The United States recorded its largest single-year decline in cancer mortality ever measured — a 2.2% drop between 2016 and 2017 — marking the 26th consecutive year that the overall cancer death rate has fallen. The milestone, reported by the American Cancer Society, was driven in large part by an accelerating decline in lung cancer deaths, the leading cause of cancer mortality in the country.
At a glance
- Cancer death rate: The overall U.S. cancer death rate has fallen 29% since its peak in 1991, translating to an estimated 2.9 million fewer cancer deaths than would have occurred if rates had held steady.
- Lung cancer mortality: Death rates from lung cancer dropped 51% among men since the 1990 peak and 26% among women since the 2002 peak, fueling the record single-year decline.
- Breast and colorectal cancer: Female breast cancer deaths fell 40% since 1989, colorectal cancer deaths among men fell 53% since 1980, and among women fell 57% since 1969.
Why lung cancer is driving the numbers
Lung cancer kills more Americans each year than breast, colorectal, and prostate cancers combined. That makes any meaningful progress in lung cancer mortality felt across the entire cancer landscape.
Rebecca Siegel, scientific director of surveillance research at the American Cancer Society and first author of the report, described what she saw in the data as a convergence of improvements: better staging, advances in surgical techniques, and refinements in radiotherapy all arriving at once. “That’s really important and reflects improvements in the treatment of lung cancer across the continuum,” she said.
The biggest single driver over the 26-year stretch, Siegel noted, is the long-term decline in smoking rates. Early detection improvements — particularly for breast and colorectal cancers — have also contributed steadily to the overall trend.
Survival rates climbing for most cancers
The report, published in CA: A Cancer Journal for Clinicians and drawing on data from the National Cancer Institute’s Surveillance, Epidemiology and End Results Program and other registries, found that five-year survival rates have improved since the mid-1970s for nearly all common cancers.
As of data through 2015, prostate cancer carried the highest five-year survival rate at 98%, followed by melanoma at 92% and female breast cancer at 90%. Pancreatic cancer remained the most difficult to treat, with a five-year survival rate of just 9% — a reminder of how uneven the progress has been. Liver, lung, and esophageal cancers also remained far below average in survival outcomes.
Prostate cancer deaths fell 52% since 1993. Those numbers represent real people — millions of them — whose lives extended further than the statistics of a generation ago would have predicted.
A record that still leaves room to go further
The report is one of many public health wins worth tracking carefully — not just celebrating. Experts who reviewed the findings were encouraged, and candid about what remains unfinished.
Dr. Mark Awad, clinical director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute and an assistant professor at Harvard Medical School, pointed to a striking gap in lung cancer screening. The U.S. Preventive Services Task Force recommends annual lung cancer screening for current or former smokers with a history of 30 or more pack-years, yet fewer than 5% of eligible patients in the U.S. actually receive it. “That’s a huge shortfall of where we need to be,” Awad said.
The report also documented a persistent racial disparity: the relative risk of death after a cancer diagnosis was 33% higher in Black patients than in white patients. Dr. Charles Fuchs, director of the Yale Cancer Center, said improvements in reducing racial and socioeconomic disparities, increasing screening rates — particularly for colon cancer — and addressing obesity-related cancer risk all represent areas where more can be done. About 20% of all cancers are estimated to be tied to excess weight.
Immunotherapy has contributed to recent treatment advances, but Fuchs noted that these treatments work for some cancers and not others. “We have to better understand how can we further leverage that success to understand how to activate the immune system to attack the other major cancers,” he said.
What the trajectory suggests
Twenty-six consecutive years of declining cancer death rates is not a streak that happens by accident. It reflects compounding investments: decades of smoking-cessation policy, steady expansion of screening programs, and a pipeline of treatment advances that has accelerated in recent years.
Research published since this 2020 report has pushed the frontier further. A personalized mRNA cancer vaccine for pancreatic cancer showed durable immune responses in early trials, and emerging psychedelic-assisted research programs are exploring new paths for patients managing serious illness. The momentum documented in the 2020 American Cancer Society report set the baseline from which those next steps will be measured.
The 2.9 million lives the data estimates were spared by the decline since 1991 are not an abstraction. They are the compounded result of policy, research, and clinical care working in the same direction over a long time — proof that sustained effort against a disease as complex as cancer can move the needle.
Read more
For more on this story, see: CNN Health
For more from Good News for Humankind, see:
- Personalized mRNA cancer vaccine shows durable results six years on
- Texas launches the largest state-funded psychedelic research program
- The Good News for Humankind archive on public health and disease wins
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