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Cancer is the second leading cause of death in the United States. But there’s some good news: over the past 25 years, the rate of deaths from cancer has dropped 27 percent. That translates to about 2.6 million fewer cancer deaths between 1991 and 2016, according to a new report from the American Cancer Society.

Since its peak in 1991, the cancer death rate has dropped steadily by about 1.5 percent each year. This is equivalent to more than 2.6 million fewer cancer deaths that would have occurred if mortality rates remained at their highest. The report estimates that in 2019, there will be more than 1.7 million new cancer cases and more than 600,000 cancer deaths.

Dr. Matthew Schabath, associate member of the Cancer Epidemiology Department, Moffitt Cancer Center.

The decline can be attributed to factors like a steady reduction in smoking and advances in detection. “Over time as fewer people are smoking, the incidence of tobacco-related cancers has been on the decline,” said Moffitt Cancer Center epidemiologist Dr. Matthew Schabath. “There is also increased availability of early detection and cancer screening modalities for numerous major cancers. If cancer is detected in its earlier stages, surgical resection is often curable.”

The death rate for lung cancer decreased by 48 percent from 1990 to 2016 among men and by 23 percent from 2002 to 2016 among women. The female breast cancer rate also dropped by 40 percent from 1989 to 2016, while prostate cancer deaths declined by 51 percent from 1993 to 2016. Colorectal cancer mortality dropped by 53 percent between 1970 and 2016. 

However, not all cancer death rates dropped. The mortality rates for liver cancer, uterine cancer, endometrial cancer and pancreatic cancer in men went up from 2012 to 2016. Cancers of the brain and other nervous system, soft tissue and cancers linked to the human papillomavirus (HPV) also increased.

While cancer deaths in the U.S. fell overall, there are still significant racial and economic gaps in mortality rates. The good news is, the racial gap is narrowing—the mortality rate for black Americans is now 14 percent higher than white Americans as opposed to 33 percent in the mid-1990s.

“The narrowing gap in racial disparities is encouraging,” said Dr. Schabath. “The narrowing is likely attributed to years of concerted efforts at the local, state and national level to reduce racial and ethnic cancer disparities. However, much more work is still needed.”

More work is also needed to reduce socioeconomic inequalities. Residents of the poorest counties are experiencing an increasingly disproportionate burden of most preventable cancers. For example, cervical cancer mortality among women in poor counties is twice that of women in affluent counties, while lung cancer mortality is more than 40 percent higher. These disparities are the result of limited access to healthcare and a higher prevalence of smoking, alcohol consumption, obesity and unhealthy lifestyle habits in poorer regions.