A new study by American Cancer Society (ACS) researchers shows that overall cancer mortality in people younger than age 50 in the United States has decreased by 44%, from 25.5 per 100,000 people in 1990 to 14.2 in 2023. The progress is due to declines in mortality for four of the five leading cancer-related deaths (breast, lung, and brain cancers, and leukemia). Only colorectal cancer mortality increased, by 1.1% per year since 2005, advancing it from the fifth most common cancer death in the early 1990s to first in 2023 in patients under 50 years. The study was published as a research letter by Siegel at al in the Journal of the American Medical Association (JAMA).
“The steady rise in colorectal deaths [in those] under 50 is even more alarming compared to the dramatic declines for lung and breast [cancers], even as breast cancer incidence is climbing,” said lead report author Rebecca Siegel, MPH, Senior Scientific Director, Surveillance Research at the ACS. “While we await answers for why colorectal cancer rates are up, lives can be saved now through symptom awareness and destigmatization, and more screening uptake, as three in four people under 50 are diagnosed with advanced disease.”
Study Methods and Results
Scientists analyzed trends in the annual numbers of cancer deaths and age-standardized rates per 100,000 men and women aged 0 to 49 years for the top five cancer-related deaths during 1990 to 2023 in the United States. They used data from the National Center for Health Statistics as provided by the Surveillance, Epidemiology, and End Results (SEER) program at the National Cancer Institute.
The results showed that 1,267,520 people died from cancer in the United States before age 50 from 1990 through 2023, and the overall death rate decreased by 44% during that time period. Four of the five leading causes of cancer death decreased, with the average annual decline during 2014 to 2023 ranging from 0.3% for brain cancer and 1.4% for breast cancer to 2.3% for leukemia and 5.7% for lung cancer. Only colorectal cancer mortality increased annually for people under 50. Lung cancer and leukemia dropped from ranking first to fourth and third to fifth, respectively, whereas breast cancer remained the second-leading cancer death overall and first in women. Cervical cancer ranked third in women in 1990 and 2023, despite a continuous decline throughout the study period. The cancer distribution in men mirrored the overall pattern, with breast cancer replaced by non-Hodgkin lymphoma (fourth) in 1990 and pancreatic cancer (fifth) in 2023.
“We weren’t expecting colorectal cancer to rise to this level so quickly, but now it is clear that this can no longer be called an old person’s disease. We must double down on research to pinpoint what is driving this tsunami of cancer in generations born since 1950,” added senior author Ahmedin Jemal, DVM, PhD, Senior Vice President, Surveillance, Prevention, and Health Services Research at the ACS. “In the meantime, people [aged] 45 to 49 years make up 50% of [cancer] diagnoses [that occur in those] under 50, so increased screening uptake will prevent disease as well as death.”
“The progress in overall cancer mortality in people under 50 is encouraging and demonstrates that increased access to prevention and screening services is making a real difference in the fight against cancer,” said Lisa A. Lacasse, President of the ACS Cancer Action Network (CAN). “This research underscores the urgent need to protect and expand access to care, especially at a time when increasing health-care premiums and cuts to prevention and screening programs threaten to reverse our progress and undo the gains we have achieved. We cannot afford to turn back the clock now. ACS CAN will continue to work with lawmakers to advocate for policies that will move us forward in our mission to end cancer as we know it, for everyone.”
DISCLOSURE: For full disclosures of the study authors, visit jamanetwork.com.
