Annual statistics reporting from the American Cancer Society shows the death rate from cancer in the US has declined steadily over the past 2 decades. The cancer death rate for men and women combined fell 23% from its peak in 1991 to 2012, the most recent year for which data is available, translating to more than 1.7 million deaths averted during this time period.

“Cancer Statistics, 2016,” 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 article, Cancer Facts & Figures 2016.

A total of 1,685,210 new cancer cases and 595,690 deaths from cancer are projected to occur in the US in 2016. During the most recent 4 years for which there are data (2009-2012), the rate of new cancer diagnoses decreased by 3.1% per year in men and stayed about the same in women.

Lung, colon, prostate, and breast cancer

Lung, colon, prostate, and breast cancers continue to be the most common causes of cancer death, accounting for almost half 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 colon cancer will account for 44% of all newly diagnosed cancers in 2016, with prostate cancer alone accounting for about 1 in 5 cases. Among women, the 3 most common cancers in 2016 will be breast, lung, and colon, which together will account for about half of all cases. Breast cancer alone is expected to account for 29% of all new cancer cases among women.

About half the overall decline in new cancer cases for men is because of the recent rapid decline in prostate cancer diagnoses. Routine screening with the PSA test is no longer recommended because of high rates of over-diagnosis (finding cancers that would never need to be treated), estimated at 23% to 42% for cancers detected this way. 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. Lung cancer incidence rates began declining in the mid-1980s in men and in the mid-2000s in women. The differences reflect historical patterns in tobacco use, where women began smoking in large numbers many years later than men.

Recent rapid declines in new colon 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 aged 50 to 75 years, colonoscopy use increased from 19% in 2000 to 55% in 2013. Colon cancer incidence and death rates declined by about 3% per year in both men and women from 2003 through 2012.

Some cancers on the rise

Despite progress overall in reducing cancer incidence and death, some cancer types are increasing. Incidence rates increased from 2003 to 2012 among both men and women for some types of leukemia and for cancers of the tongue, tonsil, small intestine, liver, pancreas, kidney, and thyroid.

In addition, incidence rates increased in men for melanoma, multiple myeloma, male breast cancer, testicular cancer, and throat cancer. Among women, incidence rates increased for anal, vulvar, and endometrial cancers. Some of the increase in endometrial cancer rates is thought to be due to increasing rates of obesity.

Cancer burden remains unequal

The rates of new cancer cases and cancer deaths vary quite a bit among racial and ethnic groups. Black men continue to have the highest cancer incidence and death rates among all ethnic groups in the US. Asian Americans have the lowest rates.

A major cause of racial disparities is poverty, which leads to differences in risk factors and access to high-quality health care. The report calls for applying existing knowledge about fighting cancer across all segments of the population, especially groups in the lowest socioeconomic bracket, as a way to speed progress against cancer.

In 21 states, cancer is now the leading cause of death, mostly because of a large decrease in deaths from heart disease, which is still the top cause of death overall in the US.

“We’re gratified to see cancer death rates continuing to drop. But the fact that cancer is nonetheless becoming the top cause of death in many populations is a strong reminder that the fight is not over,” said Gary Reedy, chief executive officer of the American Cancer Society, in a statement. “Cancer is in fact a group of more than 100 diseases, some amenable to treatment; some stubbornly resistant. So while the average American’s chances of dying from the disease are significantly lower than at any time in our 100-year history, it continues to be all-too-often the reason for shortened lives, and too much pain and suffering.”

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 2016, an estimated 10,380 children will be diagnosed with cancer and 1,250 will die from it. Leukemia accounts for almost a third (30%) 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 2012. 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 2005 to 2011. The substantial progress for all of the major childhood cancers reflects both improvements in treatment and high levels of participation in clinical trials.