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Cancer has long been one of the leading causes of death in the U.S. But according to new research, the last decade has seen “unprecedented progress” – and now, more people than ever before in the nation are surviving the disease. 

Cancer is the No. 2 cause of death in the country, killing an estimated 602,350 people in 2020, according to the Centers for Disease Control and Prevention. But the annual report from the American Association for Cancer Research found that the U.S. cancer death rate has declined by 32% from 1991 to 2019 – a decrease that the group says saved 3.5 million lives.  

“The U.S. cancer death rate is steadily declining, and more people than ever before are living longer and fuller lives after a cancer diagnosis,” the report says. Researchers noted that the number of cancer survivors has increased by more than a million just in the past year, and that from 2016 to 2019, the rate of people surviving cancer has only accelerated.

“In fact, the number of children and adults living with a history of cancer exceeded a record 18 million in January 2022,” the report says.

Researchers said the reason for this is because of “remarkable advances” in medical research and cancer prevention, detection, diagnosis and treatment. Between August 1, 2021 and July 31, 2022, for example, the Food and Drug Administration approved eight new anticancer therapeutics, 10 already approved therapeutics for use for new cancer types and two new diagnostic imaging agents. 

“We have now a revolution in immune therapies. And when you put that together with the combination of targeted therapies, chemo and radiation therapy, we now have patients that would have died within two years of a diagnosis living 15, 20, 25, 30 years, essentially cured of their malignancies,” AACR President Lisa Coussens said. 

However, this progress is not equal, and many populations “continue to shoulder a disproportionate burden of cancer,” the report says.

Black populations have historically been disproportionately impacted by cancer and other health disparities. In the ’90s, the association noted, cancer death rates were 33% higher for those who are Black than those who are White. That disparity has declined, but in 2019, Black populations continued to see disproportionate death rates. 

Gastric cancer is also nearly twice as high among those who are American Indian, Alaska Native, Asian Black or Hispanic compared to those who are White and non-Hispanic. And Native Hawaiian and other Pacific Islanders are 38% more likely to have advanced head and neck cancer and 18% more likely to die compared to those who are non-Hispanic white. 

The disparities extend beyond race. 

Gay men are 4% more likely than those who are heterosexual to report a lifetime cancer diagnosis; rural county residents are 34% more likely to die from lung cancer than those in urban areas and people with low education and income levels are more likely to be diagnosed with advanced lung cancer, the report found.

These disparities are caused by a list of factors, including access to health insurance, location, systemic racism, structural inequities and a lack of health care workforce diversity, the report says. 

These numbers, as well as other issues – such as the widespread use of e-cigarettes and restrictive abortion care rights – threaten the progress of cancer survivability in the country, researchers said. This year, the organization is still expecting that more than half a million people will die from cancer. 

To prevent a step backward, the organization is asking for bipartisan support in prioritizing medical research, as well as increasing budgets for the National Institutes of Health and National Cancer Institute to be increased by $4.1 billion and $853 million, respectively.  

“Ensuring that medical research remains a high priority for our nation’s policy makers is vital if we are to maintain the momentum in advances against cancer,” Margaret Foti, chief executive officer of AACR said, “especially as we recover from the devastating impact of COVID-19 on cancer research and patient care.”