Deaths from cancer continue to fall in the United States, the American Cancer Society reported Thursday, but within that encouraging trend is a disturbing shift in the cancer burden from older to younger adults and from men to women.
Overall, the cancer mortality rate fell by 34% from 1991 to 2022, translating to roughly 4.5 million fewer deaths over those two decades. The report’s authors attribute that improvement to less smoking, better treatment, and earlier detection. But that progress may stall, they warn, because incidence rates for many cancer types are climbing, especially among women and younger adults.
Rates in women 50 to 64 years old have now surpassed rates in men. There’s a startling jump in incidence rates in even younger groups for what is commonly understood as a disease of aging. Rates for women under 50 are now 82% higher than for men under 50, up from 51% in 2002. Incidence of lung cancer, for example, is now higher in women than in men who are younger than 65.
A puzzling rise in colorectal cancer cases among people under 45 has caused alarm in recent years, but that cancer type is not alone. New cervical cancer diagnoses are also rising in women under 45. Death rates are increasing in both men and women for cancers of the oral cavity and pancreas; women are seeing higher death rates for uterine corpus (also known as endometrial) and liver cancers.
Pancreatic cancer stands out. Both incidence and mortality rates are rising for this No. 3 cause of cancer deaths. The five-year survival rate remains 8% for the 9 out of 10 people diagnosed with pancreatic exocrine tumors. Possible explanations include better detection and rising obesity, but also the dearth of effective therapies.
Incidence is also up for breast, liver, and melanoma in women; prostate in men (up 3% per year from 2014 to 2021), and HPV-related oral cancers for men and women.
For children, the picture is brighter for kids under 14, with incidence rates declining after decades of increases. But incidence is still rising among adolescents 15 to 19 years old. Mortality rates have plummeted by 70% in children and by 63% in adolescents since 1970, largely because treatment for leukemia has improved so much.
The news is not good for health equity. Cancer mortality rates among Native American people are two to three times higher than among white people for kidney, liver, stomach, and cervical cancers. Black people are twice as likely to die of prostate, stomach, and endometrial cancers compared to white people and 50% more likely to die from cervical cancer — a cancer type that is preventable with HPV vaccination, the report notes.
“The nation should be encouraged that cancer mortality continues to decline. However, the increased incidence in certain populations, including women, adolescents, Native American people, and Black people, is an important reminder of how critical it is to ensure ongoing investment in cancer research and to prioritize policies that not only preserve but increase access to care for everyone,” Lisa Lacasse, president of the American Cancer Society Cancer Action Network, said in a statement urging Congress to protect access to Medicaid and health insurance made available under the Affordable Care Act.
Looking ahead, the report predicts there will be 2,041,910 new cancer diagnoses in the U.S. (5,600 each day) and 618,120 cancer deaths in 2025.
The report relied on incidence data collected by central cancer registries through 2021 and mortality data collected by the National Center for Health Statistics through 2022. That means there’s an asterisk for the Covid-19 pandemic. The percentage of all deaths due to cancer increased from 17% in 2021 to 19% in 2022, but when Covid deaths are excluded, cancer accounted for 20% of deaths in both years.
The report was published Thursday in CA: A Cancer Journal for Clinicians, and a companion Cancer Facts & Figures 2025 is at cancer.org.
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