Subtype, 1992–2013
www.aacrjournals.org Cancer Epidemiol Biomarkers Prev; 26(4) April 2017 633
Downloaded from http://aacrjournals.org/cebp/article-pdf/26/4/632/2283181/632.pdf by guest on 26 August 2022
Five-year relative surv ival for es opha geal cance r overall is
modestly increasing over time for both men and women
(Fig. 1). Survival is higher among those with adenocarcinoma
than those w ith squamous ce ll among men (20.5% vs. 16.6%
in 2008). However, there is not any difference in survi val
among the subtypes for women.
Kidney and renal pelvis cancer
The overall incide nce trend for kidney and renal pelvis cancer
was increasing from 1992 to 2008 but it is now stable among
both men and women. The overall t rend is driven by the
incidence in kidney cancer, as these comprise more than 90%
of cases. Indeed, the incidence tre nd for kidney cancer followed
the same pattern. Cancer of the renal pelvis has a mu ch sma ller
incidence rate and has been stable since 1992. Although the
pattern is similar among men and women, the incidence is
lower among women.
The incidence rates of kidney cancer are highest among
Black and AI/AN men (10.5 and 8.6 per 100 ,000, respectively ;
Table 1). Black and AI/AN women also have higher rates than
white women. In contrast, incidence rates for cancer of the renal
pelvis are highest among whites for both men a nd women. The
incidence rates for cancer of both kidney and renal pelvis
increase by age among men and women (Table 2). However,
the increase by age is far greater for cancer of t he renal pelvis
than for k idney.
Five-year re lative survival for kidney cancer is increasing
over time among both men and women (F ig. 2). Spe cifically,
5-year survival rate was 58.6% in 1992 and increased to 74.2%
in men and increase d from 61.2% to 78.3% i n wome n. S urvival
Table 1. Five-year incidence rates (2009–2013) for men and women by race
Race
White
a
Black AI/AN API
Total N n Rate n Rate RR (95% CI) n Rate RR (95% CI) n Rate RR (95% CI)
Men
Esophagus
Adenocarcinoma 4,639 4,372 5.7 121 1.4 0.2 (0.2–0.3) 28 3.4 0.6 (0.4–0.9) 118 1.0 0.2 (0.1–0.2)
Squamous cell 1,796 1,108 1.5 388 4.5 3.1 (2.7–3.5) 15 2.0 1.4 (0.7–2.3) 285 2.3 1.6 (1.4–1.8)
Other 304 257 0.3 24 0.3 0.9 (0.6–1.4) 21 0.2 0.5 (0.3–0.8)
Kidney and Renal Pelvis
Kidney, NOS 19,406 4,816 6.6 901 10.5 1.6 (1.5–1.7) 56 8.6 1.3 (1.0–1.7) 708 6.1 0.9 (0.9–1.0)
Renal pelvis 1,082 937 1.3 44 0.6 0.5 (0.3–0.6) 96 0.8 0.6 (0.5–0.8)
Lung and bronch us
Squamous 13,022 10,277 14.1 1,547 20.6 1.5 (1.4–1.5) 90 15.3 1.1 (0.9–1.4) 1,108 9.7 0.7 (0.6–0.7)
Small cell 6,173 5,095 6.7 549 6.8 1.0 (0.9–1.1) 47 7.1 1.1 (0.8–1.4) 482 4.1 0.6 (0.6–0.7)
Adenocarcinoma 22,187 16,660 22.5 2,644 31.4 1.4 (1.3–1.5) 99 14.9 0.7 (0.5– 0.8) 2,784 23.2 1.0 (1.0–1.1)
Large cell 926 704 0.9 143 1.7 1.8 (1.5–2.2) 78 0.6 0.7 (0.5–0.9)
Malignant neoplasm and
carcinoma unspecified
6,481 4,816 6.6 901 10.5 1.6 (1.5–1.7) 56 8.6 1.3 (1.0–1.7) 708 6.1 0.9 (0.9–1.0)
Thyroid
Papillary 6,137 5,100 6.5 262 2.7 0.4 (0.4–0.5) 38 4.1 0.6 (0.4–0.9) 737 5.4 0.8 (0.8–0.9)
Follicular 558 433 0.6 52 0.6 1.0 (0.7–1.4) 69 0.5 1.0 (0.7
–1.3)
Medullary 176 148 0.2 13 0.1 0.7 (0.4–1.3) 14 0.1 0.6 (0.3–1.0)
Anaplastic 98 74 0.1 8 0.1 0.9 (0.4–2.0) 16 0.1 1.5 (0.8–2.6)
Women
Breast
HR
þ
/HER2
þ
10,968 8,159 9.6 1,257 10.1 1.1 (1.0–1.1) 101 9.7 1.0 (0.8–1.2) 1,451 9.0 0.9 (0.9–1.0)
HR
/HER2
þ
4,832 3,386 3.9 602 4.9 1.2 (1.1–1.4) 37 3.7 0.9 (0.7–1.3) 807 4.9 1.2 (1.1–1.3)
HR
þ
/HER2
80,317 63,608 72.4 7,075 59.4 0.8 (0.8–0.8) 491 51.8 0.7 (0.7–0.8) 9,143 56.8 0.8 (0.8– 0.8)
Triple-negative 12,143 8,555 10.0 2,330 18.9 1.9 (1.8–2.0) 67 7.1 0.7 (0.5–0.9) 1,191 7.4 0.7 (0.7–0.8)
Esophagus
Adenocarcinoma 784 717 0.8 37 0.3 0.4 (0.3–0.6) 22 0.1 0.2 (0.1–0.3)
Squamous cell 1,057 726 0.8 212 1.8 2.2 (1.9–2.6) 114 0.7 0.9 (0.7–1.1)
Other 110 89 0.1 15 0.1 1.5 (0.8–2.6)
Kidney and renal pelvis
Kidney, NOS 10,807 8,450 9.6 1,376 11.6 1.2 (1.1–1.3) 155 16.0 1.7 (1.4–2.0) 826 5.2 0.5 (0.5–0.6)
Renal pelvis 815 663 0.7 58 0.6 0.8 (0.6–1.0) 91 0.6 0.8 (0.6–1.0)
Lung
Squamous 7,905 6,495 7.4 924 8.5 1.2 (1.1–1.2) 65 8.0 1.1 (0.8–1.4) 421 2.7 0.4 (0.3–0.4)
Small cell 6,068 5,185 5.8 566 5.0 0.9 (0.8–0.9) 47 5.1 0.9 (0.6–1.2) 270 1.7 0.3 (0.3–0.3)
Adenocarcinoma 24,720 18,911 21.1 2,758 23.7 1.1 (1.1–1.2) 86 9.9 0.5 (0.4–0.6) 2,965 18.9 0.9 (0.9–0.9)
Large cell 747 585 0.7 106 0.9 1.4 (1.1–1.7) 51 0.3 0.5 (0.4–0.7)
Malignant neoplasm and
carcinoma unspecified
5,110 3,971 4.4 697 6.0 1.4 (1.3–1.5) 31 4.0 0.9 (0.6–1.3) 411 2.7 0.6 (0.5–0.7)
Thyroid
Papillary 20,401 15,973 20.2 1,378 11.0 0.5 (0.5–0.6) 152 15.2 0.8 (0.6–0.9) 2,898 18.2 0.9 (0.9–0.9)
Follicular 1,381 1,025 1.3 179 1.5 1.2 (1.0–1.4) 14 1.5 1.2 (0.6–2.1) 163 1.0 0.8 (0.7
–1.0)
Medullary 290 237 0.3 33 0.3 0.9 (0.6–1.3) 19 0.1 0.4 (0.3–0.7)
Anaplastic 167 133 0.1 11 0.1 0.7 (0.3–1.3) 23 0.2 1.1 (0.6–1.7)
a
Reference group.
Counts of 10 or less were suppressed.
Noone et al.
Cancer Epidemiol Biomarkers Prev; 26(4) April 2017 Cancer Epidemiology, Biomarkers & Prevention634
Downloaded from http://aacrjournals.org/cebp/article-pdf/26/4/632/2283181/632.pdf by guest on 26 August 2022
is lower for cancer of the renal pel vis but variable due to small
case counts.
Lung and bronchus cancer
The o verall trend for lung cancer is declining among both
men and women (Fig. 3). This decline is also seen among men
and wo men with small cell, large cell, and malignant neoplasm
and car cinoma unspeci fied su btypes (Sup plem entary Table S2) .
However, adenoc arcinoma, which is the most common sub-
type making up 45% of the cases among men and 55% of the
cases among women, is increasing among both sexes (Supp le-
mentary Fig. S1). Squamous cell carcinoma, the second most
common histol ogic subtype comp ris ing 17% of cases among
men and 12% a mong women, is decreasing among men but
stable among w omen.
The incidence rates by race show that black men have a
higher incid ence for all s ubtype s except small cell tha n white
men (Table 1). This difference in particularly pronounced for
squamous cell, malig nant neopl asm and unspecified carcino-
mas, and large cell carci noma subtypes. AI/AN men had a
higher rate of malignant neoplasms and unspeci fied carcinoma
and a lower rat e of adenocarcinom a than white men. API men
had overall lower rates for all lung subtypes than white men
with the exception of adenocarcinoma. Compared with white
women, black w omen have higher rates for large cell carcino-
ma, malignant neoplasms and unspecified carcinoma , and
squamous cell carcinoma (Table 1). Incidence rates for adeno-
carcinoma are near ly equivalent for black and white women.
Small cell carcinoma was higher a mong white women than
black women. AI/AN and API women had lower rates for all
subtypes compared to white women with the only excep tion of
a higher rate o f squamous cell carcinoma among AI/AN than
white women. Among both men and women, incide nce rates of
lung subtypes by age show e ach of the subtype incidence rates
increases wi th age ( Table 2). Lung cance r incidence for
all s ubtype s is highest among men and women aged 75 y ears
and older.
Five-year relative surv ival by lu ng cancer his tologi c subt ype
indicates an increase in survival for each subtype among both
men and women (Fig. 3), although survival among women is
generally higher t han among men. Among men, those with the
adeno- and squamous ce ll carcino ma had t he highest 5-year
0
2
4
6
8
10
1992 1995 1998 2001
2004 2007 2010 2013
Age-adjusted incidence rate
Year of diagnosis
Men: Incidence
0
2
4
6
8
10
1992 1995 1998 2001 2004 2007 2010 2013
Year of diagnosis
Women: Incidence
0%
20%
40%
60%
80%
100%
1992 1995 1998 2001 2004 2007 2010 2013
5-year Relative survival
Year of diagnosis
Men: Survival
Total Adenocarcinoma
Squamous cell Other
0%
20%
40%
60%
80%
100%
1992 1995 1998 2001
2004 2007 2010 2013
Year of diagnosis
Women: Survival
A
B
DC
Figure 1.
Esophageal cancer age-adjusted incidence rates and 5-year relative survival over time by subtype for men and women. Survival estimates for other are based on
5-year groups (1992– 1998, 1999–2003, 2004 –2008).
Cancer Incidence and Survival Trends by Subtype, 1992–2013
www.aacrjournals.org Cancer Epidemiol Biomarkers Prev; 26(4) April 2017 635
Downloaded from http://aacrjournals.org/cebp/article-pdf/26/4/632/2283181/632.pdf by guest on 26 August 2022
relative survi val (22.4% and 20.5% in 2008 , respectively). A
similar pattern was seen for among women with a 5-year
relative survi val 28.6% in 2008 for adenocarcinoma and
22.6% for squamous cell carcinoma.
Thyroid cancer
The overall incidence trend for thyroid cancer is increasing
among men and women (Fig. 4). However, the overall trend is
driven by the papillary subtype, as it accounts for about 90% of the
cases among both men and women (Table 1). Indeed, incidence
trends for the papillary subtype are increasing among men and
women (Supplementary Table S2). The less common subtypes, in
descending order of incidence, are follicular, medullary, and
anaplastic. The incidence rates for these subtypes are low; how-
ever, medullary thyroid cancer has been increasing among men
and women. The trend for anaplastic thyroid cancer is stable
among men and women.
Among men the highest incidence rates for the papillary sub-
type occurred among whites and APIs with lower rates among
blacks and AI/ANs (Table 1). Incidence rates of papillary subtype
increased with age, peaked among men aged 65 to 74 years and
then decreased among men older than 75 years (Table 2). Inci-
dence rates for other thyroid cancer subtypes were lower and
typically increased with age.
Among women incidence rates for papillary subtype were
higher than those of men, with higher rates among whites and
APIs than among blacks and AI/ANs (Table 1). Rates across racial
and ethnic groups were similar for nonpapillary subtypes. Inci-
dence rates of papillary subtype peaked among women at 55 to
64 years (Table 2). Incidence rates for follicular and medullary
subtypes peaked at 65 to 74 years and those for anaplastic peaked
at 75þ years.
Among bot h men and women, overall 5-ye ar relative sur-
vival is driven by the papil lary sub typ e for which the s urvival
Table 2. Five-year incidence rates (2009–2013) for men and women by age
<55 y
a
55–64 y 65–74 y 75þ y
n Rate n Rate RR (95% CI) n Rate RR (95% CI) n Rate RR (95% CI)
Men
Esophagus
Adenocarcinoma 644 0.8 1,348 11.4 14.9 (13.5–16.4) 1,381 21.6 28.2 (25.7–31.0) 1,288 27.8 36.3 (33.0–40.0)
Squamous cell 218 0.3 525 4.4 17.7 (15.1–20.9) 545 8.5 34.1 (29.0–40.1) 515 11.1 44.5 (37.9–52.4)
Other 32 0.0 85 0.7 19.0 (12.5–29.6) 95 1.5 39.2 (25.9–60.7) 96 2.1 54.3 (35.9–83.9)
Kidney and renal pelvis
Kidney, NOS 5,144 6.3 5,503 46.6 7.4 (7.1–7.7) 5,148 80.0 12.8 (12.3–13.3) 3,838 83.2 13.3 (12.7–13.8)
Renal pelvis 80 0.1 214 1.8 19.3 (14.8–25.2) 325 5.1 54.3 (42.3–70.4) 472 10.1 107.6 (84.6– 138.3)
Lung
Squamous 819 0.9 2,722 23.0 24.4 (22.5–26.4) 4,532 72.1 76.5 (70.9–82.5) 5,006 108.4 114.9 (106.6–123.9)
Small cell 579 0.7 1,577 13.3 19.9 (18.1–22.0) 2,236 35.0 52.4 (47.7–57.5) 1,801 39.1 58.5 (53.2–64.3)
Adenocarcinoma 2,205 2.6 5,267 44.5 17.3 (16.4–18.1) 7,247 114.3 44.3 (42.2–46.5) 7,571 163.9 63.5 (60.5–66.6)
Large cell 104 0.1 238 2.0 16.6 (13.1–21.1) 310 4.8 39.9 (31.8–50.4) 277 6.0 49.7 (39.5–62.9)
Malignant neoplasm and carcinoma
unspecified
608 0.7 1,518 12.8 18.1 (16.4–19.9) 2,009 31.6 44.5 (40.6–48.8) 2,381 51.2 72.0 (65.8–78.9)
Thyroid
Papillary 3,352 4.2 1,415 12.0 2.9 (2.7–3.1) 986 15.3 3.7 (3.4–3.9) 479 10.4 2.5 (2.3–2.8)
Follicular 246 0.3 126 1.1 3.5 (2.8–4.4) 112 1.8 5.8 (4.6–7.3) 81 1.8 5.9 (4.5–7.6)
Medullary 97 0.1 34 0.3 2.4 (1.6–3.6) 28 0.4 3.6 (2.3–5.6) 21 0.5 3.8 (2.3–6.2)
Anaplastic 15 0.0 20 0.2 10.0 (4.8–21.1) 33 0.5 29.8 (15.6–59.2) 31 0.7 39.5 (20.5–78.7)
Women
Breast
HR
þ
/HER2
þ
4,790 5.9 2,902 22.9 3.9 (3.7–4.1) 1,911 25.4 4.3 (4.1–4.6) 1,459 21.0 3.6 (3.4–3.8)
HR
/HER2
þ
1,985 2.4 1,399 11.1 4.6 (4.3–4.9) 828 11.0 4.6 (4.2–5.0) 653 9.5 3.9 (3.6–4.3)
HR
þ
/HER2
24,066 29.1 20,796 163.5 5.6 (5.5–5.7) 19,592 262.6 9.0 (8.9–9.2) 16,501 240.3 8.3 (8.1–8.4)
Triple-negative 4,840 5.9 3,201 25.2 4.3 (4.1–4.4) 2,274 30.4 5.1 (4.9–5.4) 1,923 27.6 4.7 (4.4–4.9)
Esophagus
Adenocarcinoma 102 0.1 181 1.4 12.0 (9.3–15.5) 187 2.6 21.6 (16.8–27.8) 318 4.3 36.3 (28.8–45.9)
Squamous cell 116 0.1 239 1.9 14.4 (11.5–18.2) 321 4.4 33.7 (27.1–42.1) 390 5.5 42.2 (34.1–52.5)
Other 10 0.0 15 0.1 10.3 (4.3–25.7) 24 0.3 30.1 (13.7–70.6) 62 0.9 76.5 (38.4–168.0)
Kidney and renal pelvis
Kidney, NOS 2,853 3.5 2,682 21.1 6.1 (5.8–6.4) 2,681 36.2 10.5 (9.9–11.1) 2,697 38.9 11.3 (10.7–11.9)
Renal pelvis 48 0.1 97 0.8 13.6 (9.5–19.7) 218 3.0 53.3 (38.7–74.6) 459 6.4 113.9 (84.1–157.2)
Lung
Squamous 428 0.5 1,283 10.0 20.8 (18.6–23.2) 2,781 38.0 78.7 (71.0–87.3) 3,435 51.3 106.1 (95.8–117.7)
Small cell 626 0.7 1,472 11.5 16.3 (14.9–18.0) 2,107 28.5 40.4 (36.9– 44.3) 1,884 28.6 40.4 (36.9–44.4)
Adenocarcinoma 2,851 3.3 5,440 42.7 13.0 (12.4–13.6) 7,787 106.0 32.3 (30.9–33.7) 8,759 128.9 39.3 (37.6–41.0)
Large cell 88 0.1 190 1.5 14.8 (11.4–19.3) 227 3.1 30.2 (23.4–39.1) 244 3.7 36.4 (28.3–47.1)
Malignant neoplasm and carcinoma
unspecified
568 0.6 1,030 8.1 12.4 (11.2–13.8) 1,499 20.5 31.6 (28.7–34.9) 2,039 29.5 45.4 (41.3–50.0)
Thyroid
Papillary 13,586 16.9 3,910 30.9 1.8 (1.8–1.9) 2,244 29.6 1.8 (1.7–1.8) 1,007 15.5 0.9 (0.9–1.0)
Follicular 778 1.0 260 2.1 2.1 (1.9–
2.5) 226 3.1 3.2 (2.7–3.7) 147 2.3 2.4 (2.0–2.8)
Medullary 132 0.2 72 0.6 3.5 (2.6–4.7) 57 0.8 4.8 (3.4–6.6) 31 0.5 2.9 (1.8–4.3)
Anaplastic 9 0.0 28 0.2 21.3 (9.7–51.6) 45 0.6 61.7 (29.4–144.3) 85 1.1 110.7 (54.8–252.0)
a
Reference group.
Noone et al.
Cancer Epidemiol Biomarkers Prev; 26(4) April 2017 Cancer Epidemiology, Biomarkers & Prevention636
Downloaded from http://aacrjournals.org/cebp/article-pdf/26/4/632/2283181/632.pdf by guest on 26 August 2022