Cancer-related mortality fell by 2.4% from 2017–2018, the largest-ever one-year drop in cancer deaths and a continuation of the downward trend the United States has seen since 1991, the American Cancer Society (ACS) reported in Cancer Facts and Figures, 2021.

Although the statistics have fallen for nearly 30 years, the past two years represent the biggest strides: When ACS reported a 2.2% decline from 2016–2017 in its 2020 report, it broke records at the time, too. But this year’s number tops it.

The ACS panel attributed the findings to long-term declines in death rates from the four most common cancers: breast, colorectal, lung, and prostate. Reductions in lung cancer mortality alone accounted for almost half of the total drop in cancer death rates from 2014–2018, and those were mostly related to smoking reductions and advancements in non-small cell lung cancer therapies.

Breast cancer death rates fell by 40% from 1989–2018 and colorectal cancer by 55%, the result of increased screening adherence and prevention strategies and improvements in treatment. Prostate cancer mortality fell by about 4% per year from the mid-1990s–2013 but has since remained level.

The racial gap in cancer mortality is also narrowing but remains prevalent. Cancer death rates were 33% higher for Blacks than Whites in 1993 and fell to 13% for 2018, mostly because of a drop in Black teenage smoking. However, the death rate for Black men with prostate cancer remains more than double that of men in other racial groups, and Black women have a 40% higher breast cancer death rate than White women, even though their diagnosis rates are slightly lower.