Cancer was responsible for around *** deaths per 100,000 population in the United States in 2023. The death rate for cancer has steadily decreased since the 1990’s, but cancer still remains the second leading cause of death in the United States. The deadliest type of cancer for both men and women is cancer of the lung and bronchus which will account for an estimated ****** deaths among men alone in 2025. Probability of surviving Survival rates for cancer vary significantly depending on the type of cancer. The cancers with the highest rates of survival include cancers of the thyroid, prostate, and testis, with five-year survival rates as high as ** percent for thyroid cancer. The cancers with the lowest five-year survival rates include cancers of the pancreas, liver, and esophagus. Risk factors It is difficult to determine why one person develops cancer while another does not, but certain risk factors have been shown to increase a person’s chance of developing cancer. For example, cigarette smoking has been proven to increase the risk of developing various cancers. In fact, around ** percent of cancers of the lung, bronchus and trachea among adults aged 30 years and older can be attributed to cigarette smoking. Other modifiable risk factors for cancer include being obese, drinking alcohol, and sun exposure.

The leading causes of death in the United States are by far cardiovascular diseases and cancer. However, the death rates from these diseases, as well as other leading causes of death, have decreased over the past few decades. The one major exception are deaths caused by Alzheimer’s disease, which have increased significantly. Cardiovascular disease deaths Although cardiovascular diseases are currently the leading cause of death in the United States, the death rate of these diseases has dropped significantly. In the year 1950, there were around *** deaths per 100,000 population due to cardiovascular diseases. In the year 2022, this number was ***** per 100,000 population. Risk factors for heart disease include smoking, poor diet, diabetes, obesity, stress, family history, and age. Alzheimer’s disease deaths While the death rates for cardiovascular disease, cancer, diabetes, and chronic lower respiratory diseases have all decreased, the death rate for Alzheimer’s disease has increased. In fact, from the year 2000 to 2021, the death rate from Alzheimer’s disease rose an astonishing *** percent. This increase is in part due to a growing aging population.

The leading causes of death in the United States are heart disease and cancer. However, in 2022, COVID-19 was the fourth leading cause of death in the United States, accounting for around six percent of all deaths that year. In 2022, there were around 45 deaths from COVID-19 per 100,000 population.

Cardiovascular disease

Deaths from cardiovascular disease are more common among men than women but have decreased for both sexes over the past few decades. Coronary heart disease accounts for the highest portion of cardiovascular disease deaths in the United States, followed by stroke and high blood pressure. The states with the highest death rates from cardiovascular disease include Oklahoma, Mississippi, and Alabama. Smoking tobacco, physical inactivity, poor diet, stress, and being overweight or obese are all risk factors for developing heart disease.

Cancer

Although cancer is the second leading cause of death in the United States, like deaths from cardiovascular disease, deaths from cancer have decreased over the last few decades. The highest death rates from cancer come from lung cancer for both men and women. Breast cancer is the second deadliest cancer for women, while prostate cancer is the second deadliest cancer for men. West Virginia, Mississippi, and Kentucky lead the nation with the highest cancer death rates.

The rate of breast cancer deaths in the U.S. has dramatically declined since 1950. As of 2022, the death rate from breast cancer had dropped from 31.9 to 18.7 per 100,000 population. Cancer is a serious public health issue in the United States. As of 2021, cancer is the second leading cause of death among women. Breast cancer incidence Breast cancer symptoms include lumps or thickening of the breast tissue and may include changes to the skin. Breast cancer is driven by many factors, but age is a known risk factor. Among all age groups, the highest number of invasive breast cancer cases were among those aged 60 to 69. The incidence rate of new breast cancer cases is higher in some ethnicities than others. White, non-Hispanic women had the highest incidence rate of breast cancer, followed by non-Hispanic Black women. Breast cancer treatment Breast cancer treatments usually involve several methods, including surgery, chemotherapy and biological therapy. Types of cancer diagnosed at earlier stages often require fewer treatments. A majority of the early stage breast cancer cases in the U.S. receive breast conserving surgery and radiation therapy.

Death rate has been age-adjusted by the 2000 U.S. standard population. Single-year data are only available for Los Angeles County overall, Service Planning Areas, Supervisorial Districts, City of Los Angeles overall, and City of Los Angeles Council Districts.Lung cancer is a leading cause of cancer-related death in the US. People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked. Most cases are due to long-term tobacco smoking or exposure to secondhand tobacco smoke. Cities and communities can take an active role in curbing tobacco use and reducing lung cancer by adopting policies to regulate tobacco retail; reducing exposure to secondhand smoke in outdoor public spaces, such as parks, restaurants, or in multi-unit housing; and improving access to tobacco cessation programs and other preventive services.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

The rate of breast cancer deaths in the U.S. has dramatically declined since 1950. As of 2023, the death rate from breast cancer was **** per 100,000 population. However, cancer is a serious public health issue in the United States and is the second leading cause of death among women. Breast cancer incidence Breast cancer symptoms include lumps or thickening of the breast tissue and may include changes to the skin. Breast cancer is driven by many factors, but age is a known risk factor. Among all age groups, the highest number of invasive breast cancer cases were among those aged 60 to 69. The incidence rate of new breast cancer cases is higher in some ethnicities than others. White, non-Hispanic women have the highest incidence rate of breast cancer, followed by non-Hispanic Black women. Breast cancer treatment Breast cancer treatments usually involve several methods, including surgery, chemotherapy and biological therapy. Types of cancer diagnosed at earlier stages often require fewer treatments. A majority of early stage breast cancer cases in the U.S. receive breast conserving surgery and radiation therapy.

Editor’s Choice

• Global Breast Cancer Market size is expected to be worth around USD 49.2 Bn by 2032 from USD 19.8 Bn in 2022, growing at a CAGR of 9.8% during the forecast period from 2022 to 2032.
• Breast cancer is the most common cancer among women worldwide. In 2020, there were about 2.3 million new cases of breast cancer diagnosed globally.
• Breast cancer is the leading cause of cancer-related deaths in women. In 2020, it was responsible for approximately 685,000 deaths worldwide.
• The survival rate of breast cancer has improved over the years. In the United States, the overall five-year survival rate of breast cancer is around 90%.
• The American Cancer Society recommends annual mammograms starting at age 40 for women at average risk.
• Although rare, breast cancer also occurs in men. Less than 1% of breast cancer cases are diagnosed in males.

(Source: WHO, American Cancer Society)

MMWR Surveillance Summary 66 (No. SS-1):1-8 found that nonmetropolitan areas have significant numbers of potentially excess deaths from the five leading causes of death. These figures accompany this report by presenting information on potentially excess deaths in nonmetropolitan and metropolitan areas at the state level. They also add additional years of data and options for selecting different age ranges and benchmarks. Potentially excess deaths are defined in MMWR Surveillance Summary 66(No. SS-1):1-8 as deaths that exceed the numbers that would be expected if the death rates of states with the lowest rates (benchmarks) occurred across all states. They are calculated by subtracting expected deaths for specific benchmarks from observed deaths. Not all potentially excess deaths can be prevented; some areas might have characteristics that predispose them to higher rates of death. However, many potentially excess deaths might represent deaths that could be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services. Mortality data for U.S. residents come from the National Vital Statistics System. Estimates based on fewer than 10 observed deaths are not shown and shaded yellow on the map. Underlying cause of death is based on the International Classification of Diseases, 10th Revision (ICD-10) Heart disease (I00-I09, I11, I13, and I20–I51) Cancer (C00–C97) Unintentional injury (V01–X59 and Y85–Y86) Chronic lower respiratory disease (J40–J47) Stroke (I60–I69) Locality (nonmetropolitan vs. metropolitan) is based on the Office of Management and Budget’s 2013 county-based classification scheme. Benchmarks are based on the three states with the lowest age and cause-specific mortality rates. Potentially excess deaths for each state are calculated by subtracting deaths at the benchmark rates (expected deaths) from observed deaths. Users can explore three benchmarks: “2010 Fixed” is a fixed benchmark based on the best performing States in 2010. “2005 Fixed” is a fixed benchmark based on the best performing States in 2005. “Floating” is based on the best performing States in each year so change from year to year. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES Moy E, Garcia MC, Bastian B, Rossen LM, Ingram DD, Faul M, Massetti GM, Thomas CC, Hong Y, Yoon PW, Iademarco MF. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas – United States, 1999-2014. MMWR Surveillance Summary 2017; 66(No. SS-1):1-8. Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States. MMWR Surveillance Summary 2017; 66(No. SS-2):1–7.

The leading causes of death among Black residents in the United States in 2022 included diseases of the heart, cancer, unintentional injuries, and stroke. The leading causes of death for African Americans generally reflects the leading causes of death for the entire United States population. However, a major exception is that death from assault or homicide is the seventh leading cause of death among African Americans, but is not among the ten leading causes for the general population. Homicide among African Americans The homicide rate among African Americans has been higher than that of other races and ethnicities for many years. In 2023, around 9,284 Black people were murdered in the United States, compared to 7,289 white people. A majority of these homicides are committed with firearms, which are easily accessible in the United States. In 2022, around 14,189 Black people died by firearms. However, suicide deaths account for over half of all deaths from firearms in the United States. Cancer disparities There are also major disparities in access to health care and the impact of various diseases. For example, the incidence rate of cancer among African American males is the greatest among all ethnicities and races. Furthermore, although the incidence rate of cancer is lower among African American women than it is among white women, cancer death rates are still higher among African American women.

BackgroundOver the last decades, the number of patients diagnosed with thyroid carcinoma has been increasing, highlighting the importance of comprehensively evaluating causes of death among these patients. This study aimed to comprehensively characterize the risk of death and causes of death in patients with thyroid carcinoma.MethodsA total of 183,641 patients diagnosed with an index thyroid tumor were identified from the Surveillance, Epidemiology, and End Result database (1975–2016). Standardized mortality rates (SMRs) for non-cancer deaths were calculated to evaluate mortality risk and to compare mortality risks with the cancer-free US population. Cumulative mortality rates were calculated to explore the factors associated with higher risk of deaths.ResultsThere were 22,386 deaths recorded during follow-up, of which only 31.0% were due to thyroid cancer and 46.4% due to non-cancer causes. Non-cancer mortality risk among patients with thyroid cancer was nearly 1.6-fold (SMR=1.59) that of the general population. Cardiovascular diseases were the leading cause of non-cancer deaths, accounting for 21.3% of all deaths in thyroid cancer patients. Non-cancer causes were the dominant cause of death in thyroid cancer survivors as of the third year post-diagnosis. We found that males with thyroid cancer had a higher risk of all-cause mortality compared with females. The risk of suicide was highest in the first post-diagnostic year (5 years: SMR=8.27).ConclusionNon-cancer comorbidities have become the major risks of death in patients with thyroid tumor in the US, as opposed to death from the tumor itself. Clinicians and researchers should be aware of these risk trends in order to conduct timely intervention strategies.

This statistic shows the percentage changes in selected causes of death due to diseases in the United States, between 2000 and 2022. The number of deaths caused by prostate cancer increased by 7.4 percent during this period. Changes in selected causes of deathThere has been a decrease in the rate of death caused by many diseases, including stroke and heart disease. However, the mortality rate due to Alzheimer’s disease increased by 142 percent from 2000 to 2022. Alzheimer’s disease caused 27.7 deaths per 100,000 population in 2023, making it the sixth leading cause of death in the United States. Mortality rates due to different diseases vary by different factors, including race and ethnicity. For example, cancer is the leading cause of death among Asians and Pacific Islanders in the United States, accounting for 22 percent of total deaths among this population, while heart disease is the leading cause of death among the white population. Ischemic heart disease is the leading cause of death worldwide, accounting for around nine million deaths in 2021. In the early 1900's, the mortality rate was primarily concentrated among people of younger ages, but increasingly, this has shifted to older population groups. In recent years, decreased mortality rates are often linked to improved medical care, such as new developments in medical technologies. Shifts in lifestyle habits such as decreased smoking rates and healthier diets may also attribute to lower mortality rates.

Some racial and ethnic categories are suppressed for privacy and to avoid misleading estimates when the relative standard error exceeds 30% or the unweighted sample size is less than 50 respondents.

Data Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey (BRFSS) Data

Why This Matters

Breast cancer is the most commonly diagnosed cancer in women and people assigned female at birth (AFAB) and the second leading cause of cancer death in the U.S. Breast cancer screenings can save lives by helping to detect breast cancer in its early stages when treatment is more effective.

While non-Hispanic white women and AFAB individuals are more likely to be diagnosed with breast cancer than their counterparts of other races and ethnicities, non-Hispanic Black women and AFAB individuals die from breast cancer at a significantly higher rate than their counterparts races and ethnicities.

Later-stage diagnoses and prolonged treatment duration partly explain these disparities in mortality rate. Structural barriers to quality health care, insurance, education, affordable housing, and sustainable income that disproportionately affect communities of color also drive racial inequities in breast cancer screenings and mortality.

The District Response

Project Women Into Staying Healthy (WISH) provides free breast and cervical cancer screenings to uninsured or underinsured women and AFAB adults aged 21 to 64. Patient navigation, transportation assistance, and cancer education are also provided.

DC Health’s Cancer and Chronic Disease Prevention Bureau works with healthcare providers to improve the use of preventative health services and provide breast cancer screening services.

DC Health maintains the District of Columbia Cancer Registry (DCCR) to track cancer incidences, examine environmental substances that cause cancer, and identify differences in cancer incidences by age, gender, race, and geographical location.

Introduction

Breast Cancer Statistics: Breast cancer remains one of the most prevalent and concerning health challenges, mostly among women. It is the most common cancer diagnosed in women worldwide and the second leading cause of cancer-related deaths among women in the United States. The impact of breast cancer is significant, with millions of new cases diagnosed each year and hundreds of thousands of deaths attributed to the disease.

This article will provide critical insights into the incidence, survival rates, mortality, and disparities across different demographics, including age, race, and ethnicity. Understanding the latest statistics on breast cancer is crucial for driving progress in reducing the incidence and mortality rates, improving survival outcomes, and ultimately, finding a cure.

Population based cancer incidence rates were abstracted from National Cancer Institute, State Cancer Profiles for all available counties in the United States for which data were available. This is a national county-level database of cancer data that are collected by state public health surveillance systems. All-site cancer is defined as any type of cancer that is captured in the state registry data, though non-melanoma skin cancer is not included. All-site age-adjusted cancer incidence rates were abstracted separately for males and females. County-level annual age-adjusted all-site cancer incidence rates for years 2006–2010 were available for 2687 of 3142 (85.5%) counties in the U.S. Counties for which there are fewer than 16 reported cases in a specific area-sex-race category are suppressed to ensure confidentiality and stability of rate estimates; this accounted for 14 counties in our study. Two states, Kansas and Virginia, do not provide data because of state legislation and regulations which prohibit the release of county level data to outside entities. Data from Michigan does not include cases diagnosed in other states because data exchange agreements prohibit the release of data to third parties. Finally, state data is not available for three states, Minnesota, Ohio, and Washington. The age-adjusted average annual incidence rate for all counties was 453.7 per 100,000 persons. We selected 2006–2010 as it is subsequent in time to the EQI exposure data which was constructed to represent the years 2000–2005. We also gathered data for the three leading causes of cancer for males (lung, prostate, and colorectal) and females (lung, breast, and colorectal). The EQI was used as an exposure metric as an indicator of cumulative environmental exposures at the county-level representing the period 2000 to 2005. A complete description of the datasets used in the EQI are provided in Lobdell et al. and methods used for index construction are described by Messer et al. The EQI was developed for the period 2000– 2005 because it was the time period for which the most recent data were available when index construction was initiated. The EQI includes variables representing each of the environmental domains. The air domain includes 87 variables representing criteria and hazardous air pollutants. The water domain includes 80 variables representing overall water quality, general water contamination, recreational water quality, drinking water quality, atmospheric deposition, drought, and chemical contamination. The land domain includes 26 variables representing agriculture, pesticides, contaminants, facilities, and radon. The built domain includes 14 variables representing roads, highway/road safety, public transit behavior, business environment, and subsidized housing environment. The sociodemographic environment includes 12 variables representing socioeconomics and crime. This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data are stored as csv files. This dataset is associated with the following publication: Jagai, J., L. Messer, K. Rappazzo , C. Gray, S. Grabich , and D. Lobdell. County-level environmental quality and associations with cancer incidence#. Cancer. John Wiley & Sons Incorporated, New York, NY, USA, 123(15): 2901-2908, (2017).

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

In 2022, the leading causes of death for children aged one to four years in the United States were unintentional injuries and congenital malformations, deformations, and chromosomal abnormalities. At that time, around 31 percent of all deaths among these children were caused by unintentional injuries. Differences in causes of death among children by age Just as unintentional injuries are the leading cause of death among children aged one to four, it is also the leading cause of death for the age groups five to nine and 10 to 14. However, congenital malformations, deformations, and chromosomal abnormalities account for fewer deaths as children become older, while the share of deaths caused by cancer is higher among those aged five to nine and 10 to 14. In fact, cancer is the second leading cause of death among five to nine-year-olds, accounting for around 15 percent of all deaths. Sadly, the second leading cause of death among children aged 10 to 14 is intentional self-harm, with 13 percent of all deaths among those in this age group caused by suicide. Leading causes of death in the United States The leading causes of death in the United States are heart disease and malignant neoplasms. Together, these two diseases accounted for around 40 percent of all deaths in the United States in 2022. That year, COVID-19 was the fourth leading cause of death, with about six percent of all deaths caused by COVID-19. In 2022, the lifetime odds that the average person in the United States would die from heart disease was one in six, while the odds for cancer were one in seven and for COVID-19 one in 23.

Some racial and ethnic categories are suppressed for privacy and to avoid misleading estimates when the relative standard error exceeds 30% or the unweighted sample size is less than 50 respondents. Margins of error are estimated at the 90% confidence level.

Data Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey (BRFSS) Data

Why This Matters

Colorectal cancer is the third leading cause of cancer death in the U.S. for men and women. Although colorectal cancer is most common among people aged 65 to 74, there has been an increase in incidences among people aged 40 to 49.

Nationally, Black people are disproportionately likely to both have colorectal cancer and die from it. Hispanic residents, and especially those with limited English proficiency, report having the lowest rate of colorectal cancer screenings.

Racial disparities in education, poverty, health insurance coverage, and English language proficiency are all factors that contribute to racial gaps in receiving colorectal cancer screenings. Increased colorectal cancer screening utilization has been shown to nearly erase the racial disparities in the death rate of colorectal cancer.

The District Response

The Colorectal Cancer Control Program (DC3C) aims to reduce colon cancer incidence and mortality by increasing colorectal cancer screening rates among District residents.

DC Health’s Cancer and Chronic Disease Prevention Bureau works with healthcare providers to improve the use of preventative health services and provide colorectal cancer screening services.

DC Health maintains the District of Columbia Cancer Registry (DCCR) to track cancer incidences, examine environmental substances that cause cancer, and identify differences in cancer incidences by age, gender, race, and geographical location.

Age-adjusted mortality rates for the contiguous United States in 2000–2005 were obtained from the Wide-ranging Online Data for Epidemiologic Research system of the U.S. Centers for Disease Control and Prevention (CDC) (2015). Age-adjusted mortality rates were weighted averages of the age-specific death rates, and they were used to account for different age structures among populations (Curtin and Klein 1995). The mortality rates for counties with < 10 deaths were suppressed by the CDC to protect privacy and to ensure data reliability; only counties with ≥ 10 deaths were included in the analyses. The underlying cause of mortality was specified using the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (10th revision; ICD-10). In this study, we focused on the all-cause mortality rate (A00-R99) and on mortality rates from the three leading causes: heart disease (I00-I09, I11, I13, and I20-I51), cancer (C00-C97), and stroke (I60- I69) (Heron 2013). We excluded mortality due to external causes for all-cause mortality, as has been done in many previous studies (e.g., Pearce et al. 2010, 2011; Zanobetti and Schwartz 2009), because external causes of mortality are less likely to be related to environmental quality. We also focused on the contiguous United States because the numbers of counties with available cause-specific mortality rates were small in Hawaii and Alaska. County-level rates were available for 3,101 of the 3,109 counties in the contiguous United States (99.7%) for all-cause mortality; for 3,067 (98.6%) counties for heart disease mortality; for 3,057 (98.3%) counties for cancer mortality; and for 2,847 (91.6%) counties for stroke mortality. The EQI includes variables representing five environmental domains: air, water, land, built, and sociodemographic (2). The _domain-specific indices include both beneficial and detrimental environmental factors. The air _domain includes 87 variables representing criteria and hazardous air pollutants. The water _domain includes 80 variables representing overall water quality, general water contamination, recreational water quality, drinking water quality, atmospheric deposition, drought, and chemical contamination. The land _domain includes 26 variables representing agriculture, pesticides, contaminants, facilities, and radon. The built _domain includes 14 variables representing roads, highway/road safety, public transit behavior, business environment, and subsidized housing environment. The sociodemographic environment includes 12 variables representing socioeconomics and crime. This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. It can be accessed through the following means: Human health data are not available publicly. EQI data are available at: https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Format: Data are stored as csv files. This dataset is associated with the following publication: Jian, Y., L. Messer, J. Jagai, K. Rappazzo, C. Gray, S. Grabich, and D. Lobdell. Associations between environmental quality and mortality in the contiguous United States 2000-2005. ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, USA, 125(3): 355-362, (2017).

BackgroundEarly-onset colorectal cancer (EOCRC) has an alarmingly increasing trend and arouses increasing attention. Causes of death in EOCRC population remain unclear.MethodsData of EOCRC patients (1975–2018) were extracted from the Surveillance, Epidemiology, and End Results database. Distribution of death was calculated, and death risk of each cause was compared with the general population by calculating standard mortality ratios (SMRs) at different follow-up time. Univariate and multivariate Cox regression models were utilized to identify independent prognostic factors for overall survival (OS).ResultsThe study included 36,013 patients, among whom 9,998 (27.7%) patients died of colorectal cancer (CRC) and 6,305 (17.5%) patients died of non-CRC causes. CRC death accounted for a high proportion of 74.8%–90.7% death cases within 10 years, while non-CRC death (especially cardiocerebrovascular disease death) was the major cause of death after 10 years. Non-cancer death had the highest SMR in EOCRC population within the first year after cancer diagnosis. Kidney disease [SMR = 2.10; 95% confidence interval (CI), 1.65–2.64] and infection (SMR = 1.92; 95% CI, 1.48–2.46) were two high-risk causes of death. Age at diagnosis, race, sex, year of diagnosis, grade, SEER stage, and surgery were independent prognostic factors for OS.ConclusionMost of EOCRC patients died of CRC within 10-year follow-up, while most of patients died of non-CRC causes after 10 years. Within the first year after cancer diagnosis, patients had high non-CRC death risk compared to the general population. Our findings help to guide risk monitoring and management for US EOCRC patients.

BackgroundFemale breast cancer is the most common cancer in Latin American and Caribbean (LAC) countries and is the leading cause of cancer deaths. The high mortality-to-incidence ratio in the regions is associated with mainly the high proportion of advanced stage diagnosis, and also to inadequate access to health care. In this study we aimed to systematically review the proportion of advanced stage (III-IV) at diagnosis (pas) and the five-year stage-specific survival estimates of breast cancer in LAC countries.MethodsWe searched MEDLINE, Embase, and LILACS (Latin American and Caribbean Health Science Literature) to identify studies, in any language, indexed before Nov 5, 2018. We also conducted manual search by reviewing citations of papers found. pas was summarized by random effects model meta-analysis, and meta-regression analysis to identify sources of variation. Stage-specific survival probabilities were described as provided by study authors, as it was not possible to conduct meta-analysis. PROSPERO CRD42017052493.ResultsFor pas we included 63 studies, 13 of which population-based, from 22 countries comprising 221,255 women diagnosed from 1966 to 2017. The distribution of patients by stage varied greatly in LAC (pas 40.8%, 95%CI 37.0% to 44.6%; I2 = 99%; p