Cancer deaths fall sharply, but racial and income gaps persist

U.S. cancer death rates have fallen 35% over the past 35 years, a drop the American Association for Cancer Research said has spared nearly 5 million lives since 1991. The group’s report, released Wednesday, credits wider screening and better treatments for much of the progress, while warning that many communities have not benefited equally.

Mariana Stern, who chaired the AACR report and teaches at the University of Southern California’s Keck School of Medicine, said African American, American Indian and Alaska Native communities have the highest overall cancer death rates among U.S. racial and ethnic groups. The report said those groups also face higher incidence and mortality for several cancers.

The gap between Black and white cancer mortality has narrowed, according to the report, but large differences remain. Black people are about twice as likely as white people to die from multiple myeloma and cancers of the stomach, prostate and gallbladder. Black women have breast cancer death rates 35% higher than white women, the report said.

Colorectal cancer shows a similar pattern, according to the AACR. The report said mortality is higher among Black people and American Indian and Alaska Native people than among white people, even as the disease is rising among adults younger than 50.

Screening has played a major role in cutting colorectal cancer deaths, the report said. The AACR attributed 79% of averted colorectal cancer deaths to increased screening, which can allow doctors to remove precancerous polyps during colonoscopy. People at average risk are advised to begin screening at age 45, according to the report.

Screening rates still differ by race and ethnicity. In 2023, the report found that 53% of Hispanic people and 57% of Asian people and American Indian or Alaska Native people were current on colonoscopy screening, compared with 67% of white people. The AACR also said Hispanic people have seen the largest rise in early-onset colorectal cancer, with annual increases of 4.7% among women and 3.7% among men.

Alex Valdez, who was diagnosed with colorectal cancer at 38, told NBC News that doctors found a 7-centimeter tumor during a colonoscopy he had for ulcerative colitis and Crohn’s disease monitoring. He said he had likely had cancer for 1½ to two years without knowing it, and that many people mistakenly believe colonoscopies are not needed until the mid-40s.

The report also pointed to unequal cervical cancer screening. Asian and Hispanic women were screened at lower rates than white women, according to the AACR, and women in poor counties were less likely to receive regular screening.

Dr. Sarah Kim, a gynecologic surgeon at Memorial Sloan Kettering Cancer Center, told NBC News that cervical cancer remains a concern for patients who have trouble getting care, including people who are socially disadvantaged, work multiple jobs or lack strong health coverage. The report found cervical cancer rates 32% higher in poor counties than in higher-income counties, while death rates were 49% higher.

Kim said HPV vaccination can prevent cervical cancer and can be obtained at pharmacies without a doctor’s appointment. The report said unequal outcomes reflect many factors, including systemic racism and social and economic conditions that affect screening, diagnosis and treatment.

The AACR said patients from racial and ethnic minority groups, low-income communities and medically underserved populations are less likely to receive recommended cancer care. Stern told NBC News that patient navigators have helped people overcome barriers and stay connected to treatment, but she warned that proposed cuts to the National Institutes of Health and the National Institute on Minority Health and Health Disparities could threaten progress.

This story draws on original reporting from NBC News.