Cancer

Cancer
Other names	Malignant tumor, malignant neoplasm
A coronal CT scan showing a malignant mesothelioma Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver
Pronunciation	/ˈkænsər/ ⓘ
Specialty	Oncology
Symptoms	Lump, abnormal bleeding, prolonged cough, unexplained weight loss, change in bowel movements[1]
Risk factors	Exposure to carcinogens, tobacco, obesity, poor diet, lack of physical activity, excessive alcohol, certain infections[2][3]
Treatment	Radiation therapy, surgery, chemotherapy, targeted therapy[2][4]
Prognosis	Average five-year survival 66% (USA)[5]
Frequency	24 million annually (2019)[6]
Deaths	10 million annually (2019)[6]

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.^[2][7] These contrast with benign tumors, which do not spread.^[7] Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements.^[1] While these symptoms may indicate cancer, they can also have other causes.^[1] Over 100 types of cancers affect humans.^[7]

Tobacco use is the cause of about 22% of cancer deaths.^[2] Another 10% are due to obesity, poor diet, lack of physical activity or excessive alcohol consumption.^[2][8][9] Other factors include certain infections, exposure to ionizing radiation, and environmental pollutants.^[3] Infection with specific viruses, bacteria and parasites is an environmental factor causing approximately 16–18% of cancers worldwide.^[10] These infectious agents include Helicobacter pylori, hepatitis B, hepatitis C, human papillomavirus infection, Epstein–Barr virus, Human T-lymphotropic virus 1, Kaposi's sarcoma-associated herpesvirus and Merkel cell polyomavirus. Human immunodeficiency virus (HIV) does not directly cause cancer but it causes immune deficiency that can magnify the risk due to other infections, sometimes up to several thousand fold (in the case of Kaposi's sarcoma). Importantly, vaccination against hepatitis B and human papillomavirus have been shown to nearly eliminate risk of cancers caused by these viruses in persons successfully vaccinated prior to infection.

These environmental factors act, at least partly, by changing the genes of a cell.^[11] Typically, many genetic changes are required before cancer develops.^[11] Approximately 5–10% of cancers are due to inherited genetic defects.^[12] Cancer can be detected by certain signs and symptoms or screening tests.^[2] It is then typically further investigated by medical imaging and confirmed by biopsy.^[13]

The risk of developing certain cancers can be reduced by not smoking, maintaining a healthy weight, limiting alcohol intake, eating plenty of vegetables, fruits, and whole grains, vaccination against certain infectious diseases, limiting consumption of processed meat and red meat, and limiting exposure to direct sunlight.^[14][15] Early detection through screening is useful for cervical and colorectal cancer.^[16] The benefits of screening for breast cancer are controversial.^[16][17] Cancer is often treated with some combination of radiation therapy, surgery, chemotherapy and targeted therapy.^[2][4] Pain and symptom management are an important part of care.^[2] Palliative care is particularly important in people with advanced disease.^[2] The chance of survival depends on the type of cancer and extent of disease at the start of treatment.^[11] In children under 15 at diagnosis, the five-year survival rate in the developed world is on average 80%.^[18] For cancer in the United States, the average five-year survival rate is 66% for all ages.^[5]

In 2015, about 90.5 million people worldwide had cancer.^[19] In 2019, annual cancer cases grew by 23.6 million people, and there were 10 million deaths worldwide, representing over the previous decade increases of 26% and 21%, respectively.^[6][20]

The most common types of cancer in males are lung cancer, prostate cancer, colorectal cancer, and stomach cancer.^[21][22] In females, the most common types are breast cancer, colorectal cancer, lung cancer, and cervical cancer.^[11][22] If skin cancer other than melanoma were included in total new cancer cases each year, it would account for around 40% of cases.^[23][24] In children, acute lymphoblastic leukemia and brain tumors are most common, except in Africa, where non-Hodgkin lymphoma occurs more often.^[18] In 2012, about 165,000 children under 15 years of age were diagnosed with cancer.^[21] The risk of cancer increases significantly with age, and many cancers occur more commonly in developed countries.^[11] Rates are increasing as more people live to an old age and as lifestyle changes occur in the developing world.^[25] The global total economic costs of cancer were estimated at US$1.16 trillion (equivalent to $1.62 trillion in 2023) per year as of 2010^[update].^[26]