More Americans are surviving cancer, but the disease strikes younger, middle-aged adults and women more frequently, the American Cancer Society reported Thursday.
And despite overall improvements in survival, Black and Native Americans die from some cancers at rates two to three times higher than white Americans.
These trends represent a stark shift for a disease that has long been considered a disease of aging, affecting many more men than women.
The changes reflect declines in smoking-related cancers and prostate cancer among older men and a staggering increase in cancer in people born since the 1950s.
Cancer is the second leading cause of death in the United States, but the leading cause among Americans under 85. The new report predicts that there will be approximately 2,041,910 new cases this year and that 618,120 Americans will die from the disease.
Six of the 10 most common cancers are on the rise, including breast and uterine cancers. Colorectal cancers among people under 65 are also on the rise, as are prostate cancer, melanoma and pancreatic cancer.
“These unfavorable trends are tilted in favor of women,” said Rebecca L. Siegel, an epidemiologist at the American Cancer Society and lead author of the report.
“Of all the cancers on the rise, some are increasing in men, but the phenomenon is unbalanced: the greatest increase concerns women”.
Women are also diagnosed at a younger age. Cancer rates are increasing among women under 50 (so-called early-onset cancer), as well as among women between 50 and 64.
Despite the increase in some early-onset cancers, such as colorectal cancer and testicular cancer, “overall rates are stable in men under 50 and declining in those between 50 and 64,” he said Siegel.
Several other worrying trends are outlined in the report. The first is the increase in new cases of cervical cancer – a disease widely considered preventable in the United States – among women aged 30 to 44.
The incidence of cervical cancer has plummeted since the mid-1970s, when Pap smear screening to detect precancerous changes became widely available. But recent surveys have found that many women are putting off visits to their gynecologists.
A Harris Poll survey of more than 1,100 U.S. women conducted last year for BD, a medical technology company, found that 72% said they had put off a visit to their doctor that would include screening; half said they didn’t know how often they should be screened for cervical cancer.
(The current recommendation is a bit complicated: Get a Pap test every three years starting at age 21, or a combined Pap test and a test for human papillomavirus, which can cause cervical cancer, every five years.)
Another disturbing trend began in 2021 when, for the first time, the incidence of lung cancer in women under 65 exceeded the incidence in men: 15.7 cases per 100,000 women under 65, compared at 15.4 per 100,000 in men.
Lung cancer has declined over the past decade, but it has declined faster in men. Women started smoking later than men and took longer to quit.
There have also been increases in smoking among people born after 1965, the year after the surgeon general first warned that cigarettes cause cancer.
Smoking continues to be the leading cause of preventable death in the United States, and will account for nearly 500 daily cancer deaths in 2025, mostly from lung cancer, the American Cancer Society said.
“There is growing concern that e-cigarettes and vaping may contribute to this burden in the future, given their carcinogenic potential and widespread popularity,” the report said.
Breast cancer rates have also been increasing for many years, increasing by about 1% per year between 2012 and 2021. The steepest increase has been seen in women under 50, and there have been sharp increases among Hispanic Americans, Asian Americans and Pacific Islanders. women.
The increases are driven by the detection of localized cancers and some hormone-fueled cancers.
Part of the increase comes from changing fertility patterns. Pregnancy and breastfeeding protect against breast cancer, but more American women are postponing childbirth or choosing not to have children.
Other risk factors include genetics, family history and excessive alcohol consumption, a habit that is increased in women under 50. In older women, excess body weight may play a role in cancer risk.
Uterine cancer is the only cancer for which survival has actually decreased over the past 40 years, the ACS said.
Mortality rates for liver cancer among women and for oral cancer for both sexes are also increasing.
The incidence of pancreatic cancer has been increasing among both men and women for decades. It currently represents the third leading cause of death from cancer. As with many other cancers, obesity is thought to be a contributor.
Little progress has been made in understanding and treating pancreatic cancer. Mortality rates have risen since records began, now reaching 13 per 100,000 in men and 10 per 100,000 in women, compared with about 5 per 100,000 in both men and women in the 1930s.
The lack of progress has frustrated many scientists and doctors. Cancer is often quite advanced at the time of diagnosis, and the five-year survival rate is only 13%.
“We need to make progress in understanding specifically what drives pancreatic tumors to grow, what treatment will prevent these tumors, what can prevent them in the first place, and how we can detect them early,” said Dr. Amy Abernethy, an oncologist who has co-founded Highlander Health, which focuses on accelerating clinical research.
Some experts are beginning to recognize that environmental exposures could contribute to the early onset of cancer, beyond the usual suspects: lifestyle, genetics and family history.
“I think the increase in not one but a variety of cancers in young people, particularly young women, suggests that there is something broader than variations in individual genetics or population genetics,” said Neil Iyengar, an oncologist of Memorial Sloan. Kettering Cancer Centre.
“This strongly highlights the possibility that environmental exposures and our lifestyles in the United States are contributing to the increase in cancers among young people.”
Public health efforts to reduce risky lifestyle behaviors have focused on people at higher risk and older Americans, who still bear the brunt of cancer, he noted.
But the risk factors in young people can be different.
Emerging research suggests that maintaining regular sleep patterns, for example, may also help prevent cancer, he said.
Lifestyle and behavioral changes can reduce the risk of many cancers, Ms. Siegel said.
“I don’t think people realize how much control they have over their cancer risk,” he said. “There is so much we can all do. Not smoking is the most important thing.
Among others: Maintain a healthy body weight; do not consume alcohol or consume it in moderation; follow a diet rich in fruit and vegetables and low in red and processed meat; physical activity; and regular cancer screenings.
“There are all these things you can do, but they are individual choices, so just pick one that you can focus on,” he said. “Small changes can make a difference.”