A Mixed Picture: Progress and Emerging Challenges
While cancer mortality in the United States has dropped by 34% since 1991, saving an estimated 4.5 million lives, the latest report from the American Cancer Society reveals a complex and evolving landscape. Advances in early detection, treatment, and prevention have driven these gains, particularly for lung, breast, colorectal, and prostate cancers. Yet, the burden of cancer is increasingly shifting to women, younger adults, and communities of color.
“Cancer mortality has continued to decline since the 1990s when rates peaked,” said Dr. Ahmedin Jemal, senior vice president of surveillance and health equity science at the American Cancer Society. “But mortality is not declining for all cancers, nor for all populations.”
Rising Incidence Among Women and Younger Adults
Cancer rates among women, especially those under age 65, have risen significantly, with women ages 50 to 64 now surpassing men in cancer incidence for the first time. Younger women under 50 also experience 82% higher cancer rates than men of the same age group. Notably, lung cancer incidence among women under 65 has overtaken men, attributed in part to historically lower smoking cessation rates among women.
Breast cancer remains a major driver, accounting for one in three cancer diagnoses among women. “One reason for the increase in breast cancer is the reduction in fertility rates,” Jemal explained, noting that pregnancy-related factors are associated with a lower risk of breast cancer.
Persistent Racial and Ethnic Disparities
The report also underscores stark racial disparities in cancer outcomes. Native American populations face two to three times higher mortality rates for kidney, liver, stomach, and cervical cancers compared to white populations. Similarly, Black Americans are twice as likely as whites to die from prostate, stomach, and uterine cancers and have a 50% higher mortality rate from cervical cancer.
“While overall progress is encouraging, the inequalities in cancer mortality highlight the gaps in applying what we know about prevention and treatment to all populations,” Jemal said.
Understanding Progress
The 34% decline in cancer mortality is a testament to reduced tobacco use, improved early detection, and advances in treatment. For example, the mortality rate for lung cancer—the leading cause of cancer deaths—has plummeted thanks to smoking cessation efforts and better therapies. Yet, about 40% of cancer cases remain potentially preventable through lifestyle changes such as quitting smoking, maintaining a healthy weight, and improving diet.
“Individual behavior plays a role, but policy is the most important factor in driving widespread change,” Jemal emphasized.
Looking Ahead
While cancer survival rates have improved, the growing incidence among women, younger adults, and underserved communities signals an urgent need for targeted interventions. Future efforts must prioritize equitable access to prevention, early detection, and cutting-edge treatments, particularly for populations disproportionately affected by cancer.
As the report projects more than 2 million new cancer diagnoses and nearly 620,000 deaths in the U.S. by 2025, addressing these disparities and trends is essential to building on the progress made over the past 30 years.
The Bottom Line
“We are making progress,” Jemal concluded. “But we still have a long way to go to ensure that everyone benefits from advances in cancer prevention and care.”