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Overall cancer deaths in the United States continue to decline, but trends are mixed when it comes to deaths associated with specific cancer types and overall cancer incidence, according to the 2025 Annual Report to the Nation on the Status of Cancer.

The report — a joint initiative of the National Cancer Institute (NCI), the Centers for Disease Control and Prevention (CDC), the American Cancer Society (ACS), and the North American Association of Central Cancer Registries (NAACCR) — provides insight into cancer trends, including the impact of the first 2 years of the COVID-19 pandemic on cancer diagnoses and deaths.

The findings, based on incidence data from CDC- or NCI Surveillance, Epidemiology, and End Results–supported population-based cancer registries and data from the National Center for Health Statistics, were published on April 21 in Cancer.

Cancer deaths decreased by an average of 1.7% per year for men and 1.3% for women during 2018-2022 and by 1.5% per year from 2001 through 2022 among children aged 0-14 years. Among adolescents and young adults aged 15-39 years, cancer deaths decreased by 2.9% per year from 2001 to 2005 and 1% per year from 2005 to 2020 and remained stable from 2020 to 2022.

Cancer incidence remains higher among men than among women (146.0 vs 126.4 per 100,000 standard population). However, the rate of new cancer cases declined among men by 1.6%-2.2% each year from 2001 through 2013, then stabilized through 2021, whereas new cases among women increased by 0.3% each year from 2003 to 2021, except in 2020.

And while the rates of new cases and deaths from tobacco-related cancers decreased during the study period, the rates of those associated with excess body weight — including female breast, uterus, colon and rectum, pancreas, kidney, and liver cancers — increased.

In fact, the progress in reducing overall cancer deaths is largely attributable to sustained declines in both incidence and death rates of lung cancer and several other smoking-related cancers, the investigators noted.

“The continued reduction in tobacco use has led to declines in incidence and death rates for several smoking-related cancers, including lung, bladder, and larynx,” first author Recinda L. Sherman, MPH, PhD, of the NAACCR, and her colleagues explained. “The pace of reduction in the lung cancer death rate has been faster than the decline in incidence since the middle 2000s, coinciding with multiple breakthroughs in treatments for non–small cell lung cancer and increased access to care through Medicaid expansion.”

Increased screening rates also likely play a part, they noted, but screening prevalence remains low at 18% in eligible adults.

This suggests there may be opportunities to further decrease lung cancer death rates as lung cancer remains the leading cause of cancer death for both men and women, despite the remarkable progress, they added.

The report also highlighted racial, ethnic, and sex-based disparities in cancer incidence and death rates. From 2018 to 2022, cancer deaths decreased for each major racial and ethnic population group. However, from 2017 to 2021 (excluding 2020), cancer incidence was stable among men in each major racial and ethnic population group but increased among women in each major racial and ethnic population group. Among men, non-Hispanic Black men had the highest cancer incidence, and among women, American Indian and Alaska Native women had the highest cancer incidence.

A sharp decline in overall cancer incidence was apparent in 2020 — a finding likely attributable to pandemic-related disruptions in healthcare, according to the investigators, who noted that incidence rates returned to pre-pandemic levels by 2021.

“Overall, cancer incidence and death rates continue to decline, representing changes in risk factors, increases in screening utilization, and advances in treatment. However, sustained disparities by race and ethnicity emphasize the need to fully understand the factors that create these differences so that they can be mitigated,” the authors stated, noting that “population-based incidence and mortality data play a vital role in informing cancer control efforts to help reduce the cancer burden in the United States.”

As for the effects of the COVID-19 pandemic on cancer incidence and deaths, additional data years are needed to “correctly interpret this decline and assess whether cases went undiagnosed or underreported because the rates in 2021 were not greater than expected,” they said.

“The full impact of the decline in cancer diagnoses during 2020 on stage at diagnosis and survival will become clearer with additional years of incidence data. However, our results underscore the importance of public health policy to ensure continued access to cancer-related care, even during public health emergencies such as pandemics,” they concluded.

In a prior report, the ACS also highlighted these and other cancer trends data derived from population-based cancer registries and the National Center for Health Statistics and noted the increasing incidence of many cancer types in women and younger adults and “alarming disparities” that persist in Native American and Black populations.

“These data tell us that we’ve made great progress against cancer, but there is more work to do,” Rebecca Siegel, MPH, the lead author on the ACS report and a co-author on the current report, told Medscape Medical News.

The 2025 Annual Report to the Nation on the Status of Cancer is based on cancer incidence data from population-based cancer registries, funded by the CDC and NCI and compiled by the NAACCR, and on cancer death data from the National Center for Health Statistics’ National Vital Statistics System. Siegel is an employee of the ACS. Sherman reported having no disclosures.

Sharon Worcester, MA, is an award-winning medical journalist based in Birmingham, Alabama, writing for Medscape Medical News, MDedge, and other affiliate sites. She currently covers oncology, but she has also written on a variety of other medical specialties and healthcare topics. She can be reached at sworcester@mdedge.com or on X: @SW_MedReporter.