Shifting demographics and cancer incidence projections in the United States.

Abstract

e22618 Background: Over the last four decades, racial and ethnic diversity in the United States has increased substantially. Understanding how these demographic shifts will shape future cancer burden is critical for anticipating demands on the oncology care delivery systems. This study estimated overall and site-specific cancer incidence through 2030 by race and ethnicity. Methods: Using delay-adjusted incidence data from 2019-2022 (excluding 2020) in the population-based SEER national registry, we projected the number of invasive cancers overall and for the ten most common cancer sites through 2030. Projections were generated for the total population and for non-Hispanic American Indian and Alaskan Native (AIAN), non-Hispanic Asian American and Pacific Islander (AAPI), non-Hispanic Black, Hispanic, and non-Hispanic White (NHW) populations. Analyses used data-driven Joinpoint algorithm with Poisson variance and weighted Bayesian Information Criterion model selection method. Results: Based on current trends, an estimated 1,002,653 cancer cases will occur in 2030, representing a 19.4% increase from 2022, with substantial variation by race and ethnicity. The largest increases are projected among Hispanic (126,246 to 182,002 cases, 44.2%), followed by AAPI (57,339 to 81,701, 42.5%), AIAN (2,927 to 4,141 cases, 41.5%) and Black (95,467 to 119,189 cases, 24.9%) populations, whereas NHW populations are projected to experience the smallest increase (550,073 to 617,277 cases, 12.2%). Projected changes varied by cancer site across racial and ethnic groups. Among AIAN populations, relative increases ranged from 9.3% (43 to 47 cases) for cervical cancer to 88.1% (159 to 299 cases) for kidney cancer and decreases of 10.7% for liver cancer (112 to 100 cases) and 53.6% for bladder cancer (69 to 32 cases); among AAPI populations, from 7.7% (1,954 to 2,104 cases) for liver cancer to 61.3% (1,838 to 2,964 cases) for pancreatic cancer; among Hispanic populations, from 24.1% (7,624 to 9,461 cases) for lung cancer to 58.5% (4,016 to 6,366 cases) for pancreatic cancer; and among Black populations, from 6.4% (3,941 to 4,193 cases) for kidney cancer to 32.8% (3,255 to 4,321 cases) for pancreatic cancer and decreases of 6.2% for liver cancer (1976 to 1,854 cases) and 5.5% for lung cancer (10,063 to 9,510 cases). In contrast, projected changes across cancer sites among NHW populations were generally modest ( < 15%), with declines observed for lung (11%, 63,866 to 56,853 cases), bladder (1.3%, 25,754 to 25,408 cases), and cervical (1.2%, 2,837 to 2,802 cases) cancers. Conclusions: Projected cancer incidence through 2030 varies by race, ethnicity, and cancer site, with Hispanic, AAPI, and AIAN populations expected to experience the largest increases. These projections can inform healthcare systems, public health agencies, and policymakers to plan effective cancer control strategies that address emerging disparities in future cancer burden.