Facts & Figures 2019: US Cancer Death Rate has Dropped 27% in 25 Years

The death rate from cancer in the US has declined steadily over the past 25 years, according to annual statistics reporting from the American Cancer Society. As of 2016, the cancer death rate for men and women combined had fallen 27% from its peak in 1991. This decline translates to about 1.5% per year and more than 2.6 million deaths avoided between 1991 and 2016.

The drop in cancer mortality is mostly due to steady reductions in smoking and advances in early detection and treatment. But not all populations are benefitting. Although the racial gap in cancer deaths is slowly narrowing, socioeconomic inequalities are widening. “Cancer Statistics, 2019,” published in the American Cancer Society’s journal CA: A Cancer Journal for Clinicians, estimates the numbers of new cancer cases and deaths expected in the US this year. The estimates are some of the most widely quoted cancer statistics in the world. The information is also released in a companion report, Cancer Facts and Figures 2019, available on the interactive website, the Cancer Statistics Center.

A total of 1,762,450 new cancer cases and 606,880 deaths from cancer are expected to occur in the US in 2019. During the most recent decade of available data (2006 – 2015), the rate of new cancer diagnoses decreased by about 2% per year in men and stayed about the same in women. The cancer death rate (2007 – 2016) declined by 1.4% per year in women and 1.8% per year in men.

Major cancer types: Lung, breast, prostate, and colorectal cancer

The most common cancers diagnosed in men are prostate, lung, and colorectal cancers. Together, they account for 42% of all cases in men, with prostate cancer alone accounting for nearly 1 in 5 new cases. For women, the 3 most common cancers are breast, lung, and colorectal. Together, they account for one-half of all cases, with breast cancer alone accounting for 30% of new cases.

These cancers also account for the greatest numbers of cancer deaths. One-quarter of all cancer deaths are due to lung cancer.

• Lung cancer death rates declined 48% from 1990 to 2016 among men and 23% from 2002 to 2016 among women. From 2011 to 2015, the rates of new lung cancer cases dropped by 3% per year in men and 1.5% per year in women. The differences reflect historical patterns in tobacco use, where women began smoking in large numbers many years later than men and were slower to quit. However, smoking patterns do not appear to explain the higher lung cancer rates being reported in women compared with men born around the 1960s.
• Breast cancer death rates declined 40% from 1989 to 2016 among women. The progress is attributed to improvements in early detection.
• Prostate cancer death rates declined 51% from 1993 to 2016 among men. Routine screening with the PSA blood test is no longer recommended because of concerns about high rates of over-diagnosis (finding cancers that would never need to be treated). Therefore, fewer cases of prostate cancer are now being detected.
• Colorectal cancer death rates declined 53% from 1970 to 2016 among men and women because of increased screening and improvements in treatment. However, in adults younger than age 55, new cases of colorectal cancer have increased almost 2% per year since the mid-1990s.

Cancer outcomes differ among racial/ethnic groups

The rates of new cancer cases and cancer deaths vary quite a bit among racial and ethnic groups, with rates generally highest among African Americans and lowest for Asian Americans. The cancer death rate in 2016 was 14% higher in Blacks than in whites. That gap has narrowed from a peak of 33% in 1993. The progress is due to the steep drop in smoking rates among Black teens from the late 1970s through the early 1990s.

Racial and ethnic differences in cancer burden reflect several factors related to socioeconomic status. People living in the poorest counties in the US are more likely to smoke and be obese. During 2012-2016, death rates in the poorest counties were 2 times higher for cervical cancer and 40% higher for male lung and liver cancers, compared with the richest counties. Poverty is also associated with lower rates of routine cancer screening, later stage at diagnosis, and a lower likelihood of getting the best treatment.

Cancer in children and adolescents

Cancer is the second most common cause of death among children ages 1 to 14 years in the US, after accidents. In 2019, an estimated 11,060 children in this age group will be diagnosed with cancer and 1,190 will die from it. Leukemia accounts for almost a third (28%) of all childhood cancers, followed by brain and other nervous system tumors (26%).

Cancer incidence rates increased in children and adolescents by 0.7% per year since 1975. However, death rates have declined continuously. The 5-year relative survival rate for all cancer sites combined improved from 58% for children diagnosed during 1975 to 1977 to 83% for those diagnosed during 2008 to 2014.

Special section on the oldest old

Each year, American Cancer Society researchers include a special section in Cancer Facts & Figures highlighting an issue of cancer research or care. This year, the topic is the “oldest old,” adults ages 85 and older. This age group represents the fastest-growing population group in the US. The group’s numbers are expected to nearly triple from 6.4 million in 2016 to 19 million by 2060.

Cancer risk increases with age, and the rapidly growing older population will increase demand for cancer care. Diagnosis and treatment of cancer at older ages are often complicated by other medical conditions.

The special section provides information about cancer in the oldest old in the US, including incidence and mortality rates and trends, survival, treatment, and the unique challenges affecting these patients.

• People ages 85 and older represent 8% of all new cancer diagnoses, translating to about 140,690 cases in 2019.
• Cancer is the second-leading cause of death in the oldest old, following heart disease.
• 103,250 cancer deaths among this age group are expected in 2019, accounting for 17% of all cancer deaths.
• As of January 1, 2019, an estimated 1,944,280 people ages 85 and older were cancer survivors, representing 1/3 of all the men and ¼ of all the women in this age group. They are the fastest-growing group of cancer survivors.
• Among adults age 85 with no history of cancer, the risk of a cancer diagnosis in their remaining lifetime is 16.4% for men and 12.8% for women.

Other highlights from the report:

• An estimated 1,762,450 cancers will be in diagnosed in 2019, which equals more than 4,800 new cases each day.
• The lifetime probability of being diagnosed with cancer is 39.3% for men and 37.7% for women, which is a little more than 1 in 3.
• 22% of deaths in the US in 2016 were from cancer, making it the second leading cause of death after heart disease in both men and women.
• Rates of new liver cancers are rising faster than for any other cancer. People infected with hepatitis C virus (HCV) are at greater risk for liver cancer. All baby boomers (those born between 1945 and 1965) are recommended to be tested for HCV because 75% of HCV-infected people are in this age group. Other risk factors for liver cancer include obesity, heavy drinking, and smoking.
• Rates of new cases also rose for melanoma skin cancer, thyroid cancer, endometrial cancer, and pancreatic cancer.

“Cancer Statistics 2019” can be viewed at cacancerjournal.com, while “Cancer Facts & Figures 2019” is available at cancer.org/statistics.