The death rate from cancer in the US has declined steadily over the past 2 decades, according to annual statistics reporting from the American Cancer Society. The cancer death rate for men and women combined fell 25% from its peak in 1991 to 2014, the most recent year for which data are available. This decline translates to more than 2.1 million deaths averted during this time period.

“Cancer Statistics, 2017,” 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 will also be released in a companion report, Cancer Facts & Figures 2017 and will be available on the interactive website, the Cancer Statistics Center.

A total of 1,688,780 new cancer cases and 600,920 deaths from cancer are projected to occur in the US in 2017.

During the most recent decade of available data, 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 declined by about 1.5% annually in both men and women.

“The continuing drops in the cancer death rate are a powerful sign of the potential we have to reduce cancer’s deadly toll,” said Otis W. Brawley, MD, FACP, chief medical officer of the ACS. “Continuing that success will require more clinical and basic research to improve early detection and treatment, as well as creative new strategies to increase healthy behaviors nationwide. Finally, we need to consistently apply existing knowledge in cancer control across all segments of the population, particularly to disadvantaged groups.”

Common cancer killers: lung, colon, prostate, and breast cancer

Lung, colorectal, prostate, and breast cancers continue to be among the most common causes of cancer death, accounting for about 46% of the total cancer deaths among men and women. More than 1 out of every 4 cancer deaths is due to lung cancer.

Among men, prostate, lung, and colorectal cancer will account for 42% of all newly diagnosed cancers in 2017, with prostate cancer alone accounting for about 1 in 5 cases. Among women, the 3 most common cancers in 2017 will be breast, lung, and colorectal, which together will account for about half of all cases. Breast cancer alone is expected to account for 30% of all new cancer cases among women.

Understanding the decline in prostate, lung, and colorectal cancer rates

Much of the overall decline in new cancer rates for men is because of the recent drop in prostate cancer diagnoses. 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.

The rate of new lung cancer cases has also continued to decline as fewer people smoke. These rates are declining about twice as fast in men as 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.

Recent rapid declines in new colorectal cancer cases have been attributed in part to more people getting screened with tests such as colonoscopies, which can prevent cancer through the removal of pre-cancerous growths called polyps. Among adults ages 50 years and older, colonoscopy use has tripled, increasing from 21% in 2000 to 60% in 2015. Colorectal cancer incidence rates declined by about 3% per year in both men and women from 2004 through 2013. However, in people younger than 50 years, colorectal cancer incidence rates increased by about 2% per year from 1993 to 2013.

Continued improvement in cancer disparities, but burden remains unequal

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 Asian Americans. However, racial disparities continue to decline. The excess risk of cancer death in black men as compared to white men has dropped from 47% in 1990 to 21% in 2014. The racial disparity has also declined in black women, from a peak of 20% in 1998 to 13% in 2014.

Although the cancer death rate remained 15% higher in blacks than in whites in 2014, increasing access to care as a result of the Patient Protection and Affordable Care Act may contribute to a further narrowing of the racial gap across all population groups. In 2015, 11% of blacks and 7% of non-Hispanic whites were uninsured, compared with 21% of blacks and 12% of non-Hispanic whites in 2010. Progress for Hispanics is similar, with the uninsured rate dropping from 31% in 2010 to 16% in 2015.

Cancer in children

Cancer is the second most common cause of death among children ages 1 to 14 years in the US, after accidents. In 2017, an estimated 10,270 children in this age group will be diagnosed with cancer and 1,190 will die from it.Leukemia accounts for almost a third (29%) of all childhood cancers, followed by brain and other nervous system tumors (26%).

Cancer incidence rates increased in children and adolescents by 0.6% per year from 1975 through 2013. 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 2006 to 2012.

More than 200,000 new cases of rare cancers expected in 2017

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 rare cancers in adults. Rare cancers can be especially challenging for patients and health care providers because they are typically harder to research and diagnose. This often means that fewer treatment options are available, and information is harder to find.

For this report, the researchers defined rare cancers as those with fewer than 6 cases per 100,000 people per year. They included testicular cancer, even though its incident rate is 7.2 per 100,000, because it is often considered a rare cancer. They excluded others – including leukemia subtypes, Hodgkin lymphoma, and cancers of the oral cavity and pharynx – because they are described in detail elsewhere in the report.

The special section provides incidence and mortality rates for 28 rare cancers in adults ages 20 and older in the US. It also includes an overview of symptoms and risk factors for a subset of these cancers – those of the small intestine, anus, gallbladder, larynx, nasopharynx, nose and nasal cavity, vulva, vagina, penis, bone (including osteosarcoma), soft tissue, and eye, as well as testicular cancer, breast cancer in men, mesothelioma, and Kaposi sarcoma.

Approximately 208,000 new cases of rare cancer are expected to be diagnosed in 2017, not including the 8,850 estimated new cases of testicular cancer.

In recent years, national and international collaborations have formed to address some of the challenges associated with rare diseases, including rare cancers. In 2013, the National Cancer Institute launched the Rare Tumors Initiative, a collaboration of scientists, advocates, and industry experts with the goal of advancing research and treatment for rare cancers. In addition, one of the goals of the 2014 transformation of the National Cancer Institute’s clinical trial program (National Clinical Trials Network) is to improve the care of patients with rare and molecularly defined cancers.

“Cancer Statistics 2017” can be viewed at cacancerjournal.com, while “Cancer Facts & Figures 2017” is available at cancer.org/statistics.