The short answer
The Report on Carcinogens is a U.S. government list, updated by the National Toxicology Program, of substances that pose a cancer hazard. It uses two categories: 'known' and 'reasonably anticipated' to be human carcinogens. Like IARC, it identifies hazard, not personal risk.
The Report on Carcinogens (RoC) is a congressionally mandated U.S. list of cancer hazards.
It is prepared by the National Toxicology Program (NTP), based at NIEHS.
It uses two categories: 'known' and 'reasonably anticipated' to be human carcinogens.
The 15th edition (2021) has 256 listings.
Choose how you want to read this
The whole article, with every detail and caution.
This page explains the main US list of cancer-causing substances: what it is, how it sorts them, and how to read a listing.
The U.S. counterpart to IARC
The World Health Organization (WHO) has its cancer agency's IARC Monographs. The United States has its own respected carcinogen list. It is the Report on Carcinogens (RoC), prepared by the National Toxicology Program (NTP). NTP is an interagency program based at the National Institute of Environmental Health Sciences.
The RoC is required by Congress. It is a cumulative, science-based public health document. It identifies substances, mixtures, and exposures that may pose a cancer hazard to people in the United States.
Two categories
IARC uses four groups. The RoC uses just two categories.
- "Known to be a human carcinogen."
- "Reasonably anticipated to be a human carcinogen."
The NTP puts each listing in one of these two categories. Its website explains how it weighs the evidence for each.
The 15th edition (2021) was released in December 2021. It contains 256 listings of chemical, physical, and biological agents, mixtures, and exposure circumstances.
Hazard, not risk — again
Just like IARC, the RoC performs hazard identification. A listing means the substance can pose a cancer hazard. It does not mean any one exposure will cause cancer in a given person. The NTP is careful to make this distinction. Real-world risk depends on how much, how often, and how long a person is exposed.
What's new in the latest edition
The NTP says the 15th edition (2021) added three new listings. They give a sense of how wide the list is.
- Helicobacter pylori is a germ (a biological agent).
- Antimony trioxide is a chemical.
- Haloacetic acids are byproducts of disinfecting drinking water.
How it compares to IARC
The RoC and IARC are separate systems, with different scopes and category labels.
- The RoC is U.S. federal, with two categories.
- IARC is international (WHO), with four groups.
An agent can appear on both lists. Both identify hazard, so the same hazard-versus-risk reasoning applies to each. A listing tells you the evidence is strong enough to flag a cancer hazard. It does not tell you how much risk you personally face.
Why it's useful
The RoC is a trustworthy, government-vetted reference. It shows whether a substance is recognized as a cancer hazard in the United States. Pair it with real-world exposure information, and with an EPA risk assessment where one exists. Together they help you judge what actually matters for your health.

Common questions
What is the Report on Carcinogens?
It is a science-based public health document, required by Congress, that lists substances, mixtures, and exposures that may pose a cancer hazard to people in the United States. The National Toxicology Program prepares it.
What are its two categories?
The NTP sorts listings as 'known' or 'reasonably anticipated' to cause cancer in humans. See the NTP page for how it defines each one.
How is it different from IARC?
The RoC is a U.S. federal list with two categories; IARC is the WHO's international program with four groups. Both identify hazard rather than calculating personal risk, and the two lists are separate.
What's new in the latest edition?
The NTP says the 15th edition (2021) added three new listings: Helicobacter pylori infection, antimony trioxide, and haloacetic acids (water-disinfection byproducts).
Questions to ask your doctor
Being prepared helps you get the most out of your appointments. Save or print these questions.
Tap a question to save it to your list (kept on this device).
Talk with a trained specialist or navigator
Cancer Explained provides educational guidance, but does not replace trained specialists, social workers, or your medical team.
Talk to a trained cancer information specialist
Free, confidential assistance from NCI Cancer Information Service via phone, chat, or email.
Contact your oncology team
Locate after-hours contact numbers, portal messages, or urgent triage phone lines.
Find a patient navigator
Get one-on-one help with appointments, logistics, translation, and care coordination.
Find a genetic counselor
Discuss inherited mutation risk, family history, and genetic testing options.
Find an oncology social worker
Access emotional counseling, family support groups, and mental health resources.
Find a financial navigator
Locate copay assistance foundations, grant programs, and lodging/travel support.
Find a clinical-trial specialist
Search matching studies and speak with NCI trial information specialists.
Plain-language explanation of the published sources cited on this page. AI-assisted, source-checked, not clinician-reviewed.
Last updated: 2026-10-16Next planned review: 2028-07-05
Review details and limits
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status — Source checked. This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
General education — varies by person. Answers genuinely differ between people. This page explains what commonly varies and points you to your care team for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
Words to know
Tap any term to see what it means.
Knowledge check
0 of 4 answered
This self-assessment checks understanding of educational content only. It is not medical advice.
How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
Read more about our editorial process, our use of AI, and our corrections policy.
Spotted a problem? Report an error — a factual mistake, broken or outdated source, confusing wording, or anything that seems unsafe. Please do not include names, medical record numbers, dates of birth, addresses, or other identifying medical information in your report.
After using this page, do you understand what to do next?
Anonymous — we only record the answer, never who gave it.
