The overall U.S. cancer death rate fell 35% between 1991 and 2024, a decline that translates into more than 4.8 million cancer deaths averted, according to the AACR Cancer Progress Report 2026. The American Association for Cancer Research released the report in mid-September, drawing on national data from the National Cancer Institute and the American Cancer Society.
The progress is real, but it is not the whole story. Fewer people are dying of cancer relative to the size of the population, yet more people are being diagnosed each year, and adults ages 18 to 49 are the only age group with a consistent rise in overall cancer incidence. For families, the practical message is that screening and prompt care still matter, including for younger adults who may not think cancer applies to them.
Lung Cancer Led the Decline
The report attributes the steady decline largely to lower smoking rates and the resulting drop in lung cancer deaths, a trend it says has sped up in recent years because of advances in early detection and treatment. The lung cancer death rate has fallen by more than half since 1990, from 58.8 to 27.9 deaths per 100,000 people. Even so, lung cancer still kills more people than any other cancer.
Other cancers contributed. From 1989 to 2024, the female breast cancer death rate fell 44%, which the report credits to screening mammography and personalized treatment. The colorectal cancer death rate fell by nearly 50% between 1990 and 2024, though that progress has been largely limited to older adults.
Survival has improved as well. The five-year relative survival rate for all cancers combined rose from 49% for people diagnosed in the mid-1970s to 71% for those diagnosed from 2016 to 2022. For cancer that has spread to distant parts of the body, five-year survival more than doubled, from 17% in the mid-1990s to 36%, according to the AACR's announcement of the report. About 18.6 million Americans with a history of cancer were alive as of January 1, 2025.
Falling Death Rates Do Not Mean Fewer Diagnoses
The report estimates 2,114,850 new cancer diagnoses and 626,140 cancer deaths in the United States in 2026. Annual new cases are projected to top 2.5 million by 2050, driven largely by an aging population.
Early-onset cancer is a growing concern. From 2010 to 2019, incidence rose for 14 cancer types among people ages 15 to 49, including melanoma and cancers of the colon, breast, pancreas, stomach, and uterus.
Women carry a growing share of that burden. In 2023, cancer incidence among people younger than 50 was 78% higher in women than in men, up from a 55% gap in 2003. Colorectal cancer death rates among adults ages 18 to 49 have risen about 1% a year since 2004, and colorectal cancer is now the leading cause of cancer death in that age group. MedicalDaily recently reported on what an oncologist wants younger adults to know.
Progress is also uneven. Cancer death rates from 2020 to 2024 were about 18% higher among rural residents than among urban residents, and death rates have declined more slowly in rural counties. Black Americans had the highest overall cancer death rate during that period, followed by American Indian and Alaska Native people.
Screening Gaps and Research Funding Concerns
Screening remains a weak link for lung cancer. Only 13% of people eligible for lung cancer screening reported a low-dose CT scan in the past year, compared with 80% for breast cancer screening. Nearly half of lung cancers, 46.5%, are diagnosed at an advanced stage.
Readers can act on the evidence now. The U.S. Preventive Services Task Force recommends that adults at average risk begin colorectal cancer screening at 45 and that women begin breast cancer screening at 40. Current and former heavy smokers should ask a clinician whether they qualify for yearly low-dose CT lung screening. Younger adults with rectal bleeding, lasting changes in bowel habits, unexplained weight loss, or a new breast lump should see a clinician rather than wait.
Cost can be a barrier. The report notes that uninsured adults are less likely to get recommended screening and that patients without private insurance are less likely to receive newer therapies such as immunotherapy. Community health centers and state programs may offer low-cost screening for eligible residents.
The AACR also warned that research funding is under strain. According to the report, the National Institutes of Health budget fell in fiscal year 2024, stayed flat in 2025, and rose about 1% in 2026, while the president's fiscal year 2027 budget request proposed a $5 billion NIH cut. The AACR advocates for federal research funding, a purpose the group states openly, as Managed Healthcare Executive noted. Readers should weigh its policy recommendations with that role in mind.
Congress will decide 2027 NIH funding in the coming months. The American Cancer Society typically publishes its annual cancer statistics each January, which will show whether the long decline in cancer deaths continues.
Key Questions Answered
How much has the cancer death rate fallen? The overall U.S. cancer death rate fell 35% from 1991 to 2024, which translates into more than 4.8 million deaths averted.
Which cancer drove the decline? Lung cancer, mainly because of lower smoking rates, along with better detection and treatment. Declines in breast and colorectal cancer deaths also contributed.
Are cancer diagnoses falling too? No. About 2.1 million new cases are projected in 2026, and adults ages 18 to 49 are the only age group with a consistent rise in overall cancer incidence.
Which early-onset cancers are increasing? Cancers rising among people ages 15 to 49 include melanoma and cancers of the colon, breast, pancreas, stomach, and uterus.
When should screening start? For average-risk adults, colorectal screening is recommended starting at 45 and breast screening starting at 40. Some current and former heavy smokers qualify for yearly lung screening.
Who faces higher cancer death rates? Rural residents, Black Americans, and American Indian and Alaska Native people face higher cancer death rates.
Published by Medicaldaily.com
