Cancer in North America CiNA Volumes

Cancer in North America CiNA Volumes

CiNA PUBLICATION (2015-2019) – UPDATED 06/10/22

Produced annually, the CiNA report provides the most current cancer incidence and mortality statistics for the United States and Canada.


Executive Summary

Members of the North American Association of Central Cancer Registries, Inc. (NAACCR) participate voluntarily in an annual call for data to develop a multi-registry, aggregated data resource for cancer surveillance and research. NAACCR issues the call, and the member registries’ data submissions are combined and used to create the Cancer in North America (CiNA) monograph and other CiNA products for data analyses and cancer incidence information (e.g., NAACCR CiNA Explorer, NAACCR CiNA Maps online query system, CiNA Public Use Dataset, CiNA Research Datasets). These preeminent cancer data resources are unparalleled in geographic scope, timeliness of statistics, and assurance of standardization of information and data quality.

In May 2022, NAACCR released a five-volume monograph, Cancer in North America: 2015–2019. This release is the 32nd publication of the series and the 30th release that includes statistics for both Canada and the United States.

This year’s publication includes cancer incidence data for all 50 U.S. states, the District of Columbia, Puerto Rico, and 11 Canadian provinces and territories. We also report data by five regions: California (excluding the Greater Bay area and Los Angeles) and four Surveillance, Epidemiology, and End Results (SEER) urban registries (Detroit, Los Angeles, San Francisco/Oakland, and Seattle). CiNA includes registry-specific data on stage at diagnosis, survival, and delay-adjusted estimates of counts and age-adjusted rates for selected cancers. These delay adjustment figures provide a projection of the likely volume of tardy reports of cancer for the time period and are recommended for use in assessing current cancer incidence trends.

New this year, all rates are age-adjusted based on 20 age groups, which now include an additional older age group, 85–90 years. As cancer is a significant burden among our older populations, this update provides more accurate descriptions of the burden of cancer in North America. To accommodate issues with underlying denominator data, racial/ethnic groups are presented differently. This change results in more accurate assessments of the burden of cancer among Asian and Pacific Islander populations and American Indian and Alaska Native (AI/AN) populations. This change in racial/ethnic calculations results in higher presented rates for these populations compared to previous monographs, particularly for AI/AN rates. It is critical to understand that these rates more accurately reflect the true burden of cancer in these populations but do not reflect a difference in the actual risk of cancer among these populations. These rates are a correction to previous calculations.


The CiNA monograph encompasses five separate volumes:

Volume One: Combined Cancer Incidence for the United States and Canada
Includes aggregated cancer incidence data by site, sex, race, ethnicity, and stage, including pediatric cancer and cancer by stage at diagnosis from the high-quality registries in the U.S. and Canada.

Volume Two: Registry-Specific Cancer Incidence for the United States and Canada
Includes registry-specific cancer incidence rates by cancer site, sex, race, ethnicity, and stage for all NAACCR member registries submitting data for inclusion in the monograph. To help interpret the statistics, data tables for each registry include demographic and data quality information; registry descriptions are also presented.

Volume Three: Registry-Specific Cancer Mortality for the United States and Canada
Includes registry-specific cancer death rates by cancer site, sex, race, and ethnicity.

Volume Four: Cancer Survival for the United States and Canada
Includes cancer survival data for the U.S. and Canada from 59 registries on more than 13 million cases diagnosed among North Americans between 2012 and 2018.

Volume Five: Cancer Prevalence for the United States and Canada
Includes cancer prevalence estimates for the U.S. and Canada from 59 registries on more than 18 million cases diagnosed among North Americans between 2009 and 2018.


All CiNA volumes are available to download free of charge from the NAACCR website, along with accompanying technical data, including population data and supporting appendices. Additional visualizations of CiNA data are available as online query systems available here:

This publication is made possible by the continuing efforts of the NAACCR member registries. High-quality, standardized cancer incidence data aggregated across the states, provinces, territories, and regions in North America are made possible by the dedication of our members to cancer surveillance. The Editors would like to acknowledge the fine work and support of the National Cancer Institute, the National Center for Health Statistics, and Statistics Canada for their assistance in developing this publication.

We hope that Cancer in North America: 2015–2019, with the companion CiNA products and resources, facilitates studies of cancer burden, so that we are better able to identify—and understand—appropriate and important measures to control the myriad diseases known collectively as cancer.

The Editors, May 2022


Click here to go to the archive of previous five years of CiNA reports.

Publication Note

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