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. As of 2015, the cancer death rate for men and women combined had fallen 26% from its peak in 1991. This decline translates to nearly 2.4 million deaths averted during this time period.

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.

“Cancer Statistics, 2018,” 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 is also released in a companion report, Cancer Facts and Figures 2018, available on the interactive website, the Cancer Statistics Center. A total of 1,735,350 new cancer cases and 609,640 deaths from cancer are projected to occur in the US in 2018.

The drop in cancer mortality is mostly due to steady reductions in smoking and advances in early detection and treatment. “This new report reiterates where cancer control efforts have worked, particularly the impact of tobacco control,” said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society. “A decline in consumption of cigarettes is credited with being the most important factor in the drop in cancer death rates. Strikingly though, tobacco remains by far the leading cause of cancer deaths today, responsible for nearly 3 in 10 cancer deaths.”

Major cancer types: Lung, breast, prostate, and colorectal cancer

The overall drop in cancer death rates is largely due to decreasing death rates for lung, breast, prostate, and colorectal cancers.

Lung cancer death rates declined 45% from 1990 to 2015 among men and 19% from 2002 to 2015 among women. From 2005 to 2014, the rates of new lung cancer cases dropped by 2.5% per year in men and 1.2% per year 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.

Breast cancer death rates declined 39% from 1989 to 2015 among women. The progress is attributed to improvements in early detection.

Prostate cancer death rates declined 52% from 1993 to 2015 among men. 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.

Colorectal cancer death rates declined 52% from 1970 to 2015 among men and women because of increased screening and improvements in treatment. However, between 2006 and 2015, the death rate among adults younger than 55 increased by 1% per year.

Cancer outcomes vary among racial/ethnic groups

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 for Asian Americans. The cancer death rate in 2015 was 14% higher in Blacks than in whites. That gap has narrowed from a peak of 33% in 1993. However, the racial gap was much larger for those younger than 65 than it was for those 65 or older, likely in part due to universal health care access for seniors through Medicare.

Racial and ethnic disparities in the cancer burden are a reflection of several factors related to socioeconomic status. According to the US Census Bureau, in 2016, 22% of Blacks and 19% of Hispanics/Latinos lived below the poverty line, compared to 9% of whites and 10% of Asians.

People with lower socioeconomic status are more likely to smoke and be obese, partly because of targeted marketing to this population by tobacco companies and fast food chains. In addition, community factors often limit opportunities for physical activity and access to fresh fruits and vegetables.

In 2016, 11% of Blacks and 16% of Hispanics/Latinos were uninsured, compared to 6% of whites and 8% of Asians.

Even when other factors are equal, studies show that racial and ethnic minorities tend to receive lower-quality health care than whites.

Cancer in children and adolescents

Cancer is the second most common cause of death among children ages 1 to 14 years in the US, after accidents. In 2018, an estimated 10,590 children in this age group will be diagnosed with cancer and 1,180 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 since 1975. 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 2007 to 2013.

Special section on ovarian cancer

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 ovarian cancer. The report’s authors say improving the ability to detect ovarian cancer early is a research priority. Some key facts about ovarian cancer:

Women diagnosed with local-stage ovarian cancer have more than a 90% 5-year survival rate.

About 4 out of 5 ovarian cancer patients are diagnosed with advanced disease that has spread throughout the abdominal cavity.

Ovarian cancer accounts for just 2.5% of all cancer cases in women, but 5% of cancer deaths because of the disease’s low survival rate.

In 2018, there will be an estimated 22,240 new cases of ovarian cancer diagnosed and 14,070 deaths in the US.

The special section provides information about ovarian cancer risk factors, incidence and mortality rates and trends, early detection, and treatment that is primarily related to epithelial tumors, the most common subtype of ovarian cancer. Understanding of this subtype has evolved rapidly in recent years.

Other highlights from the report:

The overall estimate of 1,735,350 cases for 2018 equals more than 4,700 new cancer diagnoses each day.

The lifetime probability of being diagnosed with cancer is 39.7% for men and 37.6% for women, which is a little more than 1 in 3.

The most common cancers to be diagnosed in men are prostate, lung, and colorectal cancers, which account for 42% of all cases, with prostate cancer alone accounting for almost 1 in 5 new diagnoses.

The most common cancers to be diagnosed in women are breast, lung, and colorectal cancers, which combined represent one-half of all cases; breast cancer alone accounts for 30% of all new cancer diagnoses in women.

The most common causes of cancer death continue to be lung, prostate, and colorectal cancers in men and lung, breast, and colorectal cancers in women. These 4 cancers account for 45% of all cancer deaths, with 1 in 4 cancer deaths from lung cancer.

Liver cancer incidence continues to increase rapidly in women, but appears to be stabilizing in men. People infected with hepatitis C virus (HCV) are at greater risk for liver cancer. All baby boomers (those born between 1945 and 1965) are recommended to be tested for HCV because 80% of HCV-infected people are in this age group.

“Cancer Statistics 2018” can be viewed at cacancerjournal.com, while “Cancer Facts & Figures 2018” is available at cancer.org/statistics.