A major new report from the American Cancer Society (ACS) presents a complex picture of the fight against cancer, revealing record-high survival rates alongside a concerning surge in certain cancers among younger Americans.
A Tale of Two Trends: Survival Up, But Young People at Risk
The data offers significant hope: the overall cancer mortality rate has fallen by 34 percent since its peak in 1991, preventing an estimated 5 million deaths. This decline is attributed to reduced tobacco use, earlier detection, and vastly improved treatments. Today, seven in 10 cancer patients are expected to live at least five years after diagnosis, an all-time high.
However, this progress is shadowed by a disturbing rise in specific cancers among younger adults, a demographic traditionally considered low-risk. The ACS projects cancer will strike 2.1 million Americans and claim 626,000 lives in 2026, with shifting patterns in who is affected.
Colorectal cancer (CRC) has become a particular scourge for those under 50. Since 2004, incidence has risen by 1.6 percent annually in the 20-39 age group, with even steeper increases of two percent and 2.6 percent for those aged 40-44 and 50-54 respectively.
Similarly, new diagnoses of breast cancer that have spread are increasing most rapidly among young women. From 2004 to 2021, cases in patients aged 20 to 39 rose by nearly three percent, a rate more than double that seen in women in their 70s.
Even lung cancer, long in decline due to reduced smoking, is seeing an uptick among young, non-smoking adults in otherwise good health. While only 10 percent of US lung cancer cases are in people under 55, this proportion has been climbing for two decades.
Modern Lifestyle and Environmental Suspects
Scientists are urgently investigating the drivers behind this shift. For colorectal cancer, the primary suspects are modern dietary habits, including ultra-processed foods, low fibre intake, and rising obesity rates, all of which can disrupt the gut microbiome and cause chronic inflammation.
For breast cancer in younger women, key contributors are thought to include later pregnancies, fewer children, increased alcohol use, and lifelong exposure to endocrine-disrupting chemicals found in plastics and pesticides. There is concern that exposure during critical developmental periods may subtly 'reprogram' breast tissue, increasing cancer risk decades later.
For the rise in lung cancer among non-smokers, chronic exposure to environmental pollutants like fine particulate matter, radon gas, and secondhand smoke is a leading suspect.
Compounding the problem is that cancers in young people, including CRC, are often diagnosed at later, more fatal stages. This is partly due to delayed diagnosis, as doctors may not initially consider cancer in a young patient, and because screening guidelines like colonoscopies are typically not recommended until age 45.
Persistent and Profound Racial Disparities
The report underscores that cancer is not an equal opportunity disease. Dr Ahmedin Jemal, senior author of the report published in CA: A Cancer Journal for Clinicians, stated that lack of access to high-quality care and socioeconomics continue to fuel significant racial disparities.
These inequities are stark. For American Indian and Alaska Native (AIAN) people, death rates for kidney, liver, stomach and cervical cancers are about double those of White people. Lung cancer incidence has yet to decline among AIAN women.
Black men have the highest cancer incidence rate of any sex-racial group. Their prostate cancer mortality rate is approximately two to four times higher than that for all other men, with a lifetime risk as high as one in four. Black women face the highest mortality rates for breast and endometrial cancers, being 38 to 40 percent more likely to die from breast cancer than white women, often diagnosed with more aggressive subtypes.
The ACS attributes these disparities to a higher prevalence of risk factors, medical mistrust, lack of insurance, unconscious bias, and treatment inequality.
Funding Fears for Future Research
Progress faces a new threat from significant cuts to research funding. A May 2025 congressional report noted the federal government cut approximately $2.7 billion in National Institutes of Health (NIH) funding over the first three months of 2025, including a 31 percent reduction in cancer research funding compared to the previous year.
According to the National Cancer Institute, President Trump's 2026 budget request includes an NCI budget of $4.5 billion, a 37 percent decrease from the 2025 fiscal year. These cuts risk stymieing the search for cures and equitable interventions just as new challenges emerge.
The report concludes that while the war on cancer has seen historic victories, the changing face of the disease demands a renewed and equitable focus on prevention, early detection, and addressing the modern environmental and lifestyle factors putting younger generations at risk.
