{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T14:00:22Z","timestamp":1773842422067,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health\/Office of the Director (OD)","award":["K12HD052023"],"award-info":[{"award-number":["K12HD052023"]}]},{"name":"National Institutes of Health\/Office of the Director (OD)","award":["K12AR084228-20S1"],"award-info":[{"award-number":["K12AR084228-20S1"]}]},{"name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health","award":["K12HD052023"],"award-info":[{"award-number":["K12HD052023"]}]},{"name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health","award":["K12AR084228-20S1"],"award-info":[{"award-number":["K12AR084228-20S1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Tobacco use remains a global challenge to public health, accounting for almost eight million deaths per year worldwide, with a significant portion attributable to tobacco-related cancers. Examining the epidemiology of tobacco-related cancers and assessing the trends in the incidence and mortality will allow for more effective prevention, treatment, and targeted strategies. Methods: We assessed the trends in the incidence and mortality of tobacco-related cancers among adults in the United States using data from United States Cancer Statistics (USCS) 2001\u20132021 and mortality data 1975\u20132022 from the National Center for Health Statistics (NCHS). The incidence and mortality rates of tobacco-related cancers were calculated as cases per 1,000,000 persons and age-adjusted to the 2000 United States standard population. Results: There was a recent overall decreasing trend in both the incidence (2001\u20132021) and mortality rate (2001\u20132022). Among adults 20\u201349 years old, there was an increasing trend from 2001 to 2021 in the incidence among non-Hispanic American Indians\/Alaska Natives (APC 2.6, 95% CI 2.1\u20133.0) and those in the West (APC 0.2, 95% CI 0.0\u20130.4); in Hispanics, the incidence rate increased most recently from 2013 to 2021 (APC 1.7, 95% CI 1.0\u20133.0). The mortality rate first increased from 1975 to 1990 among females 50\u201364 years old and males 65+ years old and from 1975 to 2000 among females 65+ years old, and then decreased thereafter. Conclusions: The rising incidence in some younger groups highlights the need for targeted public health interventions to address disparities and improve cancer prevention in these vulnerable populations.<\/jats:p>","DOI":"10.3390\/cancers17030534","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T07:44:59Z","timestamp":1738741499000},"page":"534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Trends in the Incidence and Mortality of Tobacco-Related Cancers Among Adults in the United States"],"prefix":"10.3390","volume":"17","author":[{"given":"Nandika","family":"Mansingka","sequence":"first","affiliation":[{"name":"School of Public and Population Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7394-1640","authenticated-orcid":false,"given":"Victor","family":"Adekanmbi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"},{"name":"Center for Interdisciplinary Research in Women\u2019s Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine D.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"},{"name":"Center for Interdisciplinary Research in Women\u2019s Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8444-0529","authenticated-orcid":false,"given":"Thao N.","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"},{"name":"Center for Interdisciplinary Research in Women\u2019s Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacques G.","family":"Baillargeon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public and Population Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbey B.","family":"Berenson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"},{"name":"Center for Interdisciplinary Research in Women\u2019s Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3729-2724","authenticated-orcid":false,"given":"Fangjian","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"},{"name":"Center for Interdisciplinary Research in Women\u2019s Health, The University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Surveillance for Cancers Associated with Tobacco Use\u2014United States, 2010\u20132014","volume":"67","author":"Gallaway","year":"2018","journal-title":"MMWR. Surveill. Summ. Morb. Mortal. Wkly. Rep. Surveill. Summ.\/CDC"},{"key":"ref_2","first-page":"1","article-title":"Surveillance for cancers associated with tobacco use\u2014United States, 1999\u20132004","volume":"57","author":"Stewart","year":"2008","journal-title":"MMWR. Surveill. Summ. Morb. Mortal. Wkly. Rep. Surveill. Summ.\/CDC"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1016\/S0140-6736(21)01169-7","article-title":"Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019","volume":"397","author":"Collaborators","year":"2021","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2662","DOI":"10.1002\/cam4.4647","article-title":"Global, regional, and national burden of cancers attributable to tobacco smoking in 204 countries and territories, 1990\u20132019","volume":"11","author":"Safiri","year":"2022","journal-title":"Cancer Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1136\/tobaccocontrol-2021-056535","article-title":"Evolution of the global smoking epidemic over the past half century: Strengthening the evidence base for policy action","volume":"31","author":"Dai","year":"2022","journal-title":"Tob. Control"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1002\/cncr.28695","article-title":"The 2014 Surgeon General\u2019s report: \u201cThe health consequences of smoking--50 years of progress\u201d: A paradigm shift in cancer care","volume":"120","author":"Warren","year":"2014","journal-title":"Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"475","DOI":"10.15585\/mmwr.mm7218a1","article-title":"Tobacco Product Use Among Adults\u2014United States, 2021","volume":"72","author":"Cornelius","year":"2023","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"397","DOI":"10.15585\/mmwr.mm7111a1","article-title":"Tobacco Product Use Among Adults\u2014United States, 2020","volume":"71","author":"Cornelius","year":"2022","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_9","unstructured":"CDC (2024, December 10). Smoking Cessation: A Report of the Surgeon General, Available online: https:\/\/www.hhs.gov\/sites\/default\/files\/2020-cessation-sgr-full-report.pdf."},{"key":"ref_10","unstructured":"(2025, February 01). NPCR and SEER Incidence\u2014USCS Public Use Databases, Available online: https:\/\/www.cdc.gov\/united-states-cancer-statistics\/public-use\/index.html."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"524","DOI":"10.3322\/caac.21754","article-title":"Breast Cancer Statistics, 2022","volume":"72","author":"Giaquinto","year":"2022","journal-title":"CA Cancer J. Clin."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3133","DOI":"10.1002\/cncr.11380","article-title":"Long-term trends in cancer mortality in the United States, 1930\u20131998","volume":"97","author":"Wingo","year":"2003","journal-title":"Cancer"},{"key":"ref_14","first-page":"1","article-title":"Deaths: Final Data for 2012","volume":"63","author":"Murphy","year":"2015","journal-title":"Natl. Vital. Stat. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_16","unstructured":"US Department of Health and Human Services (2014). The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health."},{"key":"ref_17","unstructured":"NAACCR Race and Ethnicity Work Group (2011). NAACCR Guideline for Enhancing Hispanic\/Latino Identification: Revised NAACCR Hispanic\/Latino Identification Algorithm [NHIA v2.2.1], North American Association of Central Cancer Registries."},{"key":"ref_18","unstructured":"National Cancer Institute (2024). Joinpoint Regression Program, National Cancer Institute. Version 5.3.0.0\u2014November 2024; Statistical Methodology and Applications Branch, Surveillance Research Program."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1177\/0962280206070621","article-title":"Efficient interval estimation for age-adjusted cancer rates","volume":"15","author":"Tiwari","year":"2006","journal-title":"Stat. Methods Med. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z","article-title":"Permutation tests for joinpoint regression with applications to cancer rates","volume":"19","author":"Kim","year":"2000","journal-title":"Stat. Med."},{"key":"ref_21","unstructured":"Kleinbaum, D.G., Kupper, L.L., Muller, K.E., and Nizam, A. (1988). Applied Regression Analysis and Other Multivariable Methods, PWS-Kent. [2nd ed.]."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"693","DOI":"10.2307\/2530689","article-title":"The natural variability of vital rates and associated statistics","volume":"42","author":"Brillinger","year":"1986","journal-title":"Biometrics"},{"key":"ref_23","unstructured":"National Center for Health Statistics (2025, February 01). Survey Description, National Health Interview Survey, 2013; Hyattsville, Maryland, Available online: https:\/\/ftp.cdc.gov\/pub\/health_statistics\/nchs\/Dataset_Documentation\/NHIS\/2013\/srvydesc.pdf."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Shehata, S.A., Toraih, E.A., Ismail, E.A., Hagras, A.M., Elmorsy, E., and Fawzy, M.S. (2023). Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk. Cancers, 15.","DOI":"10.3390\/cancers15184525"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.canlet.2019.10.009","article-title":"Epidemiology of lung cancer and lung cancer screening programs in China and the United States","volume":"468","author":"Yang","year":"2020","journal-title":"Cancer Lett."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1002\/cac2.12099","article-title":"The mortality of lung cancer attributable to smoking among adults in China and the United States during 1990\u20132017","volume":"40","author":"Liu","year":"2020","journal-title":"Cancer Commun."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1136\/tc.2010.040352","article-title":"Implementation of the WHO Framework Convention on Tobacco Control in mainland China","volume":"20","author":"Lv","year":"2011","journal-title":"Tob. Control"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e1006","DOI":"10.1016\/S2468-2667(23)00242-6","article-title":"Tobacco control in China","volume":"8","author":"Chan","year":"2023","journal-title":"Lancet Public. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/S0140-6736(15)60174-X","article-title":"The road to effective tobacco control in China","volume":"385","author":"Yang","year":"2015","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"394696","DOI":"10.1155\/2014\/394696","article-title":"Smokeless tobacco and oral cancer in South Asia: A systematic review with meta-analysis","volume":"2014","author":"Khan","year":"2014","journal-title":"J. Cancer Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"701932","DOI":"10.1155\/2012\/701932","article-title":"Challenges of the oral cancer burden in India","volume":"2012","author":"Coelho","year":"2012","journal-title":"J. Cancer Epidemiol."},{"key":"ref_32","first-page":"269","article-title":"Disparities in current cigarette smoking among US adults, 2002\u20132016","volume":"29","author":"Agaku","year":"2020","journal-title":"Tob. Control"},{"key":"ref_33","unstructured":"(2024, November 19). U.S. Census Bureau, 2019 American Community Survey, 1-year Estimates, Available online: https:\/\/www.census.gov\/content\/dam\/Census\/library\/publications\/2022\/acs\/acs-50.pdf."},{"key":"ref_34","unstructured":"(2024, November 18). Issue Brief No. HP-2024-12 \u201cHealth Insurance Coverage and Access to Care Among Latinos: Recent Trends and Key Challenges\u201d. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. June 2024, Available online: https:\/\/aspe.hhs.gov\/reports\/health-insurance-coverage-access-care-latinos."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.2105\/AJPH.94.12.2188","article-title":"Undoing an epidemiological paradox: The tobacco industry\u2019s targeting of US Immigrants","volume":"94","author":"Barbeau","year":"2004","journal-title":"Am. J. Public. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2975","DOI":"10.1001\/jama.283.22.2975","article-title":"Are increasing 5-year survival rates evidence of success against cancer?","volume":"283","author":"Welch","year":"2000","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1513\/AnnalsATS.201307-244PS","article-title":"Tobacco control policies and their impacts. Past, present, and future","volume":"11","author":"Warner","year":"2014","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e2351529","DOI":"10.1001\/jamanetworkopen.2023.51529","article-title":"Medicaid Expansion Under the Affordable Care Act and Early Mortality Following Lung Cancer Surgery","volume":"7","author":"Nogueira","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1001\/jamaoncol.2021.4323","article-title":"Understanding the Implications of Medicaid Expansion for Cancer Care in the US: A Review","volume":"8","author":"Ermer","year":"2022","journal-title":"JAMA Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1001\/jamaoncol.2017.3176","article-title":"Changes in Insurance Coverage Among Cancer Patients Under the Affordable Care Act","volume":"4","author":"Soni","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3906","DOI":"10.1200\/JCO.2017.73.7817","article-title":"Changes in Insurance Coverage and Stage at Diagnosis Among Nonelderly Patients With Cancer After the Affordable Care Act","volume":"35","author":"Jemal","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1158\/1055-9965.EPI-20-1754","article-title":"Updated Review of Major Cancer Risk Factors and Screening Test Use in the United States in 2018 and 2019, with a Focus on Smoking Cessation","volume":"30","author":"Bandi","year":"2021","journal-title":"Cancer Epidemiol. Biomark. 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