Annual Report 1988-2023

The Greater Bay Area Cancer Registry (GBACR), part of the California Cancer Registry (CCR) and the National Cancer Institute’s (NCI) Surveillance, Epidemiology and End Results (SEER) program, is operated by the University of California, San Francisco (UCSF) and collects information on all newly diagnosed cancers 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 began in 1988. At present, the most recent year of complete cancer ascertainment and follow-up for deaths is 2023. 

We highlight current cancer statistics for the ten most common invasive cancers, defined as tumors that have spread beyond the tissue of origin to other parts of the body. The report is based on available data for new cases of cancer and cancer deaths for the 36-year period from 1988 through 2023. Downloadable cancer-specific data include incidence and mortality rates, information on trends in incidence and mortality over time (annual percent change or APC), and highlight the most recent five years of data from 2019-2023. Per California Department of Public Health policies for release and presentation of data, case counts less than 11, and rates based on less than 11 cases and fewer than 20,000 in population were suppressed. As a result, information for males or females or certain racial or ethnic groups, as well as between-group comparisons, may not be available. State and national rates are included for comparison (see County- or Region-specific Incidence and Mortality Rates worksheets and Comparison worksheet). A detailed guide to data in each file appears in the first worksheet entitled “README”.

Since 1988, the overall age-adjusted incidence and mortality rates of cancer (calculated as the number of new cases and deaths per 100,000 individuals in the population at risk, respectively) have greatly decreased in the Greater Bay Area. For each cancer site, there are notable differences in rates by sex, race, and ethnicity, but overall, there are patterns of decreasing incidence and mortality for most cancer sites. In the downloadable files, we focus on sex- and racial and ethnic-specific cancer rates and trends for (1) Asian American, Native Hawaiian, and Pacific Islander (AANHPI), (2) Hispanic, (3) non-Hispanic (NH) Black and (4) NH White populations.  

We use population estimates that were produced by Woods & Poole Economics, Inc. through a contract with NCI SEER Program. The population estimates incorporate intercensal (2000-2009, 2010-2019) and bridged race estimates (2020-2023) that are derived from the original multiple race categories in the Censuses. The bridged race estimates and a description of the methodology used to develop them appear on the National Center for Health Statistics website. Read more about population estimates for this data release here.

All Invasive Sites

Rates of invasive cancer across all sites generally decreased during the 36-year period from 1988 through 2023 in the Greater Bay Area, however, among females, there was an increase in the incidence of cancer beginning in 2016 of 1.1% per year. An overall decline in all cancer incidence was noted by the American Cancer Society in their 2026 Annual Cancer Statistics report [1]. The American Cancer Society report also found that over the last ten years (2014-2023), the cancer mortality rate dropped by 1.5% per year on average. We also observed this in the Greater Bay Area; among males and females combined, cancer mortality declined by 2.2% per year from 2012-2023.

After it was reported that in the SEER registry, the overall cancer incidence rate was roughly 8% to 9% lower than expected in 2020 due to the reduction in screening and diagnosis with the COVID-19 pandemic (https://seer.cancer.gov/report_to_nation/stats.html), we continue to see the number of cancer cases diagnosed aligned with expectations prior to 2020. In fact, we report a slight increase in the number of cancer cases since 2022, while deaths due to cancer continue to fall in the Greater Bay Area. The recent increase in incidence may be a result of shifts to higher distribution of later stage cancers, particularly for breast and prostate cancers. 

The five most common invasive cancers—breast, prostate, lung and bronchus, colorectal, and uterine—accounted for half (50%) of all newly diagnosed cancers in the Greater Bay Area from 2019 through 2023. Lung and bronchus, prostate, breast, pancreas and colorectal were the most common cause of cancer deaths, collectively accounting for almost half (48%) of all cancer deaths in the Greater Bay Area for this same period.  

Incidence and Mortality Trends Over Time

• Since 1988, yearly incidence rates of invasive cancer declined more among males than females. Males in the GBACR experienced a significant decline in incidence from 2010 through 2014 (-3.9% per year), followed by a stabilization of rates through 2023. Decreases overall were driven largely by declines in the incidence of smoking-related cancers (e.g., lung and bronchus) and prostate cancer in males. While females experienced a significant decline from 1988 through 2016 (-1.1% per year), more recently females showed a significant increase in invasive cancer incidence rates from 2016 through 2023 of 1.1% per year. 
•  A significant annual decline in cancer mortality rates occurred among males from 1995 through 2023 (-2.1% per year). Among females, a significant annual decline in cancer mortality rates occurred from 2004 through 2023 (-2.0% per year). These declines are likely due to a combination of factors, including advancements in treatment, continued increased screening, and the effects of a continued reduction in smoking behavior.  

Incidence, 2019-2023

• In 2023, 37,661 invasive cancers were diagnosed in the Greater Bay Area. 
• The incidence rate of all invasive cancers from 2019-2023 was higher in males (424.5 per 100,000) than females (399.6 per 100,000). 
  • Males: The incidence rate was highest among NH Black males (492.6 per 100,000), followed by NH White (487.0 per 100,000), Hispanic (352.6 per 100,000), and AANHPI (300.9 per 100,000) males.
  • Females: NH White females had the highest cancer incidence rate (443.7 per 100,000), followed by NH Black (411.4 per 100,000), Hispanic (354.5 per 100,000), and AANHPI (333.7 per 100,000) females.
• Across Greater Bay Area counties, Santa Cruz County had the highest overall cancer incidence rate among males and females combined (470.3 per 100,000), followed by Marin County (469.2 per 100,000). This appeared to be driven by higher incidence of female breast cancer and melanoma (particularly among males). Alameda County had the lowest overall cancer incidence rate (382.7 per 100,000).
• The cancer incidence rate among males was slightly lower in the Greater Bay Area than California overall (424.5 vs. 431.0 per 100,000). Among females, the overall cancer incidence rate was similar in the Greater Bay Area when compared to all of California (399.6 vs. 396.0 per 100,000, respectively). 
   

Mortality, 2019-2023

• In 2023, 10,213 cancer deaths occurred in the Greater Bay Area.
• The cancer mortality rate from 2019-2023 was higher in males (133.2 per 100,000) than females (102.9 per 100,000). 

  • Males: The highest mortality rate was among NH Black males (189.7 per 100,000), followed by NH White (141.3 per 100,000), Hispanic (122.4 per 100,000), and AANHPI (107.8 per 100,000) males.

  • Females: NH Black females had the highest cancer mortality rate (145.0 per 100,000), followed by NH White (109.8 per 100,000), Hispanic (97.0 per 100,000), and AANHPI (81.1 per 100,000) females.

• From 2019 through 2023, the overall cancer mortality rate in the Greater Bay Area was significantly lower than California for both males (133.2 vs. 152.6 per 100,000) and females (102.9 vs. 115.9 per 100,000).
   

Data Tables - All Cancer Sites

References

[1] American Cancer Society. Cancer Facts & Figures 2026.  Atlanta: American Cancer Society; 2026. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2026/2026-cancer-facts-and-figures.pdf

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 California. Recent evidence of increasing breast cancer incidence also has been reported nationwide among females of all racial and ethnic groups with a notable increase among females younger than 50 years of age and AANHPI females of all ages [1]. In the Greater Bay Area, among those less than 50 years of age, incidence increased most significantly among Hispanic women (2.4% per year from 2011-2023) followed by a steady increase of 1.3% per year among AANHPI women from 1988-2023. 

About one in eight females in the United States (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 pregnancy after age 30), postmenopausal hormone therapy use, obesity and excessive weight gain, physical inactivity, alcohol consumption, and dense breast tissue (as indicated on a mammogram). However, risk factors differ across subtypes of breast cancer [2-5]. The U.S. Preventive Services Task Force recommends biennial screening mammography for breast cancer for most females 40 to 74 years of age. This recommendation states that current evidence is insufficient to assess the balance of benefits and harms of screening mammography in females more than 75 years of age [6].

Data Tables - Breast Cancer

References

[1] Giaquinto, A. N., H. Sung, L. A. Newman, R. A. Freedman, R. A. Smith, J. Star, A. Jemal and R. L. Siegel (2024). "Breast cancer statistics 2024." CA Cancer J Clin 74(6): 477-495. 
[2] National Cancer Institute. SEER Cancer Stat Facts: Female Breast Cancer. National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/statfacts/html/breast.html 
[3] 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.
[4] 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.
[5] 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.
[6] Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. JAMA, 2024. 331(22): p. 1918-1930. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening. 

Prostate cancer was the most commonly diagnosed cancer among males in the Greater Bay Area in the years 1988 through 2023. Risk factors include a family history of disease and increasing age. In the U.S., prostate cancer incidence rates spiked in 1992 then steadily declined, a trend that has been attributed to the widespread adoption of PSA testing [1]. However, the incidence rate increased by 2.8% per year from 2014 through 2023 in the Greater Bay Area, with the greatest increase among males diagnosed with advanced stage disease [1,2]. These changing patterns may reflect a lack of consensus among professional bodies (U.S Preventive Services Task Force, American Cancer Society, and American Urological Association) over the benefits of screening against harms, as well as changes in screening guidelines over time [3,4,5]. 

Data Tables - Prostate Cancer

References

[1] Siegel, R. L., T. B. Kratzer, A. N. Giaquinto, H. Sung and A. Jemal (2025). "Cancer statistics, 2025." CA Cancer J Clin 75(1): 10-45. Available at: https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21871

[2] Van Blarigan, E. L., M. A. McKinley, S. L. Washington, 3rd, M. R. Cooperberg, S. A. Kenfield, I. Cheng and S. L. Gomez (2025). "Trends in Prostate Cancer Incidence and Mortality Rates." JAMA Netw Open 8(1): e2456825.

[3] US Preventive Services Task Force. Grossman, S. J. Curry, D. K. Owens, K. Bibbins-Domingo, A. B. Caughey, K. W. Davidson, C. A. Doubeni, M. Ebell, J. W. Epling, Jr., A. R. Kemper, A. H. Krist, M. Kubik, C. S. Landefeld, C. M. Mangione, M. Silverstein, M. A. Simon, A. L. Siu, and C. W. Tseng. "Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement." JAMA 319, no. 18 (May 8 2018): 1901-13. https://dx.doi.org/10.1001/jama.2018.3710. 

[4] American Cancer Society. American Cancer Society Recommendations for Prostate Cancer Early Detection. 2023 Nov 22.  Available at: https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/acs-recommendations.html. 

[5] American Urological Association. Early Detection of Prostate Cancer AUA/SUO Guideline (2023, Amended 2026). Available at: https://www.auanet.org/guidelines-and-quality/guidelines/early-detection-of-prostate-cancer-guideline. 

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 2003, 16.5% of Californians smoked compared to 5.1% in 2023 [2]. However, despite these declines, lung cancer remains the second-most common cancer among males (behind prostate) and females (behind breast). CDC notes that in the United States, about 10% to 20% of lung cancers, or 20,000 to 40,000 lung cancers each year, happen in people who never smoked, and recent studies have noted that lung cancer may be increasing in people who never smoked, particularly among females [3]. Exposures to radon, air pollution and second-hand smoke are also established risk factors [4]. Lung cancer is also the most common cause of cancer deaths in the Greater Bay Area, California, and nationwide [5]. 

Data Tables - Lung Cancer

References

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

[2] UCLA Center for Health Policy Research: https://healthpolicy.ucla.edu/.

[3] Center for Disease Control and Prevention. “Lung Cancer Among People Who Never Smoked”. October 15, 2024. Available at: https://www.cdc.gov/lung-cancer/nonsmokers/.

[4] American Cancer Society. Cancer Facts & Figures 2025. Atlanta: American Cancer Society; 2025. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2025/2025-cancer-facts-and-figures-acs.pdf

Colorectal cancer was the fourth most common cancer diagnosed in the Greater Bay Area in the most recent years (2019-2023). Usually, these cancers develop when tissue in the inner surface of the colon or rectum starts to grow, forming a polyp [1]. Older age, obesity, smoking, history of colorectal polyps, alcohol consumption, and a diet high in red and processed meats are associated with increased risk of this cancer [1-3]. Adhering to colorectal cancer screening guidelines, engaging in regular physical activity, and a diet rich in whole grains and dairy products are associated with lower risk of colorectal cancer [3]. Colorectal cancer screening is important because it can identify polyps that could lead to in situ or invasive cancer, allowing for early intervention (removal of the polyp). The U.S. Preventive Services Task Force recommends screening for colorectal cancer in adults aged 45-75 years [4]. 

While incidence of colorectal cancer is decreasing overall, it is increasing among people less than 50 years of age throughout the U.S., including California [5,6]. In the Greater Bay Area, among those less than 50 years of age, incidence rates increased among all races/ethnicities, with the most significant increase in the AANHPI population in recent years (8.8% per year from 2018-2023) followed by Hispanic (6.6% per year from 2013-2023) and NH White (4.0% per year from 2008-2023) populations. 

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] World Cancer Research Fund International, Colorectal Cancer. Available at: https://www.wcrf.org/diet-activity-and-cancer/cancer-types/colorectal-cancer/. Accessed on June 28, 2023. WCRF International, London.

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

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

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 the difficulty in identifying true at-risk populations (females who have not had a hysterectomy), which may vary across time and racial and ethnic groups. For example, NH Black females experience higher hysterectomy rates in the U.S., partly due to higher prevalence of uterine fibroids [3]. However, hysterectomy data is not available and thus not used in these calculations.

Data Tables - Uterine Cancer

References

[1] Centers for Disease Control and Prevention. What Are the Risk Factors for Uterine Cancer?; 2024 Feb 23. Available from: https://www.cdc.gov/uterine-cancer/risk-factors/index.html 

[2] American Cancer Society. Key Statistics for Endometrial Cancer. Uterine Cancer - Statistics; 2026 Jan 14.  Available from: https://www.cancer.net/cancer-types/uterine-cancer/statistics 

[3] Temkin, S. M., L. Minasian and A. M. Noone (2016). "The End of the Hysterectomy Epidemic and Endometrial Cancer Incidence: What Are the Unintended Consequences of Declining Hysterectomy Rates?" Front Oncol 6: 89.

Invasive melanoma, a cancer of the skin’s pigment cells, is more common among populations with fair complexions and prolonged exposure to ultraviolet (UV) light from the sun or tanning beds. NH White populations have a 3% lifetime risk of melanoma, compared to 0.1% for NH Black and 0.5% in Hispanic populations [1]. It is significantly more common among NH White males than NH White females. In the Greater Bay Area, among NH White males, melanoma was the second most common newly diagnosed invasive cancer. Compared to other types of skin cancers, melanoma is more likely to spread to other parts of the body [2].  

Data Tables - Melanoma

References

[1] American Cancer Society. Key Statistics for Melanoma Skin Cancer. 2026 Jan 13. Available at: https://www.cancer.org/cancer/types/melanoma-skin-cancer.html

[2] 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. 

Non-Hodgkin lymphoma is a cancer that starts in cells called lymphocytes, which are part of the body’s immune system. Lymphomas 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 the cancer 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. Factors affecting an individual’s risk of developing non-Hodgkin lymphoma include immune disorders, infections, genetics, family history, and occupational factors [2,3]. Non-Hodgkin lymphoma is a common cancer, primarily affecting children, teens and young adults. Progress has been made to reduce mortality in recent years. From 2013-2022, the American Cancer Society noted that the mortality rate declined by around 2% per year [4].

Data Tables - Non-Hodgkin Lymphoma

References

[1] American Cancer Society. What Is Non-Hodgkin Lymphoma? 2024 Feb 15. Available at: https://www.cancer.org/cancer/types/non-hodgkin-lymphoma/about/what-is-non-hodgkin-lymphoma.html

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

[3] Armitage, J. O., R. D. Gascoyne, M. A. Lunning and F. Cavalli (2017). "Non-Hodgkin lymphoma." Lancet 390(10091): 298-310.

[4] American Cancer Society. Key Statistics for Non-Hodgkin Lymphoma. 2026 Jan 13. Available at: https://www.cancer.org/cancer/types/non-hodgkin-lymphoma/about/key-statistics.html

Bladder cancer is the eighth most common cancer and four times more prevalent among males than females. As of 2022, approximately 94% of cases in the U.S. occur in those ages 55 and over [1]. 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 [2]. Bladder cancer mortality rates in the U.S. have been decreasing since 1988, by about 1% per year in both males and females. These improvements in mortality rates may be attributed to better awareness and treatments of bladder cancer [3].

Data Tables - Bladder Cancer

References

[1] SEER Cancer Stat Facts: Bladder Cancer. National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/statfacts/html/urinb.html   

[2] Saginala, K., A. Barsouk, J. S. Aluru, P. Rawla, S. A. Padala and A. Barsouk (2020). "Epidemiology of Bladder Cancer." Med Sci (Basel) 8(1).  

[3] American Cancer Society. Key Statistics for Bladder Cancer. 2026 Jan 13. Available at: https://www.cancer.org/cancer/types/bladder-cancer/about/key-statistics.html

Kidney cancer is about twice as common in males than females and is more common in NH Black and American Indian and Alaska Native populations, although reasons for these patterns are not clear [1]. Established risk factors for kidney cancer include older age (55 to 74), tobacco smoking, obesity, and history of hypertension and chronic kidney disease [2]. Most 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 [3,4]. The increasing incidence rate may in part be attributed to the greater use of medical imaging procedures, which results in incidental detection of early kidney cancers. Increasing kidney cancer incidence may also reflect changes in the prevalence of kidney cancer risk factors, such as obesity and hypertension, in the population [4]. 

Data Tables - Kidney Cancer

References

[1] American Cancer Society, Kidney Cancer: 2025 Jan 16: Available at: https://www.cancer.org/cancer/kidney-cancer/about/key-statistics.html

[2] Scelo, G. and T. L. Larose (2018). "Epidemiology and Risk Factors for Kidney Cancer." J Clin Oncol 36(36): JCO2018791905

[3] Kase, A. M., D. J. George and S. Ramalingam (2023). "Clear Cell Renal Cell Carcinoma: From Biology to Treatment." Cancers (Basel) 15(3).

[4] 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.  

Pancreatic cancer is the 10th most common cancer and the 5th most common cause of cancer mortality, in the Greater Bay Area. Pancreatic 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]. Smoking, obesity, personal or family history of diabetes or pancreatitis, occupational exposure to some chemicals, and certain hereditary conditions have been associated with risk of pancreatic cancer. Pancreatic adenocarcinoma is the most common type of pancreatic cancer, accounting for approximately 95% of pancreatic cancers [1]. In the Greater Bay Area, we saw an increase in pancreatic cancer incidence particularly among AANHPI males and females (1.1% per year from 1993-2023); and in those less than 50 years of age at diagnosis, incidence increased dramatically among females of all races/ethnicities from 1999-2023 by 3.8% per year. 

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.