Cancer Deaths Have Fallen Drastically Over the Last 25 Years. But These Types Are On the Rise

Cancer is the second-leading cause of death among Americans, behind only heart disease. But there’s good news: the cancer death rate has drastically declined over the past 25 years, according to a new report from the American Cancer Society (ACS).

Overall, the cancer death rate dropped by 27% between 1991 and 2016, according to the report’s data, which came from the National Center for Health Statistics. Steadily declining cancer mortality rates saved about 2.6 million lives between 1991 and 2016.

Significant reductions in lung cancer mortality explain a large part of the overall trend. Smoking rates have fallen dramatically in recent years, corresponding to a significant dip in lung cancer deaths. And since smoking rates have traditionally been higher among men than women, male death rates have fallen especially far: by 48% between 1990 and 2016, compared to a 23% drop among women between 2002 and 2016.

Improvements in cancer screening and treatment have also led to lower death rates, the report says, especially among the four major cancers: lung, breast, prostate and colorectal. Together, these cancers are expected to account for more than 800,000 new diagnoses this year, so any further improvements in their detection and care could have a sizable impact.

But while cancer mortality rates are shrinking, diagnoses aren’t dropping across the board. Incidence of breast cancer, the most common type of cancer overall, is increasingly modestly, perhaps in part because it is associated with common risk factors like obesity and alcohol use. Liver cancer is also killing a rising number of Americans — including younger people — in large part because of widespread alcohol abuse. Melanoma and cancers of the thyroid, pancreas and uterus are also getting more common, the report says.

Racial gaps in cancer mortality are narrowing. But black Americans were still about 14% more likely to die from cancer than white Americans in 2016. That’s a sizable drop from 25 years ago, when the difference was 33%, but it still reflects the “inequalities in wealth that lead to differences in risk factor exposures and barriers to high-quality cancer prevention, early detection, and treatment,” the authors write. Lower smoking rates among young black Americans largely explain the progress that has been made in shrinking these disparities, the report says.

Socioeconomic-related differences in cancer mortality are also still prevalent regardless of race, according to the paper. Between 2012 and 2016, the cancer death rate was about 20% higher among residents of the U.S.’ poorest counties, compared to its richest.

Tackling these systemic issues represents “low-hanging fruit” for cancer prevention efforts, the authors write. Working at the local level to expand affordable access to basic healthcare and screening services, smoking cessation programs and healthy living resources, they write, “would undoubtedly accelerate progress against cancer.”