Data Visualizations Tool Technical Notes

These pages provide the technical documentation to accompany the Data Visualizations Tool 2020 submission data (1999–2018).

A complete version is also available in the Data Visualizations Technical Notes document. pdf icon[PDF-550KB]

The Impact of Cancer

Cancer is the second-leading cause of death among Americans.1 About one of every four deaths in the United States is due to cancer.2 The 2021 release of United States Cancer Statistics data indicates that, in 2018 (the most recent year of incidence* data available), 1,708,923 Americans received a new diagnosis of invasive cancer and 599,265 Americans died from this disease.3 These counts do not include in situ cancers, benign and borderline brain and central nervous system tumors, and basal and squamous cell skin cancers. As of January 1, 2018, an estimated 12.1 million Americans were alive with a history of invasive cancer diagnosed in the past 17 years.3

The Agency for Healthcare Research and Quality’s (AHRQ) Medical Expenditure Panel Surveyexternal icon estimates estimated that for 2018, the direct medical costs for cancer, including all health care expenditures, were $112.5 billion, of which 43.4% was spent on hospital outpatient or office-based provider visits, 28.1% on inpatient hospital stays, and 21.3% on prescription medications.4

*2018 is the most recent year for which incidence data are available. These data include cancer deaths during 1999 through 2018. Cancer mortality data for 2019 are available and can be accessed at CDC’s National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS).

Data are from selected central cancer registries, covering 99% of the U.S. population, that meet the data quality criteria for all invasive cancer sites combined. See registry-specific data quality information.

Cancer Prevention

Several effective primary and secondary prevention measures could substantially reduce the number of new cancer cases and prevent many cancer-related deaths. To reduce the nation’s cancer burden, we must reduce behavioral and environmental factors that increase cancer risk and ensure that high-quality screening services and evidence-based treatments are available and accessible to everyone, including medically underserved populations.5 6 The Centers for Disease Control and Prevention’s (CDC) Division of Cancer Prevention and Control (DCPC) has supported all 50 states, the District of Columbia, tribes and tribal organizations, Pacific Island Jurisdictions, and Puerto Rico in developing comprehensive cancer control plans, which include proven strategies and planned actions to prevent cancer in their geographic regions.7

How Cancer Data Are Collected

Cancer registries collect population-based data about the occurrence of cancer (incidence), the types of cancer (morphology), the site in the body where the cancer first occurred (primary site), the extent of disease at the time of diagnosis (stage), the planned first course of treatment, and the outcome of treatment and clinical management (survival and vital status).8 9 Cancer incidence data are reported to metropolitan area, regional, and statewide cancer registries from a variety of medical facilities, including hospitals, physicians’ offices, radiation facilities, freestanding surgical centers, and pathology laboratories. Death data, including deaths due to cancer, are recorded on death certificates that are sent to state vital statistics offices. Death data include information regarding primary cancer site, and may also include morphology according to International Classification of Diseases, Tenth Revision (ICD-10).

Uses of Cancer Data

Information derived from population-based central cancer registries and from state vital statistics systems is critical for directing effective geographic area and population-specific cancer prevention and control programs that focus on preventing behaviors that put people at increased risk for cancer (such as smoking), and on reducing environmental risk factors (such as occupational exposure to known carcinogens). This information also is essential for deciding which geographic areas should have cancer screening programs, and for making long-term plans for adequate diagnostic and treatment services. Combined data at the national, state, congressional district, and county levels help federal and state public health officials establish, prioritize, and monitor national initiatives in public health surveillance and track progress toward the national goals and objectives set forth in Healthy People.external icon

Additional resource: Archive of the Annual Reports to the Nationexternal icon


  1. Kochanek KD, Xu JQ, Arias E. Mortality in the United States, 2019. NCHS Data Brief, no 395. Hyattsville, MD: National Center for Health Statistics. 2020.
  2. National Center for Health Statistics. Health, United States, 2019. Hyattsville, Maryland. 2021. DOI: 10.15620/cdc:100685.external icon
  3. U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on 2020 submission data (1999–2018): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute;, June 2021.
  4. Agency for Healthcare Research and Quality. Total expenditure in millions by condition and event type, United States, 2018.external icon Medical Expenditure Panel Survey. Generated interactively: April 28, 2021.
  5. Curry SJ, Byers T, Hewitt M. Fulfilling the Potential of Cancer Prevention and Control. Washington (DC): The National Academies Press; 2003.
  6. Haynes MA, Smedley BD. The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington (DC): The National Academies Press; 1999.
  7. National Comprehensive Cancer Control Program. Comprehensive Cancer Control Plans. Atlanta: U.S. Department of Health and Humans Services, Centers for Disease Control and Prevention.
  8. American College of Surgeons Commission on Cancer. Standards of the Commission on Cancer Vol II: Registry Operations and Data Standards (ROADS). Chicago (IL): American College of Surgeons; 1998.
  9. Fritz A, Ries LAG. The SEER Program Code Manual, third edition. Bethesda (MD): National Cancer Institute; 1998.


CDC’s National Program of Cancer Registries (NPCR), NCI’s Surveillance, Epidemiology, and End Results (SEER) Program, and CDC’s National Vital Statistics System (NVSS) are groups that contributed to United States Cancer Statistics data.

Data Sources

Incidence, mortality, and population denominator data are key data sources for the U.S. Cancer Statistics.

U.S. Cancer Statistics Publication Criteria

Cancer incidence data that appear on this website are from central cancer registries that have high-quality cancer incidence data.

Statistical Methods

An overview of statistical methods used in United States Cancer Statistics, including incidence and death rates, confidence intervals, relative cancer interval, cancer prevalence, and suppression of rates and counts.

Interpreting the Data

Interpretation of U.S. Cancer Statistics data such as incidence, mortality, race, and ethnicity, as well as guidance for comparing cancer data by state.