Cancer Detection Tool
Examining the impact of cancer screening in the U.S.
Click here to download the fact sheet.
Improved cancer screening has the potential to detect cancers earlier, when treatment is more likely to improve outcomes and save lives. However, at present, only 14% of diagnosed cancers are detected by screening with a recommended screening test.
Until now, the proportion of cancers detected each year by a preventive screening test has not been calculated. NORC at the University of Chicago developed a method to calculate this statistic, which we call the percent of cancers detected by screening (PCDS). We estimate PCDS using annual incidence data (National Cancer Institute), self-reported preventive screening data (National Health Information Survey), screening test efficacy (published literature), and state cancer statistics (Behavioral Risk Factor Surveillance System).
Regular screening is recommended1 for breast, cervical, and colorectal cancers, as well as lung cancer screening for people who are at a high risk. Together, in 2017, these 4 cancers made up 37.6% of all cancers and 41.8% of all cancer deaths in the US.2 Though not broadly recommended, prostate-specific antigen (PSA) tests can also screen for prostate cancer, which accounts for another 14.1% of all cancers in the U.S. The other 48.2% of cancers do not have recommended screening tests and account for 53.7% of cancer deaths in the US.3
Among cancers with screening tests, the PCDS varies widely across cancer types. A majority (61%) of diagnosed breast cancers are detected through mammography. While the incidence of cervical cancer is low, 52% of all cases are detected by a PAP test, while 45% of diagnosed colorectal cancers are detected by screening. Only 3% of diagnosed lung cancers are detected through screening. Given high rates of prostate cancer screening and some over-diagnosis, we estimate that 77% of diagnosed prostate cancers are detected through the PSA test.4
PCDS by race and ethnicity vary by cancer type, as a result of differences in incidence and screening rates. In breast cancer, Hispanic women have the highest PCDS because of their relatively low incidence rates. Black people have the highest rate of PCDS for colorectal cancer, owing to relatively higher screening and incidence rates than other groups. People of color, especially people of Asian and Pacific Islander descent are consistently underrepresented in cancer data in the US5, which limits our ability to calculate state-specific PCDS for these groups.
For more information about our PCDS methodology and results, please visit www.cancerdetection.norc.org.
This project was conducted with funding support from GRAIL.
1Cancer screening recommendations include those that are A and B rated by the United States Preventive Services Task Force (USPSTF).
2Calculated from the ACS Cancer Facts & Figures 2017
3ACS Cancer Facts & Figures 2017
4Estimates for prostate cancer assume that all cancers diagnosed at grade 1 and 2 were detected through preventive screening PSA test, while grade 3 and 4 cancers were not detected by screening.
5ACS Cancer Facts & Figures 2021 (51) – data limitations prevented researchers from calculating PCDS at the state level
PCDS is the proportion of screen-detected cancers (Breast, Colorectal, Cervical, Lung) among all diagnosed cancers detected by screening including prostate cancer.
NOTE: Race results are only available at a national level. Breast and cervical data is female only.
SOURCE: NORC analysis of the percent of cancers detected by screening (PCDS), 2017.
The study objective was to estimate the overall percentage of cancers detected by screening (PCDS) in the United States in 2017 with a primary focus on 4 specific cancer screening programs—breast, cervical, colorectal, and lung cancer—for which population screening is recommended by the United States Preventive Services Task Force (USPSTF) . The study also estimated the PCDS for prostate cancer, which has a widely available screening test but is not widely recommended by the USPSTFt. As a result, prostate cancer estimates are held separately from the other estimates throughout the analysis. PCDS estimates are available by age group and state. At a national level, we also estimate PCDS by racial and ethnic group.
For breast, cervical, and colorectal cancers, the PCDS for each demographic group is the product of the screening rate and the expected number of cancers detected per screening, divided by the overall cancer incidence. The screening rate is estimated as the national, self-reported screening rate for the prior 12 months from the CDC’s National Health Interview Survey (NHIS) database. NORC adjusted for state variation in screening using Behavioral Risk Factor Surveillance System (BRFSS) data, after adjustments to account for the over-reporting of screening relative to actual screening rates using published estimates.
This method was unreliable for prostate cancer PCDS estimates, so prostate cancer PCDS reflects the percent of all diagnosed prostate cancers (NPCR) that were diagnosed as grade 1 (“well differentiated”) or 2 (“moderately differentiated”), encompassing cancers with a Gleason score of 2 through 6.
Data on annual lung cancer screening with low-dose chest computed tomography for older adults with a history of smoking are limited. PCDS estimates for lung cancer are based on 2017 results from a published paper using data from The American College of Radiology’s Lung Cancer Screening Registry1. Results are presented at the state level without stratification by age and sex.
For a full description of the methodology, please see the technical report available here.
1Fedewa, S. A., Kazerooni, E. A., Studts, J. L., Smith, R. A., Bandi, P., Sauer, A. G., ... & Silvestri, G. A. (2021). State variation in low-dose computed tomography scanning for lung cancer screening in the United States. JNCI: Journal of the National Cancer Institute, 113(8), 1044-1052.
Cancer is the second leading cause of death in the U.S.1 Today, regular screening is recommended for breast, cervical, and colorectal cancers, as well as lung cancer for people who are at high risk. These four cancers account for over one-third (37%) of all cancer deaths in the U.S.
Despite data on cancer prevalence and mortality, there is a data gap in cancer screening. NORC at the University of Chicago, developed a method to calculate the percent of cancers detected each year by a preventive screening test, known as the percent of cancers detected through screening (PCDS).
Our analysis found that, at present, only 14% of diagnosed cancers detected by screening with a recommended screening test. Improved cancer screening has the potential to detect cancers earlier when treatment is more likely to improve outcomes and save lives.
This website allows users to view PCDSPCDS estimates the percent of diagnosed cancers that were detected by a USPSTF recommended preventive screening test. PCDS methodology was developed by researchers at NORC. Lower PCDS equates to fewer cancers detected by screenings. Higher PCDS means more cancers are detected by screenings., cancer screening ratesScreening Rate is the number of preventive screenings for a specific cancer site/type in a specified population in the past year. This analysis derived the national screening rate from the National Health Interview Survey (NHIS)., and cancer incidence Cancer Incidence is the number of new cancer cases diagnosed in a specified population in the past year, usually expressed as the number of new cancers diagnosed per 100,000 population at risk. NORC derived the annual cancer incidence from the National Cancer Institute (NCI) United States Cancer Statistics. in the U.S. by state and population demographics. It serves as a tool for researchers, policymakers, journalists, and the general public, and insights derived from this tool can be used to inform our understanding of cancer screening and detection in the U.S. to guide resources, policy decisions, and interventions.
1Centers for Disease Control and Prevention. (2022). Leading Causes of Death. Retrieved from https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
The modeling and analysis for this work was supported by GRAIL.
NORC at the University of Chicago is an objective, non-partisan research institution that delivers reliable data and rigorous analysis to guide critical programmatic, business, and policy decisions. Since 1941, NORC has conducted groundbreaking studies, created and applied innovative methods and tools, and advanced principles of scientific integrity and collaboration. Today, government, corporate, and nonprofit clients around the world partner with NORC to transform increasingly complex information into useful knowledge.
NORC at the University of Chicago. (2022). Percent of Cancers Detected by Screening in the U.S. Available at https://cancerdetection.norc.org/
For more information please contact:
NORC Senior External Affairs Manager
This tool allows researchers, policymakers, journalists, and the general public to view the percent of cancers detected by screening in the United States, by state and population demographics. The tool also includes information about cancer screening rates and incidence. Insights derived from this tool can be used to inform our understanding of cancer screening and detection in the U.S. to guide resources, policy decisions, and interventions.
Click on the drop down icon under “Data Type” on the left side of the screen to change the displayed data between PCDS, screening rates, and incidence.
PCDS results estimate the percent of diagnosed cancers that were detected by a United States Preventive Services Taskforce (USPSTF) preventive screening test. PCDS methodology was developed by researchers at NORC at the University of Chicago. Lower PCDS equates to fewer cancers detected by screening. Higher PCDS means more cancers were detected by screening.
Screening Rate is the number of preventive screenings for a specific cancer site/type in a specified population in the past 12 months. This analysis derived the national screening rate from the National Health Interview Survey (NHIS). Screening rates were calculated for preventive screening tests relevant to breast cancer (mammogram), cervical cancer (Pap smear/Pap test), colorectal cancer (colonoscopy), and prostate cancer (PSA test). National lung cancer screening rates are not available in the 2019 NHIS data; therefore, published screening rates were used (Fedewa et al., 2020).
Cancer Incidence is the number of new cases diagnosed in a specified population during a year, usually expressed as the number of new cancer cases diagnosed per 100,000 population at risk. NORC derived the annual cancer incidence from the National Cancer Institute (NCI) United States Cancer Statistics.
To view different cancers and/or cancer groups, click the “Cancer Group” drop down on the left-side of the screen. PCDS, screening rate, and incidence are available for breast, cervical, colorectal, prostate, and lung cancers. These cancers were selected for this analysis because there are associated preventive screening tests recommended for the general population (breast, cervical, colorectal, and prostate cancers) and high-risk populations (lung cancer) by the United States Preventive Services Task Force.
Choose variables from the left-hand column to view results for a single demographic group. For example, choosing “Female” from the “Sex” dropdown will show results for PCDS, screening rates, and incidence for females in the state.
Results by race/ethnicity are not available at the state level due to insufficient data samples. To view results by race/ethnicity at the national level, click on “See Data by Race/Ethnicity”.
There are three data tables for each state, which can be found when selecting a state by clicking on “View Details.” State data include: 1) Percent Cancers Detected by Screening; 2) Screening Rates; and 3) Incidence. For all three fact sheets, state and national data are provided.