New face of cancer: More survivors, also more younger, females sufferers

More Americans are surviving cancer, but the disease is striking young and middle-aged adults and women more frequently, the American Cancer Society reported on Thursday.

And despite overall improvements in survival, Black and Native Americans are dying of some cancers at rates two to three times higher than those among white Americans.

These trends represent a marked change for an illness that has long been considered a disease of aging, and which used to affect far more men than women.

The shifts reflect declines in smoking-related cancers and prostate cancer among older men and a disconcerting rise in cancer in people born since the 1950s.
Cancer is the second leading cause of death in the United States, but the leading cause among Americans under 85. The new report projects that some 2,041,910 new cases will occur this year and that 618,120 Americans will die of the disease.

Six of the 10 most common cancers are on the rise, including cancers of the breast and the uterus. Also on the rise are colorectal cancers among people under 65, as well as prostate cancer, melanoma and pancreatic cancer.

“These unfavorable trends are tipped toward women,” said Rebecca L. Seigel, an epidemiologist with the American Cancer Society and the report’s first author.

“Of all the cancers that are increasing, some are increasing in men, but it’s lopsided — more of this increase is happening in women.”
Women are also being diagnosed at younger ages. Cancer rates are rising among women under 50 (so-called early-onset cancer), as well as among women 50 to 64.

Despite increases in some early-onset cancers, like colorectal cancer and testicular cancer, “overall rates are flat in men under 50 and decreasing in those 50 to 64,” Ms. Seigel said.

Several other troubling trends are outlined in the report. One is an increase in new cases of cervical cancer — a disease widely viewed as preventable in the United States — among women 30 to 44.

The incidence of cervical cancer has plummeted since the mid-1970s, when Pap smear screening to detect precancerous changes became widely available. But recent surveys have found many women are postponing visits to their gynecologists.
A Harris Poll survey of over 1,100 U.S. women last year found that 72 percent said they had put off a visit with their doctor that would have included screening; half said they didn’t know how frequently they should be screened for cervical cancer.

(The current recommendation is a bit complicated: Get a Pap smear every three years starting at age 21, or a combined Pap smear and test for the human papillomavirus, which can cause cervical cancer, every five years.)

Another disturbing trend started in 2021 when, for the first time, lung cancer incidence in women under 65 surpassed the incidence in men: 15.7 cases per 100,000 women under 65, compared with 15.4 per 100,000 in men.

Lung cancer has been declining over the past decade, but it has decreased more rapidly in men. Women took up smoking later than men and took longer to quit.