Annual Report Shows Continued Progress in US Cancer Outcomes

Cancer mortality in the United States continued to decline, with progress against lung cancer accounting for a substantial portion of the reduction, according to the 2026 Annual Report to the Nation on the Status of Cancer.^1,2

The annual report, a collaboration between the Centers for Disease Control and Prevention (CDC), National Cancer Institute, American Cancer Society, and North American Association of Central Cancer Registries, evaluated cancer incidence trends from 2003 through 2022 and mortality trends from 2004 through 2023. The 2026 report placed particular emphasis on lung cancer, examining changes in risk factors, screening, biomarker testing, stage at diagnosis, survival, and mortality during the 21^st century.

Overall Cancer Trends Continue to Improve

Overall cancer incidence rates during 2018-2019 and 2021-2022 were 504.6 cases per 100,000 among males and 443.0 among females. Excluding 2020, incidence remained stable among males and increased 0.4% per year among females from 2011 through 2022. In contrast, overall cancer mortality continued to decline, a trend that has persisted for more than 20 years.²

Lung Cancer: The Success of Prevention and Early Detection

The report attributes much of the overall cancer mortality reduction to continued decreases in lung cancer mortality. From 2004 through 2023, lung cancer death rates decreased 52% among males and 37% among females. Lung cancer accounted for 29% of all cancer deaths in 2004 compared with 21% in 2023, when it remained responsible for approximately 1 in 5 cancer deaths.

The report highlights reductions in tobacco exposure as an important component of declining lung cancer burden. Cigarette smoking prevalence among US adults decreased 56%, from 22.6% in 2001 to 9.9% in 2024. Secondhand smoke exposure among nonsmoking individuals also decreased 42%, from 41.8% between 2001 and 2002 to 24.3% between 2017 and March 2020.

These trends have occurred alongside improvements in incidence and survival. Lung cancer incidence decreased 38% among males and 15% among females from 2003 through 2022. From 2018 to 2022, incidence continued to decrease by 3.5% annually among males and 1.9% annually among females. Five-year relative survival for lung cancer doubled from 15.1% in 2000 to 30.1% in 2018.

Early detection has also increased. From 2003 to 2022, the proportion of lung cancers diagnosed at a localized stage increased from 16% to 27% among males and from 19% to 33% among females. The percentage of adults eligible for lung cancer screening who reported being up to date with screening increased from 4.5% in 2015 to 18.7% in 2024.

Despite Gains, Disparities Persist

Despite these observed gains, the report identified substantial differences in cancer outcomes across populations. Cancer incidence and mortality varied by age, race and ethnicity, socioeconomic factors, and geography, underscoring that improvements in cancer outcomes have not been experienced uniformly.

The report highlights disparities in lung cancer as one example. Lung cancer death rates were more than 5 times higher among people with a high school education or less compared with those with a college education and approximately 40% higher in rural areas than urban areas. Differences in smoking prevalence contribute to some of these disparities, while access to screening and other preventive and cancer care services may also influence outcomes.

The Role of Oncologists in Driving Further Progress

The report highlights the crucial role of physicians in translating these population-level gains into further reductions in cancer incidence and mortality. In practice, this includes identifying patients who could benefit from evidence-based screening, addressing modifiable cancer risk factors, and helping patients navigate diagnostic and treatment services.

For lung cancer in particular, the report emphasizes the role of clinicians in encouraging tobacco cessation and screening education. According to the CDC, among US adults for whom screening is recommended, only about 18% were up to date with screening in 2024.²

More broadly, the findings reinforce the importance of prevention and early detection alongside advances in cancer treatment. Sustaining such positive trends will require continued attention to risk reduction, screening, equitable access to care, and comprehensive management throughout diagnosis, treatment, and survivorship.

REFERENCES

1. Henley SJ, Siegel DA, Firth AU, et al. Annual Report to the Nation on the Status of Cancer, featuring 21st century progress against lung cancer. Cancer. 2026;132(19). doi:10.1002/cncr.70577

2. Annual Report to the Nation on the Status of Cancer. United States Centers for Disease Control and Prevention. September 23, 2026. Accessed September 24, 2026. https://tinyurl.com/u65yn3ny