More Americans are surviving cancer, but the disease strikes young and middle-aged adults and women more often, the American Cancer Society said Thursday.
And despite overall improvements in survival, blacks and Native Americans die from certain cancers at rates two to three times higher than white Americans.
These trends represent a remarkable change for a disease long considered a disease of aging that affects far more men than women.
The changes reflect a decline in smoking-related cancers and prostate cancer among older men, and an alarming rise in cancer among people born since the 1950s.
Cancer is the second leading cause of death in the United States, but the leading cause among Americans under the age of 85. The new report predicts that about 2,041,910 new cases will occur 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 in people under 65 are also increasing, as well as prostate cancer, melanoma and pancreatic cancer.
“These adverse trends are skewed toward women,” said Rebecca L. Siegel, an epidemiologist at the American Cancer Society and first author of the report.
“Of all the cancers that are increasing, some are increasing in men, but it’s lopsided — more of that increase is happening in women.”
Women are also diagnosed at younger ages. Cancer rates are increasing in women under 50 (so-called early-onset cancer), as well as in women 50 to 64 years old.
Despite increases in some early cancers, such as colon and testicular cancer, “overall rates are stable in men under 50 and declining in those 50 to 64,” Ms. Siegel.
Several other worrying trends are outlined in the report. One is the rise in new cases of cervical cancer — a disease widely viewed as 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. However, recent surveys have shown that many women are postponing 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 percent said they had put off a visit with their doctor that would have included screening. Half said they did not 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 test for human papillomavirus, which can cause cervical cancer, every five years. )
Another worrying 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 with 15.4 per 100,000 to men.
Lung cancer has been on the decline over the past decade, but it has declined more rapidly in men. Women started smoking later than men and took longer to quit.
There were also increases in smoking among people born after 1965, the year after the surgeon general first warned that cigarettes cause cancer.
Smoking remains the leading cause of preventable death in the United States, accounting for nearly 500 cancer deaths every day 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 high popularity,” the report said.
Breast cancer rates have also been rising for many years, increasing by about 1 percent annually between 2012 and 2021. The steepest increase has been seen in women younger than 50, and there have been steep increases among Hispanic Americans, Asian Americans, and Pacific Island women.
The increases are due to the detection of localized tumors and some hormone-fueled cancers.
Some of the increase is due to changing fertility patterns. Childbearing and breastfeeding protect against breast cancer, but more American women are putting off childbearing — or choosing not to have children at all.
Other risk factors include genetics, family history and heavy drinking — a habit that has 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 declined over the past 40 years, the ACS reported.
Death rates are also rising for liver cancer in women and oral cavity cancers for both sexes.
Pancreatic cancer has been increasing in incidence in both men and women for decades. It is now the third leading cause of cancer death. As with many other cancers, obesity is thought to be a contributing factor.
Little progress has been made in understanding and treating pancreatic cancer. Death rates have been rising since record-keeping began, rising to 13 per 100,000 in men and 10 per 100,000 in women today, from about five per 100,000 in both men and women in the 1930s.
The lack of progress has frustrated many scientists and doctors. The cancer is often quite advanced when diagnosed and the five-year survival rate is only 13 percent.
“We need to make progress in understanding what leads to the development of pancreatic cancers, what treatment will subsequently prevent these cancers, what can prevent it in the first place and how we can screen for it early,” said Dr. Amy Abernethy. an oncologist who co-founded Highlander Health, which is focused on accelerating clinical research.
Some experts are beginning to recognize that environmental exposures may contribute to early cancer, in addition to the usual suspects: lifestyle, genetics and family history.
“I think the increase in not just one but a variety of cancers in younger people, particularly young women, suggests that there’s something broader than variations in individual genetics or population genetics,” said Neil Iyengar, an oncologist at Memorial Sloan. Kettering Cancer Center.
“It strongly points to the possibility that our environmental exposures and lifestyles in the U.S. are contributing to an increase in cancers in younger people.”
Public health efforts aimed at reducing risky lifestyle behaviors have focused on higher-risk individuals and older Americans, who still bear the brunt of cancer, he noted.
But risk factors in young people may 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, said Ms. Siegel.
“I don’t think people realize how much control they have over their cancer risk,” she said. “There is so much we can all do. Not smoking is the most important thing.”
Among others: Maintaining a healthy body weight. not drinking alcohol or drinking in moderation. diet high 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’re individual choices, so pick one that you can focus on,” he said. “Small changes can make a difference.”
