U.S. — Cancer deaths in the U.S. decreased by 34% between 1991 and 2022, resulting in an estimated 4.5 million fewer deaths. A report from the American Association for Cancer Research (AACR) states that cancer death rates in the U.S. fell by 35% over the past 35 years, translating to nearly 5 million fewer cancer deaths since 1991.

Prior to 1991, cancer deaths in the U.S. increased for decades, peaking at 215 deaths per 100,000 people. At this peak, approximately one in four deaths in the U.S. were attributed to cancer. Research examined cancer death rates for almost 3,000 U.S. counties between 1981 and 2019.

Disparities in cancer mortality rates by income, geography, and race have persisted and grown. By 2019, the 10% of the U.S. population in counties with the highest median incomes had cancer mortality improvements approximately seven times greater than the 10% in the lowest-income counties. Approximately 458 rural counties in the U.S. experienced increasing cancer mortality.

Metropolitan areas like Manhattan saw a 47% decline in cancer deaths between 1991 and 2019, while Queens, Bronx, and Brooklyn experienced declines over 40%. Other areas like Marin County had a 47% decline, San Mateo County saw a 44% decline, and San Francisco County had a 40% decline in cancer deaths. In contrast, nonmetropolitan areas in Mississippi had a 20% decline, Arkansas had a 23% decline, West Virginia had a 24% decline, and Montana had a 29% decline.

Lung cancer is the leading cause of cancer deaths in the U.S. Manhattan had 60% fewer lung cancer deaths in 2019 compared to 1991. Increased screening contributed to 79% of colorectal cancer deaths averted, according to the AACR report.

In 2023, 67% of white people were up to date on colonoscopies, while 57% of Asian and American Indian/Alaska Native people were up to date. Fifty-three percent of Hispanic people were up to date on colonoscopies. The Hispanic population has had annual rises of 4.7% in early-onset colorectal cancer among women and 3.7% among men. "A lot of people are under the misconception that they don't need to get a colonoscopy until their mid-40s, but it happened to me at 38," Alex Valdez said.

Cervical cancer rates were 32% higher among women living in poor counties compared to higher-income counties, and death rates from cervical cancer are 49% higher in poor counties, according to the report. "Cervical cancer still remains a problem," said Sarah Kim, a gynecologic surgeon at Memorial Sloan Kettering Cancer Center. "Especially for patients who don't have access to care for a multitude of reasons, one of them is really people who are socially disadvantaged or maybe working multiple jobs or don't have good healthcare and therefore aren't able to see their gynecologist once a year."

"African American communities and American Indian and Alaska Native populations have the highest overall cancer death rates of any U.S. racial or ethnic group, and this means higher incidence and mortality for multiple cancers," said Mariana Stern, a professor of clinical population and public health sciences and urology at the Keck School of Medicine of the University of Southern California. Enrollment in Medicaid and the Affordable Care Act has fallen by more than 5 million over the past year, according to a report from Protect Our Care.