People with cancer are far more likely to live 5 years or more after their diagnosis than they were decades ago, and survival rates for even the most fatal cancers have doubled or more, according to the 2026 American Cancer Society annual report on cancer trends.
At the same time, the number of new cases continues to rise, and survival for selected cancers, such as some endometrial cancers and prostate cancer, is not improving, pointing to a potential need for better prevention and education, Arif Kamal, MD, MBA, MHS, told Medscape Medical News.
The finding that the 5-year survival rate for cancer patients surpassed 70% is “good news,” said Kamal, who is an oncologist, researcher, and chief patient officer of the American Cancer Society. But he added, “We need to recognize that there will be more people diagnosed with cancer this year than have ever been diagnosed before: 2.1 million.”
And that number continues to grow, Kamal said. “So, what we’re solving for and have made great progress around is survival and mortality. What we have not yet solved for is new diagnoses of cancer itself.”
The report, published in the journal CA: A Cancer Journal for Clinicians, projects 2,114,850 new cancer cases and 626,140 cancer deaths this year in the US. That compares with 2,041,910 new cancer cases in 2025, an increase of 3.5%, and 618,120 deaths, an uptick of about 1.3%.
Survival Improving
The 5-year relative survival for all cancers increased from 49% in the mid-1970s and 64% in the late 1990s to 70% in 2015-2021, representing a “remarkable improvement,” Kamal said.
That 5-year relative survival rate means that cancer is no longer a “death sentence,” Kamal said. “To say today that over two thirds will survive and that we’re making discoveries and findings every single day that will continue to push that number north of 70% gives an amazing amount of hope that newly diagnosed patients today feel, which is that your future is not predestined for you,” he said.
According to the report, survival is highest for cancers of the thyroid and prostate, at 98% each, followed by cancers of the testicles and melanoma, at 95% each. Lowest survival rates are for cancers of the lung (28%), liver (22%), esophagus (22%), and pancreas (13%).
But people with lung cancer also had the most notable improvement in survival between the mid-1990s and 2015-2021, according to the report, improving from 20% to 37% for regional-stage lung cancer and increasing fivefold for distant-stage disease, from 2% to 10%. People with distant-stage melanoma, rectal cancer, and stomach cancer also had significant improvement in 5-year relative survival, which estimates life expectancy in people after their cancer diagnosis with similar groups in the general population in those comparative periods.
Yet, lung cancer will be responsible for more cancer deaths than any other cancer, 124,990, surpassing the second- and third-most deadly cancers, colorectal (55,230) and pancreatic (52,740) combined.
“It’s still the elephant in the room,” Kamal said. “While smoking rates have gone down, lung cancer screening rates have not materially gone up over the last decade.”
The report found that only 18% of people eligible for lung cancer screening had a test in the past year.
Oncologists should be more aggressive in screening family members of lung cancer patients, Kamal said. “There’s also a need to encourage for germline genetic testing in the 10% of the population who have an elevated risk for cancer,” he added.
Disparities and Worsened Outcomes
However, survival rates of some cancers have gone in the other direction, partly because of disparities in access to care between racial and ethnic groups, Kamal said.
Uterine corpus cancer rates have stabilized in White women but continue to increase in women of other racial and ethnic groups by 2% a year or more. The 5-year survival for endometrial carcinoma has been stuck at about 90% since the mid-1990s. The decline in prostate cancer mortality has slowed from 3.5% a year in the late 1990s to 0.6% for 2012-2023. Death rates from prostate cancer in Black men are 2-4 times higher than in all other men.
“We’re continuing to show these disparities, particularly in African American populations, but also we highlight in the paper the Native American and Alaskan Native populations; they have the highest incidence of colorectal cancer in the world,” Kamal said.
One thing oncologists can do to improve cancer outcomes is to “really lean into” enrolling their patients in clinical trials, Kamal said. “Nationally, only 7% of oncology patients eligible for clinical trials, particularly treatment trials, are actually enrolled in a trial,” he said, citing a percentage from a 2024 study of cancer accreditation data. “The key is to make the ask.”
Adult oncologists need to take a page out of their pediatric counterparts’ playbook, he said. “They’ve been able to achieve pediatric leukemia cure rates as high as 90% over the last 20 years, which is really flipped on its head from what had happened 20 years ago, and that’s largely because the vast majority of pediatric leukemia patients are placed on a clinical trial.”
Other Oncologists’ Takes
Mohamed E. Abazeed, MD, PhD, chair of radiation oncology at Northwestern University Feinberg School of Medicinein Chicago, said reaching the 70% benchmark for 5-year relative survival was “the most novel and striking finding” of the report but added, “At the same time, there are worrying trends: incidence continues to rise for many common cancers, including breast, prostate, liver (female), melanoma (female), oral cavity, pancreas, and uterine corpus, even as mortality declines, highlighting that we have not yet controlled cancer incidence.”
Ryan Sugarman, MD, gastrointestinal medical oncologist at Memorial Sloan Kettering Cancer Center in New York, also saw what he called “concerning trends” in the report. “There is unexplained rise in colorectal cancer among young adults, as well as a rise in HPV [human papillomavirus]-associated oral cavity and pharynx cancer,” he said. “The oral cavity and pharynx cancer risk can be reduced with age-appropriate HPV vaccination.”
Because of his subspecialty, Sugarman said he is most concerned with the rise in incidence of young patients with colorectal cancer. “It is important to know the recent change in guidelines, and adults aged 45 years old are now recommended to start colorectal cancer screening with colonoscopy,” he said.
“I’m also saddened to see that lung cancer remains the top cause of cancer-related death,” Sugarman added. Current smokers or recent former smokers who quit within 15 years and are between ages 50 and 80 years should have a CT scan, he said. “By diagnosing lung cancer at an early stage, there is better chance of long-term survival after cancer.”
The report demonstrated “we need to think about survivorship beyond survival,” Abazeed said. “As more patients live longer with or after cancer, quality of life, functional outcomes, and long-term toxicity become central clinical priorities, not just survival at 5 years.”
Continued investment in research is “essential,” he added. “The 70% survival milestone didn’t happen by accident. It reflects decades of sustained research investment in prevention, detection, and treatment.”
Kamal reported being an employee of the American Cancer Society. Abazeed disclosed having financial relationships with Átomo Inc. and Varian Medical Systems. Sugarman reported having no relevant financial relationships.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.