"The overall cancer death rate in the US has declined by 35% since its peak in 1991."
A series of reports published in 2025 by the American Association for Cancer Research (AACR) and the American Cancer Society (ACS) document significant progress in cancer outcomes in the United States, alongside persistent disparities in mortality and screening access across racial, ethnic, and socioeconomic groups.
Overall Progress and Survival Milestones
The overall cancer death rate in the US has declined by 35% since its peak in 1991, according to the AACR report. The ACS annual report indicates that this decline has prevented approximately 4.8 million cancer deaths as of 2023.
Five-year survival rates for all cancers combined have reached a historic high. Data covering diagnoses from 2015 to 2021 shows a 70% survival rate, a significant increase from 50% in the 1970s and 63% in the mid-1990s. The ACS report notes that five-year survival rates have risen by an average of 20% over the last 50 years.
Key Improvements by Cancer Type
Significant increases in five-year survival rates over the past two decades include:
- Myeloma: Increased from 32% to 62%.
- Lung cancer: Increased from 15% to 28%.
- Liver cancer: Increased from 7% (in the 1990s) to 22% (in 2023).
- Pancreatic cancer: Exceeded 10% for the first time, reaching 13%.
- Leukemia: 20% increase.
- Non-Hodgkin lymphoma: 18% increase.
High survival rates for specific cancers currently include: 92% for breast cancer in women, 95% for melanoma of the skin, and 98% for prostate cancer.
For patients with cancers that had spread to distant organs, the average five-year survival rate has increased from 17% in the mid-1990s to 35% in the 2020s.
The ACS projects over 626,000 cancer deaths and more than 2.1 million new diagnoses in the US this year.
Factors Contributing to Progress
The decline in mortality and improvement in survival are primarily attributed to:
- Advances in treatment: Immunotherapies (such as immune checkpoint therapy and CAR T-cell therapy), targeted therapies (tyrosine kinase inhibitors), and other treatment innovations.
- Earlier detection: Increased use of routine screening.
- Reduced smoking rates.
Persistent Disparities
Despite overall progress, the reports document significant disparities in cancer outcomes and screening access.
Racial and Ethnic Disparities
- Highest overall death rates: African American communities and American Indian/Alaska Native populations have the highest overall cancer death rates among US racial or ethnic groups.
- Specific cancer mortality: Black individuals are approximately twice as likely to die from multiple myeloma, stomach, prostate, and gallbladder cancers compared to white individuals. Breast cancer mortality rates are 35% higher among Black women than among white women. Colorectal cancer mortality rates are higher among Black and American Indian/Alaska Native populations compared to white populations.
- Early-onset colorectal cancer: The Hispanic population has had the largest increase in early-onset colorectal cancer, with annual rises of 4.7% among women and 3.7% among men.
Screening Disparities
- Colonoscopy (2023 data): Screening rates were 67% for white people, compared to 53% for Hispanic people, and 57% for Asian and American Indian/Alaska Native people.
- Cervical cancer screening: Rates were consistently lower among Asian and Hispanic women compared to white women.
Socioeconomic Disparities
- Cervical cancer: Rates were 32% higher among women living in poor counties compared to higher-income counties. Death rates from cervical cancer are 49% higher in poor counties.
- Screening access: Women from poor counties are less likely to be regularly screened for cervical cancer.
Emerging Concerns
The reports note several factors that may impact future progress:
- Obesity: The national obesity epidemic is cited as a contributing factor to rising colorectal cancer rates in individuals under 50 and rising breast cancer rates among women.
- Research funding: An analysis by Senate Democrats indicated a 31% decline in cancer research grant funding for the first three months of 2025 compared to the same period in 2024. Mariana Stern, chair of the AACR report, expressed concern that proposed cuts to the NIH budget could threaten progress.
- Insurance coverage: Enrollment in Medicaid and the Affordable Care Act has fallen by over 5 million in the past year, according to a report from Protect Our Care. The expiration of ACA insurance subsidies may limit access to treatment.
- COVID-19 impact: Disruptions to cancer screening during the COVID-19 pandemic may lead to an increase in late-stage diagnoses, with the full impact yet to be observed.