The cancer death rate has dropped by 23% since its peak in 1991, averting more than 1.7 million cancer deaths through 2012. The decline is being attributed to continuing reductions in the number of people who smoke tobacco and advances made in cancer prevention, early detection, and treatment. These findings are included in Cancer Statistics, 2016, the American Cancer Society’s (ACS) latest annual report on cancer incidence, mortality, and survival, and published online in CA: A Cancer Journal for Clinicians (doi:10. 3322/caac.21332).

The American Cancer Society estimates the number of new cancer cases and deaths in the United States for the current year and compiles the most recent data on cancer incidence, mortality, and survival for its annual report. According to ACS estimates, there will be 1 685 210 new cancer cases and 595 690 cancer deaths in the United States in 2016.

Overall cancer incidence is stable in women and declining by 3.1% per year in men (from 2009-2012). One-half of the drop in cancers in men is due to recent rapid declines in prostate cancer diagnoses as PSA testing decreases.

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Cancer mortality also continues to decline. The past decade of data shows the rate dropped by 1.8% per year in men and 1.4% per year in women. The decline in cancer death rates over the past 2 decades is driven by continued decreases in death rates for the four major cancer sites: lung, breast, prostate, and colon/rectum.

Death rates for female breast cancer have declined 36% from peak rates in 1989, while deaths from prostate and colorectal cancers have each dropped approximately 50% from their peak. These declines are the results of improvements in early detection and treatment. The impact of reduced tobacco use on lung cancer death rates are a 38% decline between 1990 and 2012 among males and a 13% decline between 2002 and 2012 among females.

The report’s analysis of leading causes of death by state shows that cancer remains the second leading cause of death nationally, but significant reductions in deaths from heart disease made cancer the leading cause of death in 21 states: Alaska, Arizona, Colorado, Delaware, Florida, Georgia, Idaho, Kansas, Maine, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, Oregon, South Carolina, Vermont, Virginia, and Washington.

In addition, cancer is the leading cause of death among adults ages 40 to 79 years, and among both Hispanics and Asian/Pacific Islanders (APIs), together these groups are one-quarter of the US population. However, heart disease remains the top cause of death overall in the United States. In 2012, there were 599,711 (24%) deaths from heart disease, compared with 582,623 (23%) deaths from cancer.

“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 Otis W. Brawley, MD, chief medical officer of the American Cancer Society.