Greater Bay Area Cancer Registry

The Greater Bay Area Cancer Registry (GBACR), part of the California Cancer Registry (CCR), is operated by the University of California at San Francisco (UCSF) and collects information on all newly diagnosed cancers occurring in residents of nine Greater Bay Area counties: Alameda, Contra Costa, Marin, Monterey, San Benito, San Francisco, San Mateo, Santa Clara, and Santa Cruz. Statewide cancer reporting in California began in 1988. At present, the most recent year of complete case ascertainment and follow-up for deaths is 2019. Cancer rates from the entire state are also included for comparison. California mortality rates are calculated from vital status data obtained from the California Department of Public Health, Center for Health Statistics.

Infographics in this report highlight the most current cancer statistics for the most common invasive cancers in the Greater Bay Area. Invasive cancers are defined as tumors that have invaded surrounding tissue or other parts of the body. These include data on new cases of cancer and cancer deaths for the 32-year period from 1988 through 2019. The site-specific information reports on the incidence and mortality of the top 20 invasive cancers, examining trends, and highlighting the latest available five years of data from 2015-2019 for the nine Greater Bay Area counties. 

Since 1988, the incidence and mortality rates of cancer (calculated as number of new cases and deaths per 100,000 individuals, respectively) have greatly decreased in the Greater Bay Area. For each cancer site, there are notable differences by sex, race, and ethnicity, but overall, there are promising patterns of decreasing incidence and mortality for most cancer sites. It is of note that population estimate data for detailed Asian American and Pacific Islander ethnicities as well as other granular racial and ethnic groups are needed for cancer surveillance in our diverse communities; yet these data are not available from Census for recent years, including 2020. For highly heterogenous population groups, current limitations in available population estimate data preclude systematic surveillance of cancer rate trends in detailed ethnic groups. In these infographics, we focus on sex- and racial and ethnic-specific cancer rates and trends seen among aggregated racial and ethnic groups including the Asian American/Pacific Islander, Hispanic, non-Hispanic (NH) Black and NH White populations.

In addition to this report, there are several interactive tools available to further explore cancer statistics:

• GBACR Dashboard which provides both cancer incidence and mortality rates by county, race, ethnicity, sex, age, and year of diagnosis.
• California Health Maps website allows users to access incidence rates for several geographies, including census tract aggregation zones, medical service study areas, census designated places, and legislative districts.
• Cal*Explorer is an interactive website that provides easy access to a wide range of CCR cancer statistics. It provides detailed statistics for cancer sites by gender, race, age, region, and for a selected number of cancer sites, by histology.
• CCR interactive cancer incidence and mortality mapping tool: allows users to create and view custom tables and maps of the most current cancer incidence and mortality data by cancer site, year of diagnosis, sex, race, ethnicity, and county.

Analytic Terms

Incidence: The number of new cases of cancer diagnosed in a certain period of time. In this report, incidence data are based on the number of new cases of cancer diagnosed in residents of the Greater Bay Area over the period January 1, 1988 through December 31, 2019.

Mortality: The number of deaths due to cancer in a certain period of time. In this report, mortality data are based on the number of deaths from cancer in residents of the Greater Bay Area over the period January 1, 1988 through December 31, 2019.

Incidence/mortality rate: The number of new cancer cases (incidence) or deaths (mortality) in a certain period of time in a specific population, divided by the size of that population. Incidence and mortality rates are expressed per 100,000 population. In this report, annual and cumulative (or average) 5-year incidence and mortality rates are presented.

Confidence interval: A statistical measure of the precision of the observed incidence or mortality rate. The observed rate is an estimate of the true rate based on counts of cancer cases (or deaths) and of the population, and is subject to variation from the true value of the rate. The confidence interval for the observed rate is a range of values within which the true rate is thought to lie, with a specified level of confidence, e.g., 95%. Rates based on larger numbers of cases (or deaths) are subject to less variation.

Age-adjusted incidence/mortality rate: Age-adjustment is a statistical method that allows comparisons of incidence and mortality to be made between populations with different age distributions. An age-adjusted cancer incidence (or mortality) rate is defined as the number of new cancers (or deaths) per 100,000 population that would occur in a certain period of time if that population had a ‘standard’ age distribution. In this report, incidence and mortality rates are age-adjusted using the U.S. 2000 Standard Population.

Trend: Used to describe the change in the incidence or mortality rate over time. The Annual Percent Change (APC) is used to measure trends. For example, incidence rates may rise gradually over a period of several years, then drop sharply for several years. Statistical criteria are used to quantify the magnitude of change over a period of time.

Race and ethnicity: In this report, race and ethnicity are categorized as: All races and ethnicities, Non-Hispanic (NH) White, NH Black, Asian American/Pacific Islander, or Hispanic. “All races and ethnicities” category includes all of the above, American Indian/Alaska Native, and other/unknown race and ethnicity. The latter two groups are not reported separately due to small numbers for many cancer sites (<5 cases).

Cancer Terms

Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs.

Histology: The study of tissues and cells under a microscope. Cancers are identified and diagnosed primarily on the basis of histology. They often are classified further by histologic subtype.

In situ: Meaning ‘in its original place’. For example, in carcinoma in situ, abnormal cells are found only in the place where they first formed and have not spread.

Invasive: Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer. Invasive tumors are classified according to how far the cancer has spread at the time of diagnosis.

Malignant: Cancerous cells that can invade and destroy nearby tissue and spread to other parts of the body.

Stage: The extent of the cancer in the body, such as how large the tumor is, and if it has spread. In this report, four categories of stage are used: (1) In situ (see above), (2) localized – cancer is limited to the place where it started with no sign that it has spread, (3) regional – cancer has spread to nearby lymph nodes, tissues or organs, (4) distant – cancer has spread to distant parts of the body.

Risk Factor: A characteristic that is associated with the disease; a variable that may increase the chances of getting a specific type of cancer.

Invasive cancers are those determined by a pathologist to have spread beyond the tissue of origin and invaded the surrounding tissue (i.e., not in situ or benign cancers). Overall invasive cancer incidence and mortality includes all invasive cancers combined, and rates of these cancers have decreased significantly during the 32-year period from 1988 through 2019 in the Greater Bay Area. Significant declines were also noted two years ago in the Annual Report to the Nation.[1] This is likely the result of the decline in incidence of many cancers due in part to changes in cancer screening guidelines (e.g., colonoscopy at age 45) and the reduction in smoking prevalence.[2] 

The five most common invasive cancers—breast, prostate, lung and bronchus, colorectal, and melanoma—accounted for slightly over half (53.5%) of all newly diagnosed cancers, while lung, breast, prostate, colorectal, and pancreatic cancers were the most common cause of cancer deaths, collectively accounting for half of all cancer deaths in the Greater Bay Area.

Incidence and Mortality, 1988-2019

• The annual percent decrease in incidence rates from 1988 through 2019 was substantially greater for males (-1.0%) than females (-0.4%), driven largely by declines in the incidence rates of smoking-related cancers and prostate cancer in males. 
• As with overall cancer incidence, mortality rates also declined dramatically from 1988 through 2019 in the Greater Bay Area. A larger decline occurred for males (-2.1%) than females (-1.7%).

Incidence, 2015-2019

• The incidence rate of all invasive cancers from 2015-2019 was higher in males than females.
  • Males: the most recent incidence rates (2015-2019) are highest among NH Black males (481.6 per 100,000), followed by NH White (472.0 per 100,000), Hispanic (349.9 per 100,000), and Asian American/Pacific Islander males (292.8 per 100,000).
  • Females: NH White females had the highest incidence rate (431.8 per 100,000), followed by NH Black (399.3 per 100,000), Hispanic (334.5 per 100,000), and Asian American/Pacific Islander (311.7 per 100,000) females.
• Among Greater Bay Area counties, Marin County had the highest overall cancer incidence rate among males and females combined (450.9 per 100,000), driven by higher incidence of breast cancer and melanoma.
• Cancer incidence rates among all racial and ethnic groups in the Greater Bay Area were similar to those of California, with the exception of NH Black males and females (433.8 per 100,000), where incidence was slightly higher than in California (415.8 per 100,000).
• In 2019 alone, approximately 35,000 new cases of cancer were diagnosed. 

​Mortality, 2015-2019

• The overall cancer mortality rate in the Greater Bay Area was significantly higher among NH Black males (211.6 per 100,000) and females (154.5 per 100,000) than all other racial and ethnic groups.
  • Asian American/Pacific Islander males (114.2 per 100,000) and females (86.2 per 100,000) had the lowest mortality rates. These rates were approximately half the rates for NH Black males and females.
• From 2015 through 2019, the overall cancer mortality rate in the Greater Bay Area (123.6 per 100,000) was significantly lower than California (137.4 per 100,000) among both males and females.
• In 2019, approximately 10,300 cancer deaths occurred in Greater Bay Area residents.

Data Tables - All Cancer Sites

References

[1] Cronin, K.A., et al., Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics. Cancer, 2018. 124(13): p. 2785-2800

[2] Centers for Disease Control and Prevention [Internet]. Current Cigarette Smoking Among Adults in the United States; 2022 Mar 17. Available from: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm#references

Invasive breast cancer is the most common cancer in females, accounting for approximately a third of all invasive cancers diagnosed annually in the Greater Bay Area and in the state. About one in eight females in the U.S. will develop invasive breast cancer within their lifetime. Risk factors include older age, family history of breast cancer, inherited genetic mutations (BRCA1 and BRCA2), early age of menarche, late age of menopause, no pregnancies or pregnancies later in life (i.e., first after age 30), postmenopausal hormone therapy use, obesity and excessive weight gain, physical inactivity, alcohol consumption, and dense breast tissue (as on a mammogram). However, risk factors differ across the different subtypes of breast cancer.

Incidence and Mortality, 1988-2019

• For females in the Greater Bay Area, breast cancer incidence is declining by 0.1% from 1988-2019, though not all racial and ethnic groups are experiencing these declines in incidence rates.
  • In Asian American/Pacific Islander females, rates have been increasing annually (1.1%) followed by Hispanic females (0.5%), with rates stabilizing for NH Black females (0.1%) and declining for NH White females. The underlying reasons for these increasing rates are not well understood, with limited cancer epidemiologic cohort studies on these populations.
• Mortality rates in females in the Greater Bay Area are generally declining, although the rates differ across racial and ethnic groups.
  • The decline is highest among NH White females (-2.3%) followed by Hispanic      (-1.9%), NH Black (-1.6%), and Asian American/Pacific Islander females (-1.0%).

Incidence, 2015-2019

• The most recent 5-year incidence rates (2015-2019) show that compared to all other racial and ethnic groups, NH White females had the highest incidence rate of invasive breast cancer (146.8 per 100,000) followed by Asian American/Pacific Islander (111.8) and NH Black (125.2 per 100,000) females. 
• Compared to rates for California, Hispanic (99.9 per 100,000 in GBA vs. 95.7 per 100,000 in California) and NH White (146.8 per 100,000 in GBA vs. 140.1 per 100,000 in CA) females had significantly higher rates in the Greater Bay Area, while Asian American/Pacific Islander and NH Black female rates were similar between the two regions.
• In the year 2019, almost 6,000 invasive breast cancers were diagnosed among Greater Bay Area females.

Mortality, 2015-2019

• The most recent mortality rates (2015-2019) show that compared to all other racial and ethnic groups (16.6 per 100,000), NH Black females had the highest mortality rate (24.5 per 100,000) of invasive breast cancer followed by NH White females (18.7 per 100,000).
• Compared to rates in California, breast cancer mortality among all racial and ethnic groups in the Greater Bay Area were significantly higher.
• In the year 2019, almost 800 deaths occurred among Greater Bay Area female residents who had been diagnosed with breast cancer.

Data Tables - Breast Cancer

References

[1] Song, M. and E. Giovannucci, Preventable Incidence and Mortality of Carcinoma Associated With Lifestyle Factors Among White Adults in the United States. JAMA Oncol, 2016. 2(9): p. 1154-61.

[2] Sprague, B.L., et al., Proportion of invasive breast cancer attributable to risk factors modifiable after menopause. Am J Epidemiol, 2008. 168(4): p. 404-11.

[3] Tamimi, R.M., et al., Population Attributable Risk of Modifiable and Nonmodifiable Breast Cancer Risk Factors in Postmenopausal Breast Cancer. Am J Epidemiol, 2016. 184(12): p. 884-893.

[4] Engmann, N.J., et al., Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer. JAMA Oncol, 2017. 3(9): p. 1228-1236.

Prostate cancer was the most commonly diagnosed cancer in Greater Bay Area males in the years 1988 through 2019. Prostate cancer typically develops slowly, and males are more likely to die with the disease than of it. Risk factors include family history and increasing age. As a result of changes to prostate cancer screening guidelines, there is no single routine test that is recommended but options include digital rectal exam or prostate-specific antigen test (PSA). [1]

Prostate cancer incidence rates in the U.S. spiked in 1992 then steadily declined, a trend that has been attributed to the widespread adoption of PSA. [1,2] However, with increasing evidence that widespread screening did not improve survival among males older than 75 years of age, the U.S. Preventive Services Task Force recommended in 2008 against PSA-screening in this age group. Furthermore, in 2012, the Task Force recommended against screening at all ages due to evidence that treatment for screening-detected prostate cancer resulted in more harm than benefit. [3,4] This recommendation and the associated decrease in screening, likely contributed to the national declines in prostate cancer incidence in recent years.

Incidence and Mortality, 1988-2019

• Incidence rates and trends have changed dramatically over time as screening guidelines have changed.
• During this entire period, overall, the prostate cancer incidence rate has declined for all racial and ethnic groups, with NH White males experiencing the largest annual decline (-0.7%) followed by NH Black (-0.5%), Asian American/Pacific Islander (-0.5%), and Hispanic males (-0.2%).
• Prostate cancer mortality rates have steadily declined by an average of -2.2% per year from 1988 through 2019, and declines were seen across all racial and ethnic groups.
  • Asian American/Pacific Islander males experienced the greatest annual decline (-3.3%), followed by NH Black (-2.8%), NH White (-2.2%), and Hispanic males (-1.8%).

Incidence, 2015-2019

• The most recent data (2015-2019) show that compared to all other racial and ethnic groups, NH Black males had the highest incidence rate of prostate cancer (148.5 per 100,000), followed by NH White (99.4 per 100,000), Hispanic (80.9 per 100,000), and Asian American/Pacific Islander males (57.5 per 100,000). The high rate of prostate cancer among NH Black males is an active area of study.
• Prostate cancer incidence rates for 2015-2019 in the Greater Bay Area (93.6 per 100,000) are similar to those in California (96.3 per 100,000) for all racial and ethnic groups.
• In the year 2019, over 4,200 prostate cancer cases were diagnosed among Greater Bay Area residents.

Mortality, 2015-2019

• NH Black males had the highest mortality rate (38.9 per 100,000), followed by NH White (18.5 per 100,000), Hispanic (17.9 per 100,000), and Asian American/Pacific Islander males (8.5 per 100,000).
• Prostate cancer mortality rates for 2015-2019 in the Greater Bay Area (17.0 per 100,000) were similar to those in California (19.8 per 100,000) for all racial and ethnic groups.
• In the year 2019, just over 600 prostate cancer deaths occurred among males in the Greater Bay Area.

Data Tables - Prostate Cancer

References

[1] PDQ® Screening and Prevention Editorial Board. PDQ Prostate Cancer Screening. Bethesda, MD: National Cancer Institute. Updated 05/06/2022. Available at: https://www.cancer.gov/types/prostate/patient/prostate-screening-pdq. [PMID: 26389306]

[2] Lin, K., et al., Benefits and harms of prostate-specific antigen screening for prostate cancer: an evidence update for the U.S. Preventive Services Task Force. Ann Intern Med, 2008. 149(3): p. 192-9.

[3] Potosky, A.L., et al., The role of increasing detection in the rising incidence of prostate cancer. JAMA, 1995. 273(7): p. 548-52.

[4] Moyer, V.A., Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med, 2012. 157(2): p. 120-34.

Smoking remains by far the leading risk factor for lung and bronchus cancer (hereafter lung cancer).[1] In California, the prevalence of tobacco smoking continues to decline; in 1988, 23.7% of Californians smoked compared to 9.7% in 2018; a 41% decline in prevalence.[2] However, despite these declines, lung cancer remains the second-most common cancer among males (behind prostate) and females (behind breast) and the most common cause of cancer deaths in the Greater Bay Area, California, and nationwide.[3]

Incidence and Mortality, 1988-2019

• Since 1988, the incidence of lung cancer has continued to decline in the Greater Bay Area among NH Black (-2.0%), NH White (-1.8%), Hispanic (-1.8%), and Asian American/Pacific Islander males (-1.5%).
• Since 1988, the incidence of lung cancer has remained stable for Asian American/Pacific Islander females (0.1%), but has decreased by approximately 1% annually among Hispanic, NH Black, and NH White females.
• Compared to California, the incidence and mortality rates of lung cancer among NH White males and females in the Greater Bay Area was lower. For all other racial and ethnic groups, Greater Bay Area rates were similar compared to California.
• From 1988-2019, incidence decreased significantly by an average of -2.7% per year among males and -1.3% per year among females.
• Mortality trends of lung cancer were analogous to incidence trends. From 1998-2019, mortality decreased more significantly among males by an average of -3.6% per year compared to females (-2.5%).
  • Declines in mortality were evident among all racial and ethnic groups, from -3.6% and -3.5% among NH White and NH Black males, respectively, to -1.2% among Asian American/Pacific Islander females.

Incidence, 2015-2019

• In 2015-2019, males had significantly higher incidence rates than females (41.4 compared to 35.1 per 100,000).
  • Among males, NH Black males had the highest rate of lung cancer (62.7 per 100,000) and among females, NH Black females had the highest rate (47.9 per 100,000).
• In the year 2019, nearly 16,000 individuals in the Greater Bay Area were diagnosed with lung cancer.

Mortality, 2015-2019

• From 2015 through 2019, NH Black males and females had the highest lung cancer mortality rates (44.9 and 28.7 per 100,000, respectively), while the lowest mortality rates were observed in Hispanic and Asian American/Pacific Islander females (12.5 and 16.7 per 100,000 respectively).
• In the year 2019, over 1,800 lung cancer deaths occurred in the Greater Bay Area.

Data Tables - Lung Cancer

References

[1] Lung Cancer Prevention (PDQ) : https://www.cancer.gov/types/lung/patient/lung-prevention-pdq

[2] California Tobacco Control Program, CA BRFSS tobacco track questionnaire: https://letsgethealthy.ca.gov/goals/living-well/reducing-adult-tobacco-use/

[3] American Cancer Society. Cancer Facts & Figures 2022. Atlanta: American Cancer Society; 2022.

Colorectal cancer was the third most common cancer diagnosed in the Greater Bay Area in the most recent years (2015-2019). Usually, these cancers develop when tissue in the inner surface of the colon or rectum starts to grow, forming a polyp.[1] Obesity, smoking, history of colorectal polyps, and a diet high in red meat are associated with increased risk of this cancer.[1,2] Colorectal cancer screening is important clinically because it can identify polyps that could lead to in situ or invasive cancer, allowing for early intervention (removal of the polyp). Recently, the U.S. Preventive Services Task Force revised their recommendation for screening to include those age 45 -75 years.[3] While incidence of colorectal cancer is decreasing overall, a recent analysis of incidence in California evaluated early onset cases (< 50 years) compared to those aged ≥ 50 years, and found that early onset colorectal cancer incidence significantly increased for NH White and Hispanic males and females.[4]

Incidence and Mortality, 1988-2019

• In the Greater Bay Area, colorectal cancer incidence rates declined for all racial and ethnic groups since 1988.
  • Incidence decreased most significantly in NH White males and females (-1.8%), followed by NH Black (-1.7%), Asian American/Pacific Islander (-1.5%), and Hispanic males and females (-0.5%).
• The mortality rate for males and females in the Greater Bay Area declined among all racial and ethnic groups since 1988.  
  • Since 1988, Hispanic males and females have had the smallest reduction in mortality when compared to all other racial and ethnic groups (-1.9% per year). NH Whites males and females had the greatest reduction in mortality (-2.9% per year). Asian American/Pacific Islander males and females experienced a decrease of -2.4%, while mortality rates in NH Black males and females decreased by -2.3%.

Incidence, 2015-2019

• The most recent data (2015-2019) showed that NH Black males and females had the highest incidence rates of colorectal cancer (40.2 per 100,000) compared to all other racial and ethnic groups (33.0 per 100,000) and Asian American/Pacific Islander males and females had the lowest rates (29.0 per 100,000).
• Asian American/Pacific Islander males and females in the Greater Bay Area (29.0 per 100,000) had lower incidence than in California (34.8 per 100,000), while all other racial and ethnic groups in the Greater Bay Area had similar incidence rates to California.
• In the year 2019, over 2,800 cases of colorectal cancer were diagnosed among Greater Bay Area residents.

Mortality, 2015-2019

• Mortality data for the most recent years (2015-2019) indicated that NH Black males and females had the highest rate (16.8 per 100,000) and Asian American/Pacific Islander males and females had the lowest rate (8.9 per 100,000).
• Asian American/Pacific Islander and NH White males and females in the Greater Bay Area had lower mortality compared to California rates. Rates for Hispanic and NH Black males and females were similar between the two regions.
• From 2015 through 2019, colorectal cancer mortality rates in the Greater Bay Area for all racial and ethnic groups (10.7 per 100,000) were significantly lower than in California (12.3 per 100,000).
• In the year 2019, over 850 colorectal cancer deaths occurred among Greater Bay Area males and females.

Data Tables - Colorectal Cancer

References

[1] National Cancer Institute, SEER Cancer Statistics Factsheets: Colon and Rectum. Available at: http://seer.cancer.gov/statfacts/html/colorect.html. U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

[2] National Cancer Institute, Colon Cancer Treatment-Patient Version (PDQ). Available at: https://www.cancer.gov/types/colorectal/patient/colon-treatment-pdq#section/_112. U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

[3] US Preventive Services Task Force Recommendation Statement. Screening for Colorectal Cancer: JAMA, 2021. 325(19): p. 1965-1977.

[4] Ellis, L., et al., Colorectal Cancer Incidence Trends by Age, Stage, and Racial/Ethnic Group in California, 1990-2014. Cancer Epidemiol Biomarkers Prev, 2018.

Invasive melanoma, a cancer of the skin’s pigment cells, is substantially more common among populations with fair complexions. In the Greater Bay Area, among NH White males, melanoma was the second most common newly diagnosed invasive cancer, behind prostate cancer. Melanoma risk factors include fair skin complexion and prolonged exposure to sunlight. Compared to other types of skin cancers, melanoma is more likely to spread to other parts of the body.[1]

Incidence and Mortality, 1988-2019

• While melanoma mortality rates have been decreasing since 1988 in the Greater Bay Area, incidence rates have been increasing.
• Since 1988, there has been a steep annual increase in the number of newly diagnosed cases per 100,000 males and females each year for the NH White population, and a small increase for the Hispanic population.
  • Among NH White males, the incidence of invasive melanoma increased at a rate of 2.6% per year from 1988 through 2019. A similar increase (2.5%) occurred among NH White females during this same time period.
  • Hispanic males (0.8%) and females (1.0%) also experienced an increase in incidence.
• Mortality among NH White males and females combined decreased by 1.1% per year since 1988, likely due to improved treatment and advancements in therapies.[2]

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Incidence, 2015-2019

• In 2015-2019, among all racial and ethnic groups, the highest melanoma incidence rate was observed in the NH White population (males: 60.2 per 100,000; females: 38.0 per 100,000), and the lowest was in the Asian American/Pacific Islander population (males: 1.2 per 100,000; females: 1.3 per 100,000).
• Based on 2015-2019 incidence rates, the NH White population (47.8 per 100,000) in the Greater Bay Area had significantly higher incidence rates than in all of California (23.4 per 100,000).
• In the year 2019, over 2,400 cases of melanoma were diagnosed among Greater Bay Area residents. Among those, almost 2,100 were among the NH White residents.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• The NH White male mortality rate was three times higher among males (4.2 per 100,000) than females (1.6 per 100,000).
• The most recent melanoma mortality rates over 2015-2019 in the Greater Bay Area were comparable to those in California for both males and females among all racial and ethnic groups (GBA: 1.7 per 100,000; CA: 1.9 per 100,000).
• In 2019, just over 150 deaths due to melanoma occurred among Greater Bay Area residents. Among those, over 130 were among the NH White residents.

Data Tables - Melanoma

References

[1] National Cancer Institute, Melanoma Treatment (PDQ®)–Patient Version. Available at: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq. U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

[2] Berk-Krauss J, Stein JA, Weber J, Polsky D, Geller AC. New Systematic Therapies and Trends in Cutaneous Melanoma Deaths Among US Whites, 1986-2016. Am J Public Health. 2020;110(5):731-3.

Uterine cancer is the most common gynecologic cancer and is primarily diagnosed in post-menopausal females, with incidence peaking in the sixth decade of life.[1] In addition to age, other risk factors include obesity, estrogen-only hormone replacement therapy, and family history of uterine, colon, or ovarian cancer. Endometrial cancer (lining of the uterus) accounts for more than 90% of uterine cancers.[1,2] Rates and trends should be interpreted carefully due to true at-risk populations (females without hysterectomy), which may vary across time and racial and ethnic groups, data are not available and thus not used in these calculations.

Incidence and Mortality, 1988-2019

• Since 1988, across all racial and ethnic groups, incidence rates increased with a similar rise in mortality rates.
  • From 1988 to 2019, there were significant annual increases in incidence among NH Black (2.1%) and Asian American/Pacific Islander (2.2%) females. Hispanic females also saw a sharp annual increase since 1988 (1.8%).
  • Mortality rates significantly increased for all racial and ethnic groups from 1988-2019. NH Black (2.3%) and Asian American/Pacific Islander (1.6%) females showed the largest annual increase in mortality from 1988-2019.

Incidence, 2015-2019

• NH Black females (31.6 per 100,000) experienced the highest incidence rates, followed by NH White (27.7 per 100,000), Hispanic (25.1 per 100,000), and Asian American/Pacific Islander females (22.9 per 100,000).
• Those aged 65-69 years had the highest incidence rates from 2015-2019.
• California and Greater Bay Area female residents experienced similar incidence rates across all racial and ethnic groups (27.0 vs. 27.2 per 100,000) from 2015-2019.
• In 2019, over 1,300 cases of uterine cancer were diagnosed among Greater Bay Area residents.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• In 2015-2019, mortality rates for NH Black females (10.7 per 100,000) were more than twice as high as NH White (5.0 per 100,000), Hispanic (4.8 per 100,000), and Asian American/Pacific Islander (4.0 per 100,000) females, believed to be attributed to more aggressive subtypes and more advanced stage at diagnosis.[3]
• Greater Bay Area and California mortality rates (GBA: 5.1 per 100,000, CA: 5.1 per 100,000) were similar across all racial and ethnic groups.
• In the year 2019, almost 250 deaths due to uterine cancer occurred among Greater Bay Area residents.

Data Tables - Uterine Cancer

References

[1] Centers for Disease Control and Prevention. What Are the Risk Factors for Uterine Cancer?; 2021 Aug 5. Available from: https://www.cdc.gov/cancer/uterine/basic_info/risk_factors.htm

[2] Cancer.Net. Uterine Cancer - Statistics; 2022 Feb. Available from: https://www.cancer.net/cancer-types/uterine-cancer/statistics

[3] Long, B., F.W. Liu, and R.E. Bristow, Disparities in uterine cancer epidemiology, treatment, and survival among African Americans in the United States. Gynecol Oncol, 2013. 130(3): p. 652-9

Non-Hodgkin Lymphoma (NHL) is a type of cancer that encompasses a wide range of illnesses affecting the lymphatic system. It can start anywhere that lymph tissue is found such as lymph nodes, the spleen, bone marrow, and the tonsils.[1] Lymphomas can be indolent, meaning it does not need immediate treatment but should be monitored closely. They can also be aggressive, requiring immediate treatment due to their ability to grow and spread quickly. Older age, being male, family history of NHL, and having a weakened immune system can increase the risk of adult NHL.[2,3]

Incidence and Mortality, 1988-2019

• Since 1988, across all racial and ethnic groups, incidence rates increased while mortality rates decreased.
  • There was a significant annual increase in incidence among Hispanic males and females (0.9%), followed by NH Black (0.7%), Asian American/Pacific Islander (0.2%), and NH White males and females (0.2%).
• Mortality rates decreased for all racial and ethnic groups from 1988-2019, with NH White males and females experiencing the highest decrease (-1.9%), followed by NH Black (-1.4%), Asian American/Pacific islander (-1.4%), and Hispanic males and females (-0.7%).

Incidence, 2015-2019

• The most recent data (2015-2019) showed that NHL incidence rates were higher among males than females overall and in all racial and ethnic groups (24.2 vs. 16.2 per 100,000 ). 
• Incidence rates for 2015-2019 showed that NH White males (27.4 per 100,000) had significantly higher incidence rates than Hispanic (22.6 per 100,000), NH Black (19.5 per 100,000), and Asian American/Pacific Islander males (18.4 per 100,000).
• NH White and Hispanic females (17.3 per 100,000) had similarly high rates (17.3 and 17.2 per 100,000, respectively). These rates were significantly higher than rates among Asian American/Pacific Islander (12.6 per 100,000) and NH Black (11.6 per 100,000) females.
• In the year 2019, over 1,725 NHL cases were diagnosed among Greater Bay Area residents.

Mortality, 2015-2019

• Mortality data for the most recent years (2015-2019) indicated that NH White males had the highest rate (6.7 per 100,000) and NH Black females had the lowest rate (3.1 per 100,000).
• Mortality rate in males of all racial and ethnic groups (6.3 per 100,000) was nearly double the mortality rate of females of all racial and ethnic groups (3.7 per 100,000).
• In the year 2019, over 375 deaths from NHL occurred among Greater Bay Area residents.

Data Tables - Non-Hodgkin Lymphoma

References

[1] SEER Cancer Stat Facts: Non-Hodgkin Lymphoma. National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/statfacts/html/nhl.html

[2] Armitage, J.O., et al., Non-Hodgkin lymphoma. Lancet, 2017. 390(10091): p. 298-310.

[3] American Cancer Society, Non-Hodgkin Lymphoma. 2020: Available at: https://www.cancer.org/cancer/non-hodgkin-lymphoma/causes-risks-prevention/riskfactors.html.

Bladder cancer is the seventh most common cancer and four times more prevalent among males than females. Approximately 90% of cases occur in those ages 55 and over. NH White males and females are more likely to be diagnosed with bladder cancer than any other racial and ethnic group. The largest risk factor for bladder cancer is smoking tobacco, which contributes to 50-65% of all cases; up to another 20% of bladder cancer can be attributed to exposure to chemicals in textile, rubber, leather, and print industries.[1]

Incidence and Mortality, 1988-2019

• Declines in incidence and mortality rates from 1988-2019 occurred in both sexes and all racial and ethnic groups.
  • Asian American/Pacific Islander (-0.9%), Hispanic (-0.7%), NH Black (-0.6%), and NH White (-0.5%) males and females experienced significant annual decreases in incidence.
• Asian American/Pacific Islander males and females (-1.7%) were the only group with a significant annual decline in mortality rates from 1988-2019. Mortality in all other racial and ethnic groups remained relatively stable.

Incidence, 2015-2019

• For 2015-2019, the incidence rate in males (27.7 per 100,000) was more than four times higher than females (6.6 per 100,000).
• For 2015-2019, NH White males and females (20.8 per 100,000) had the highest incidence rates, followed by NH Black (12.4 per 100,000), Hispanic (10.8 per 100,000), and Asian American/Pacific Islander males and females (8.6 per 100,000).
• From 2015-2019, Greater Bay Area and California residents had similar overall incidence rates (16.0 vs. 16.3 per 100,000, respectively).
• In 2019, over 1,300 bladder cancer cases were diagnosed in the Greater Bay Area.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• The mortality among males (5.4 per 100,000) was more than three times higher than females (1.6 per 100,000) from 2015-2019.
• From 2015-2019, the Greater Bay Area had lower mortality rates for both males and females (3.2 per 100,000) compared to the California mortality rates (3.8 per 100,000).
• In 2019, over 250 bladder cancer deaths occurred in the Greater Bay Area.

Data Tables - Bladder Cancer

References

[1] Saginala, K., Barsouk, A., Aluru, J. S., Rawla, P., Padala, S. A., & Barsouk, A. (2020). Epidemiology of Bladder Cancer. Medical Sciences, 8(1), 15. https://doi.org/10.3390/medsci8010015

Kidney cancer is one of the top ten most common cancers in the U.S. and is about twice as common in males than females.[1] Common risk factors for kidney cancer include family history, and adverse health behaviors such as smoking and obesity.[2] The majority of kidney cancers (between 60-70%) are diagnosed before the cancer has spread outside the kidney (localized stage), and the observed incidence trends are driven by the trends in localized disease.[3] Increasing rates can in part be attributed to the greater use of medical imaging procedures resulting in incidental detection of early kidney cancers. They may also reflect changes in the prevalence of kidney cancer risk factors, such as obesity and hypertension, in the population.[4]

Incidence and Mortality, 1988-2019

• In the Greater Bay Area, kidney cancer incidence rates have been increasing, with the largest annual increases occurring in Hispanic males and females (2.2%), followed by NH Black (2.1%), Asian American/Pacific Islander (1.8%), and NH White males and females (1.4%).
• The mortality rate in the Greater Bay Area has been declining among all racial and ethnic groups since 1988, and most rapidly for NH White (-1.1%) and Hispanic individuals (-0.8%).

Incidence, 2015-2019

• In the Greater Bay Area, the most recent incidence rates (2015-2019) showed that compared to all other racial and ethnic groups, NH Black males and females (20.3 per 100,000) had the highest incidence of kidney cancer, followed by Hispanic (16.7 per 100,000), NH White (13.8 per 100,000), and Asian American/Pacific Islander (8.6 per 100,000) males and females.
• For 2015-2019, kidney cancer incidence rates overall in the Greater Bay Area (13.4 per 100,000) were similar to rates in California (15.2 per 100,000) for both males and females of all racial and ethnic groups.
• In 2019, 1,150 kidney cancer cases were diagnosed in the Greater Bay Area.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• Mortality data for the most recent years (2015-2019) indicated that NH Black males and females had the highest rate (3.9 per 100,000), followed closely by Hispanic (3.5 per 100,000), NH White (2.7 per 100,000), and Asian American/Pacific Islander (1.8 per 100,000) males and females.
• For 2015 through 2019, kidney cancer mortality rates in the Greater Bay Area (2.7 per 100,000) were lower than California (3.3 per 100,000) overall, except for rates among NH Black males and females (3.5 vs. 4.0 per 100,000, respectively).
• In the year 2019, just over 200 kidney cancer deaths occurred among Greater Bay Area residents.

Data Tables - Kidney Cancer

References

[1] ACS Report: https://www.cancer.org/cancer/kidney-cancer/about/key-statistics.html

[2] Chow, W.H., L.M. Dong, and S.S. Devesa, Epidemiology and risk factors for kidney cancer. Nat Rev Urol, 2010. 7(5): p. 245-57.

[3] Rossi, S. H., Klatte, T., Usher-Smith, J., & Stewart, G. D. (2018). Epidemiology and screening for renal cancer. World journal of urology, 36(9), 1341-1353.

[4] National Cancer Institute, Renal Cell Cancer Treatment (PDQ®)–Patient Version. Available at: https://www.cancer.gov/types/kidney/patient/kidney-treatment-pdq#_1. U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

Thyroid cancer incidence increased dramatically in the Greater Bay Area for males and females starting in the early 2000s, but has stabilized more recently. Increases in thyroid cancer may be due to improved imaging technology and thus increased detection of thyroid cancers, as well as to the increased prevalence of suspected risk factors (e.g., prior radiation exposure, obesity, insulin resistance due to obesity or type 2 diabetes).[1,2] There has been substantial scientific discourse as to whether the increase in papillary thyroid cancer diagnoses represents “overdiagnosis” of a harmless condition, and questions about potential over-treatment of otherwise indolent cancers.[3]

Incidence and Mortality, 1988-2019

• Since 1988, the incidence of thyroid cancer has increased by an average of 2-3% per year for all racial and ethnic groups. Females experienced a more significant annual increase than males during this time period (3.4% vs. 2.8%, respectively). Since approximately 2010, incidence has stabilized for both sexes and all racial and ethnic groups.
• Mortality is low (0.6 per 100,000 for all races and ethnicities combined) and has remained stable since 1988 for both sexes and all racial and ethnic groups.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Incidence, 2015-2019

• From 2015 through 2019, incidence rates are strikingly higher among females than males in all racial and ethnic groups. For each racial and ethnic group, the incidence rates are approximately three times higher for females than males.
  • For Asian American/Pacific Islander population, the incidence among males compared to females was 6.9 vs. 20.4 per 100,000.
  • For Hispanic population, the incidence among males compared to females was 5.4 vs. 18.0 per 100,000.
  • For NH Black population, the incidence among males compared to females was 3.3 vs. 8.7 per 100,000. Incidence rates for NH Black males and females were significantly lower than all other racial and ethnic groups.
  • For NH White population, the incidence among males compared to females was 7.9 vs. 18.0 per 100,000.
• In the year 2019, 1,059 thyroid cancers were diagnosed among Greater Bay Area residents.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• Thyroid cancer mortality is low. The most recent data (2015-2019) showed Asian American/Pacific Islander females (0.9 per 100,000) had mortality rates that were significantly higher than Asian American/Pacific Islander males (0.4 per 100,000) and NH White females (0.5 per 100,000).
• In the year 2019, just under 50 thyroid cancer deaths occurred among Greater Bay Area residents.

Data Tables - Thyroid Cancer

References

[1] Horn-Ross, P.L., et al., Continued rapid increase in thyroid cancer incidence in California: trends by patient, tumor, and neighborhood characteristics. Cancer Epidemiol Biomarkers Prev, 2014. 23(6): p. 1067-79.

[2] Pellegriti, G., et al., Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol, 2013.

[3] Vaccarella, S., et al., The Impact of Diagnostic Changes on the Rise in Thyroid Cancer Incidence: A Population-Based Study in Selected High-Resource Countries. Thyroid, 2015. 25(10): p. 1127-36.

Pancreatic cancer is the 11^th most common cancer in the Greater Bay Area, and is one of the leading causes of cancer mortality. This type of cancer is often detected at a later stage due to its rapid spread and the lack of symptoms in the early stages. Later stages are associated with symptoms, but these can be non-specific, such as lack of appetite and weight loss.[1] This cancer has been associated with smoking, obesity, personal or family history of diabetes or pancreatitis, and certain hereditary conditions. Pancreatic adenocarcinoma is the most common type of pancreatic cancer, accounting for approximately 85% of pancreatic cancers. Signs and symptoms of pancreatic cancer include jaundice, pain, and weight loss. It is difficult to diagnose early and survival is poor.[2]

Incidence and Mortality, 1988-2019

• Since 1988, pancreatic cancer has had a slight annual increase among Hispanic and NH White males (0.5% and 0.4%, respectively), but remained stable for males of other races and ethnicities. Among females, pancreatic cancer has increased annually in Asian American/Pacific Islander females, by 1% since 1988. Hispanic and NH White females have experienced slight annual increases during this time (0.3% and 0.4%, respectively).
• Mortality rates have remained stable in all groups during this time period, with the exception of NH Black males, where mortality has decreased by -1.1% per year since 1988.

Incidence, 2015-2019

• Compared to all other racial and ethnic groups, the most recent incidence rates (2015-2019) showed that NH Black populations had the highest incidence rate of pancreatic cancer (16.6 per 100,000), followed by NH White (12.7 per 100,000), Hispanic (11.9 per 100,000) and Asian American/Pacific Islander populations (10.1 per 100,000).
• In the year 2019, over 1,000 pancreatic cancer cases were diagnosed among Greater Bay Area residents.

Mortality, 2015-2019

• The most recent data (2015-2019) showed that NH Black populations had the highest mortality rate of pancreatic cancer compared to all other racial and ethnic groups. The rates were similar among males (13.5 per 100,000) and females (12.8). Asian American/Pacific Islander females have the lowest mortality rate (7.1 per 100,000).
• In the year 2019, just over 900 pancreatic cancer deaths occurred among Greater Bay Area residents.

Data Tables - Pancreatic Cancer

References

[1] National Cancer Institute, SEER Cancer Statistics Fact Sheets: Pancreatic Cancer. Available at: http://seer.cancer.gov/statfacts/html/pancreas.html.  U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

[2] Ilic, M. and I. Ilic, Epidemiology of pancreatic cancer. World J Gastroenterol, 2016. 22(44): p. 9694-9705.

Although leukemia is the most common type of childhood cancer, it occurs most often in adults older than 55 years. It is more common in males than females. A variety of treatment options can help control the progression of leukemia and its symptoms; these include traditional chemotherapy, targeted therapies towards genes and proteins identified in leukemia cells, radiation, and stem cell/bone marrow transplant. Leukemia is the seventh leading cause of cancer death in the U.S. with a national 5-year relative survival rate of 65.7%. Both incidence and mortality rates vary by age, race and ethnicity.

Incidence and Mortality, 1988-2019

• Since 1988, leukemia incidence rates in the Greater Bay Area remained stable among males of all racial and ethnic groups. Among females, there was a small but significant increase in annual rates only in Hispanic females (0.4%) and remained stable for all other female racial and ethnic groups.
• Mortality rates among males and females across all racial and ethnic groups remained stable during 1988-2019.

Incidence, 2015-2019

• In 2015-2019, Greater Bay Area leukemia incidence rates for males were significantly higher than females, across all racial and ethnic groups.
  • Asian American/Pacific Islander male incidence rate was 10.0 per 100,000 vs. 5.6 per 100,000 for females.
  • Hispanic male incidence rate was 11.5 per 100,000 vs. 8.1 per 100,000 for females.
  • NH Black male incidence rate was 12.5 per 100,000 vs. 7.8 per 100,000 for females.
  • NH White males incidence rate was 17.3 per 100,000 vs. 9.8 per 100,000 for females; NH White males had the highest incidence rate across groups defined by sex, race and ethnicity.
• The overall incidence rate among males and females was lower in the Greater Bay Area (11.4 per 100,000) than California (12.1 per 100,000).
• In the year 2019, just over 900 cases of leukemia were diagnosed among Greater Bay Area residents.

Mortality, 2015-2019

• In 2015-2019, the leukemia mortality rate was highest among NH White males (7.3 per 100,000), followed by NH Black males (6.2 per 100,000), then Asian American/Pacific Islander and Hispanic males (both 4.8 per 100,000).
• In 2015-2019, the leukemia mortality rates for all racial and ethnic groups combined were 6.4 per 100,000 males and 3.3 per 100,000 females, with the rate for females being significantly lower than the corresponding California statewide rate.
• In the year 2019, about 400 leukemia deaths occurred among Greater Bay Area residents.

Data Tables - Leukemia

Reference

[1] National Cancer Institute, Cancer Stat Facts: Leukemia. Available at: https://seer.cancer.gov/statfacts/html/leuks.html. U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

Most ovarian cancers start from cells that cover the outer surface of the ovaries, and are often not diagnosed until late stage.[1] Risk factors include a family history of ovarian cancer, obesity and excessive weight gain, no pregnancies, use of postmenopausal hormone therapy, and use of fertility drugs.[2,3]

Incidence and Mortality, 1988-2019

• Ovarian cancer incidence declined in all racial and ethnic groups in the Greater Bay Area since 1988. The largest annual decline occurred among NH White females (-1.5%), followed by NH Black females (-0.9%), Asian American/Pacific Islander females (-0.6%) and Hispanic females (-0.5%).
• Mortality declined significantly for NH White (-1.5%) and Hispanic (-1.6%) females per year, while remaining stable for Asian American/Pacific Islander and NH Black females.

Incidence, 2015-2019

• The most recent incidence rates (2015-2019) showed that NH White females had the highest incidence rate of ovarian cancer (11.6 per 100,000), followed closely by NH Black females (10.3 per 100,000), Hispanic females (9.5 per 100,000) and Asian American/Pacific Islander females (9.1 per 100,000).
• In the year 2019, over 460 ovarian cancers were diagnosed among Greater Bay Area residents.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• NH White females had the highest mortality rate of ovarian cancer (7.0 per 100,000), followed by NH Black females (6.0 per 100,000), Hispanic females (4.9 per 100,000) and Asian American/Pacific Islander females (4.3 per 100,000).
• Compared to California, Hispanic women in the Greater Bay Area had a lower mortality rate of ovarian cancer. All other racial and ethnic groups had rates that were similar to California rates.
• In the year 2019, over 250 ovarian cancer deaths occurred among Greater Bay Area residents.

Data Tables - Ovarian Cancer

References

[1] American Cancer Society, Ovarian Cancer: Detailed Guide. 2018: Available at: http://www.cancer.org/cancer/ovarian-cancer/about/what-is-ovarian-cancer.html.

[2] National Cancer Institute, Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention–for health professionals (PDQ®). 2022. Available at: http://www.cancer.gov/types/ovarian/hp/ovarian-prevention-pdq. U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

[3] Woolen SA, Lazar AA, Smith-Bindman R. Association Between the Frequent Use of Perineal Talcum Powder Products and Ovarian Cancer: a Systematic Review and Meta-analysis. J Gen Intern Med. Published online February 2, 2022. doi:10.1007/s11606-022-07414-7.

Cancer of the oral cavity and pharynx (oropharyngeal cancer) is more common in males than females.[1] The main risk factor responsible for approximately 70% of oropharyngeal cancers is infection with certain strains of human papillomavirus (HPV).[2] Other important risk factors are tobacco and heavy alcohol use. There is no routine screening in place, but HPV vaccination has been shown effective against oral HPV infection and is indicated for oropharyngeal cancer prevention.[3,4]

Incidence and Mortality, 1988-2019

• For all males, oropharyngeal cancer declined annually since 1988 by -0.5%. A more significant decline occurred among all females during this time (-1.1%). The largest declines were among Asian American/Pacific Islander males (-0.7%) and females (-1.0%).
• Significant declines in mortality occurred for both males and females in all racial and ethnic groups. Annual declines ranged from -1.6% among Hispanic males to -3.4% among NH Black males.

Incidence, 2015-2019

• The most recent incidence rates (2015-2019) for males showed that, compared to other racial and ethnic groups, NH White males had the highest incidence rate of oropharyngeal cancer (18.3 per 100,000). This may be due to racial and ethnic differences in prevalence of oncogenic oral HPV types and sexual behaviors.[5,6]
• Among females, Asian American/Pacific Islander (6.6 per 100,000) and NH White populations (6.5 per 100,000) had the highest incidence rates of oropharyngeal cancer.
• The incidence rate for Asian American/Pacific Islander females was significantly higher in the Greater Bay Area (6.6 per 100,000) compared to California (5.3 per 100,000). All other racial and ethnic groups had similar rates between the two regions.
• In the Greater Bay Area, Hispanic and NH Black females had lower rates than all other racial and ethnic groups (3.8 and 4.6 respectively per 100,000).
• In the year 2019, just over 600 oropharyngeal cancers were diagnosed among Greater Bay Area males, and 200 among females.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• In recent years (2015-2019) NH Black males had the highest mortality rate (4.2 per 100,000) when compared to other racial and ethnic groups, while Hispanic males had the lowest rate (2.3 per 100,000). Trends among females ranged from 1.2 per 100,000 among NH White to 0.6 per 100,000 among NH Black populations.
• Mortality rates were similar between the Greater Bay Area and California for all racial and ethnic groups except for NH White males, where California shows a higher mortality rate (4.4 per 100,000) compared to the Greater Bay Area (3.6 per 100,000).
• In the year 2019, just over 100 oropharyngeal cancers deaths occurred among Greater Bay Area males, and 60 among females.

Data Tables - Oropharyngeal Cancer

References

[1] American Cancer Society, Oral Cavity and Oropharyngeal Cancers. Detailed Guide. Available at: http://www.cancer.org/cancer/oral-cavity-and-oropharyngealcancer/causes-risks-prevention/risk-factors.html. 2021

[2] Centers for Disease Control and Prevention. Cancers Associated with Human Papillomavirus, United States, 2014–2018. United States Cancer Statistics Data Brief 2021;26.

[3] Herrero R, Quint W, Hildesheim A, Gonzalez P, Struijk L, Katki HA, Porras C, Schiffman M, Rodriguez AC, Solomon D, Jimenez S, Schiller JT, Lowy DR, van Doorn LJ, Wacholder S, Kreimer AR; CVT Vaccine Group. Reduced prevalence of oral human papillomavirus (HPV) 4 years after bivalent HPV vaccination in a randomized clinical trial in Costa Rica. PLoS One. 2013 Jul 17;8(7):e68329. doi: 10.1371/journal.pone.0068329

[4] Food and Drug Administration, Product approval information for Human Papillomavirus 9-valent Vaccine, Recombinant also known as Gardasil 9, 2020. Available at: https://www.fda.gov/vaccines-blood-biologics/vaccines/gardasil-9

[5] Raymond S, Liu B, Taioli E. Racial differences in the prevalence of oncogenic oral human papillomavirus infection types in the United States adult population. Head Neck. 2018 Oct;40(10):2219-2227. doi: 10.1002/hed.25317

[6] Wierzbicka M, Klussmann JP, San Giorgi MR, Wuerdemann N, Dikkers FG. Oral and laryngeal HPV infection: Incidence, prevalence and risk factors, with special regard to concurrent infection in head, neck and genitals. Vaccine. 2021 Apr 22;39(17):2344-2350. doi: 10.1016/j.vaccine.2021.03.047.

Hepatocellular carcinoma (HCC) is the most common type of liver cancer in adults.[1] Bile duct cancer (cholangiocarcinoma) is a rare cancer that forms inside the bile ducts of the liver, which are tubes that connect the liver and gallbladder to the small intestine. Cancer that forms in the bile ducts is called intrahepatic bile duct cancer (IBD).  This section includes data for liver cancer and IBD combined. Liver cancer and IBD is approximately three times more common in males than females. Risk factors for liver cancer include chronic hepatitis B infection, chronic hepatitis C infection, heavy alcohol use, and obesity.[2] Five-year relative survival from liver cancer is 20%, with worse survival among those with later stage of diagnosis.[3] Screening for liver cancer is recommended for high-risk groups.

Incidence and Mortality, 1988-2019

• Overall, for all Greater Bay Area residents, incidence of liver cancer increased by 2.0% per year among males and 2.3% per year among females. However, there were differences among the various racial and ethnic groups.
  • Liver cancer incidence decreased annually among Asian American/Pacific Islander males (-0.9%) and females (-0.8%).
  • Incidence rates increased most significantly for NH White females (3.1%) and Hispanic males (2.6%).
  • NH Black males and females combined also experienced an annual increase in incidence (2.5%).
• Patterns in mortality rates varied across sex, race and ethnicity.
  • Liver cancer mortality rates decreased significantly for Asian American/Pacific Islander males (-1.3%) and females (-0.9%) per year since 1988.
  • Mortality rates increased for Hispanic males (1.4%), NH Black males (2.1%), and NH White males (2.0%). Incidence also increased among Hispanic females (1.5%) and NH White females (2.1%).
  • Mortality rates remained stable for Hispanic females during this time.

Incidence, 2015-2019

• NH Black males had the highest incidence rates of liver cancer (23.1 per 100,000), closely followed by Hispanic males (21.4 per 100,000) and Asian American/Pacific Islander males (19.4 per 100,000). NH White males had the lowest rates (10.1 per 100,000).
• Hispanic females had the highest incidence rate (7.2 per 100,000) followed by NH Black females (5.5 per 100,000) and Asian American/Pacific Islander females (5.1 per 100,000). NH White females have the lowest rate (2.5 per 100,000), but similar to males, was experiencing a rapid increase in incidence.
• Liver cancer incidence rates from 2015-2019 were higher for NH Black males in the Greater Bay Area (23.1 per 100,000) compared to California (17.4 per 100,000). All other racial and ethnic groups had incidence rates that were comparable to rates in California.
• In the year 2019, almost 700 liver cancers were diagnosed among Greater Bay Area residents.

Mortality, 2015-2019

• NH Black males had the highest rates of mortality (15.7 per 100,000). Asian American/Pacific Islander and Hispanic males have similar rates (10.0 per 100,000), while NH White males had the lowest rate (7.8 per 100,000).
• Among females, Hispanics had the highest mortality (6.5 per 100,000), while NH Black and Asian American/Pacific Islander females had similar rates (5.3 per 100,000). Liver cancer mortality was lowest among NH White females (3.4 per 100,000).
• From 2015-2019, mortality rates were similar between the Greater Bay Area and California for all racial and ethnic groups.
• In the year 2019, over 600 liver cancer deaths occurred among Greater Bay Area residents.

Data Tables - Liver Cancer

References

[1] What is liver cancer?. American Cancer Society. 2019. Available from: https://www.cancer.org/cancer/liver-cancer/about/what-is-liver-cancer.html

[2] National Cancer Institute. Liver Cancer Causes, Risk Factors, and Prevention; 2022 May 18. Available from: https://www.cancer.gov/types/liver/what-is-liver-cancer/causes-risk-factors

[3] SEER. Cancer of the Liver and Intrahepatic Bile Duct - Cancer Stat Facts. Available from: https://seer.cancer.gov/statfacts/html/livibd.html

Stomach cancer, also known as gastric cancer, remains a leading cause of cancer and cancer-related mortality. It is ranked the 16^th most common cancer in the Greater Bay Area, but the 13^th contributor to cancer mortality. In most of the world, stomach cancers form in the main part of the stomach, but in the U.S., stomach cancer is more likely to affect the area where the esophagus meets the stomach. Where the cancer occurs in the stomach is a factor considered when determining treatment options. Known risk factors include smoking, a diet high in smoked and salted foods, and medical conditions including H. pylori infection. [1] Globally, stomach cancer is much more common than in the United States. [2]

Incidence and Mortality, 1988-2019

• Stomach cancer incidence rates declined significantly since 1988 for all racial and ethnic groups and both sexes. The steepest declines have been noted in Asian American/Pacific Islander males (-2.8% per year) and females (-2.8% per year).
• Overall, incidence declined more rapidly among males (-1.5%) than females (-0.6%).
• Asian American/Pacific Islander, NH Black, and NH White males all experienced a similar significant decline in mortality of approximately 3.7% per year. The mortality rate for Hispanic males declined annually from 1988-2019, at a slightly slower pace (-2.2%).

Incidence, 2015-2019

• NH Black males and Hispanic females had the highest incidence rates (12.7 per 100,000 and 8.4 per 100,000, respectively). Incidence rates for stomach cancer were significantly lower for both NH White males (7.5 per 100,000) and females (3.5 per 100,000).
• The most recent incidence rates in the Greater Bay Area were comparable to those in California for both males and females among all racial and ethnic groups.
• Almost 700 cases of stomach cancer were diagnosed in Greater Bay Area residents in 2019.

Mortality, 2015-2019

• NH White males and females had significantly lower stomach cancer mortality rates compared to other racial and ethnic groups (3.2 and 1.6 per 100,000, respectively). NH Black males (7.7 per 100,000) and Hispanic females (4.4 per 100,000) had the highest mortality rates.
• Mortality rates for stomach cancer by sex and by racial and ethnic group were similar to that of California.
• Almost 300 stomach cancer-related deaths occurred in 2019 in Greater Bay Area residents.

Data Tables - Stomach Cancer

References

[1] National Cancer Institute, Gastric Cancer Treatment (PDQ®)–Patient Version. Available at: https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq. U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.

[2] World Cancer Research Fund International Available at: https://www.wcrf.org/cancer-trends/stomach-cancer-statistics/. Accessed November 4, 2022

Myeloma, also referred to as multiple myeloma, affects the plasma cells, which are found in bone marrow. Plasma cells make antibodies that help the body respond to an infection by attacking and killing germs. When plasma cells become cancerous, they create an abnormal protein, or antibody, that grows out of control. This cancer occurs more commonly in males, particularly NH Black males. Other risk factors include older age, family history of myeloma, obesity, and having other plasma cell diseases.[1]

Incidence and Mortality, 1988-2019

• The incidence of myeloma has increased annually among Hispanic (0.6%) and NH Black males (0.5%). Among females, the incidence increased among Hispanic (0.6%), and NH White populations (0.5%) since 1988. The incidence among Asian American/Pacific Islander males and females remained stable.
• Overall there were declines in mortality among both males and females. Among NH Black males and Hispanic females, rates were relatively stable. NH Black females exhibited the steepest decline in mortality at -1.8% per year since 1988. 

Incidence, 2015-2019

• NH Black males and females had almost double the incidence of myeloma compared to other races and ethnicities.
  • The incidence rate for NH Black males was 16.4 per 100,000, compared to 8.4 per 100,000 for NH White males, 7.8 per 100,000 for Hispanic males, and 5.0 per 100,000 for Asian American/Pacific Islander males.
  • For females, the incidence rate for NH Black females was 11.2 per 100,000 compared to Hispanic females (5.5 per 100,000), NH White females (4.8 per 100,000) and Asian American/Pacific Islander females (3.5 per 100,000).
• The most recent incidence rates (2015-2019) show that Greater Bay Area rates were similar to rates for all of California.  
• In the year 2019, 562 myeloma cases were diagnosed among Greater Bay Area residents.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• NH Black males and females also has the highest mortality rates when compared to all other racial and ethnic groups. NH Black males had a rate of 8.3 per 100,000, almost twice the rate of NH Black females (4.7 per 100,000). A similar trend was seen for NH White population (males: 3.6 per 100,000, females: 1.8 per 100,000).
• The mortality rates of Asian American/Pacific Islander and Hispanic males and females were similar:
  • Asian American/Pacific Islander males (1.9 per 100,000) and females (1.2 per 100,000);
  • Hispanic males (3.0 per 100,000) and females (2.2 per 100,000).
• In the year 2019, 217 deaths in myeloma patients occurred among Greater Bay Area residents.

Data Tables - Myeloma

Reference

[1] American Cancer Society. (2018, February 28). Risk factors for multiple myeloma. https://www.cancer.org/cancer/multiple-myeloma/causes-risks-prevention/risk-factors.html#references

Data Tables - Testicular Cancer

References

[1] American Cancer Society. Cancer Facts & Figures 2022. Atlanta: American Cancer Society; 2022

[2] McGlynn, Katherine A., and Michael B. Cook. “Etiologic factors in testicular germ-cell tumors.” Future oncology 5.9 (2009): 1389-1402.

[3] Ghazarian, Armen A., et al. “Recent trends in the incidence of testicular germ cell tumors in the United States.” Andrology 3.1 (2015): 13-18.

[4] McGlynn KA, Trabert B. Adolescent and adult risk factors for testicular cancer. Nat Rev Urol. 2012;9(6):339-349. Published 2012 Apr 17. doi:10.1038/nrurol.2012.61

The most common risk factor for cervical cancer is human papilloma virus (HPV) infection. Cervical cancer typically develops slowly, and regular screenings (“Pap” and/or HPV testing) can detect high-risk HPV types and changes that occur in the cells before cancer develops.[1] HPV vaccination is contributing to the declines in incidence, but barriers to obtaining vaccination among adolescents must be addressed by clinicians, health care systems, and public health institutions for all population groups to benefit.[2] This summary represents the most recent (2015-2019) data for cervical cancer. There is a previous fact sheet here on our website.

Incidence and Mortality, 1988-2019

• The annual incidence of cervical cancer cases declined substantially since 1988 in all racial and ethnic groups, particularly among Asian American/Pacific Islander (-2.8%) and NH Black females (-2.8%). Hispanic (-2.3%) and NH White females (-1.2%) also experienced a decline in incidence.
• The mortality rate declined among all racial and ethnic groups since 1988, but particularly among NH Black (-4.1%) and Asian American/Pacific Islander females (-3.8%). NH White (-3.0%) and Hispanic females (-2.8%) experienced more moderate declines, but still significant.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Incidence, 2015-2019

• The most recent incidence rates (2015-2019) show that compared to all other racial and ethnic groups, Hispanic females (7.4 per 100,000) had the highest incidence rate of cervical cancer. This may in part be due to low rates of cervical cancer screening in this population.[1] 
  • NH Black (6.7 per 100,000), Asian American/Pacific Islander (5.5 per 100,000), and NH White (5.1 per 100,000) females had significantly lower rates compared to Hispanic females (5.7 per 100,000).
• Incidence rates by age appeared to peak among the 40-44 year old age group (12.5 per 100,000).
• Compared to California, cervical cancer incidence rates in the Greater Bay Area were significantly lower for all races and ethnicities except NH Black females. Among NH Black females, the incidence rates for California (7.3 per 100,000) and the Greater Bay Area (6.7 per 100,000) were not significantly different.
• In the year 2019, almost 250 cervical cancers were diagnosed among Greater Bay Area residents.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• In recent years (2015-2019) NH Black (2.0 per 100,000) and Hispanic females (1.8 per 100,000) had the highest mortality rates when compared to Asian American/Pacific Islander (1.4 per 100,000) and NH White females (1.1 per 100,000).
• Compared to California, cervical cancer mortality rates in the Greater Bay Area were significantly lower for all races and ethnicities except NH Black females. Among NH Black females, the rate for California (3.1 per 100,000) was significantly higher than for the Greater Bay Area approximately 1.5-2 per 100,000 among all other racial and ethnic groups.
• In the year 2019, just over 60 cervical cancer deaths occurred among Greater Bay Area residents.

Data Tables - Cervical Cancer

References

[1] Islami F, Guerra CE, Minihan A, Yabroff KR, Fedewa SA, Sloan K, Wiedt TL, Thomson B, Siegel RL, Nargis N, Winn RA, Lacasse L, Makaroff L, Daniels EC, Patel AV, Cance WG, Jemal A. American Cancer Society's report on the status of cancer disparities in the United States, 2021. CA Cancer J Clin. 2022 Mar;72(2):112-143. doi: 10.3322/caac.21703. Epub 2021 Dec 8. PMID: 34878180.

[2] World Health Organization, Cervical Cancer. Available at https://www.who.int/news-room/fact-sheets/detail/cervical-cancer. 2022.

There are many different types of brain and other nervous system tumors included in this classification: astrocytic tumors, oligodendroglial tumors, mixed gliomas, and others.[1] Tumors may be benign or malignant, however data below pertain only to malignant brain tumors. Risk factors are generally unknown; however, having specific genetic syndromes may increase the risk of a central nervous system tumor. Tumors found in the brain have often started somewhere in the body and spread to one or more parts of the brain (metastases). Brain and other nervous system cancers are one of the most common cancers among children.[2]

Glioblastoma

While glioblastoma multiforme (GBM) is relatively rare, its poor prognosis and resulting rates of mortality make it an important public health issue. These tumors arise in glial cells, a specific type of cell in the brain that surround neurons and provide support and insulation. Glial cells are the most abundant cell type in the central nervous system.[3]

Incidence and Mortality, 1988-2019

• For males and females of all racial and ethnic groups combined in the Greater Bay Area, incidence decreased from 1988-2019 (-0.4%).
  • The largest decline in incidence occurred among NH Black females (-1.0%).
• Mortality for males and females in all racial and ethnic groups decreased in the Greater Bay Area (-0.9%).
  • Hispanic men (-1.4%) experienced the largest decline in mortality since 1988.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Incidence, 2015-2019

• Brain and other nervous system cancers are significantly more common among NH White males and females than other racial and ethnic groups. 
• The most recent incidence rates (2015-2019), show that compared to all other racial and ethnic groups, NH White males and females (7.5 per 100,000) have significantly higher incidence rate of brain and central nervous system cancer, followed by Hispanic (4.8 per 100,000), Asian American/Pacific Islander (3.8 per 100,000), and NH Black males and females (3.8 per 100,000).
• Brain and other nervous system cancer incidence was similar in California (5.9 per 100,000) and the Greater Bay Area (5.7 per 100,000).
• In 2019, there were over 430 cases of brain and other nervous system cancers diagnosed in the Greater Bay Area residents.

According to California Department of Public Health guidelines, cancer incidence rates cannot be reported if based on less than 15 cancer cases and/or a population of less than 10,000 to ensure confidentiality and stable statistical rates.

Mortality, 2015-2019

• NH White males and females (4.9 per 100,000) had the highest mortality rate compared to all other racial and ethnic groups, followed by Hispanic males and females (2.8 per 100,000). NH Black (2.5 per 100,000) and Asian American/Pacific Islander (2.5 per 100,000) males and females had lower rates of mortality, comparatively.
• Recent mortality rates show that California (4.3 per 100,000) rates were slightly higher compared to rates in the Greater Bay Area (3.8 per 100,000).
• In the year 2019, 300 brain and other nervous system cancer deaths occurred among Greater Bay Area residents.

Data Tables - Brain Cancer

References

[1] SEER. Cancer of the Brain and Other Nervous System - Cancer Stat Facts. Available from: https://seer.cancer.gov/statfacts/html/brain.html

[2] SEER. Annual Report to the Nation 2021. Available from: https://seer.cancer.gov/report_to_nation/.

[3] American Cancer Society, Types of Brain and Spinal Cord Tumors in Adults. Available at: https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults/about/types-of-brain-tumors.html.