AACR report highlights unequal burden of cancer in the United States

The American Association for Cancer Research (AACR) reported in its Cancer Disparities Progress Report 2026 that overall U.S. cancer death rates fell 35% since 1991, preventing more than 4.8 million deaths. Despite this, the report finds that cancer continues to disproportionately affect racial and ethnic minorities, rural residents, and medically underserved populations.

How have cancer death rates changed for different groups?

The gap in overall cancer mortality between Black and White populations dropped from 34% higher for Black individuals in 1991 to 9% higher in 2024, according to the AACR report. Lung cancer mortality showed a significant shift; while it was 23% higher for Black individuals in 1991, it was approximately 4% lower than for White individuals by 2024.

Other improvements include cervical cancer mortality for Hispanic women, which fell from 70% higher than White women in 2000 to 10% higher in 2024. Stomach cancer mortality for Asian or Pacific Islander (API) populations also declined from 150% higher than White populations in 2000 to 81% higher in 2024.

Did You Know? Since 1991, the U.S. has seen a growing population of more than 18.6 million cancer survivors.

Which populations still face the highest cancer risks?

Black and American Indian or Alaska Native (AIAN) individuals currently have the highest overall cancer death rates of any U.S. racial or ethnic group. The report notes that AIAN, API, and Hispanic populations experience significantly higher incidence and mortality for liver, gallbladder, and stomach cancers.

Geography and identity also play roles in outcomes. Rural residents are 27% more likely to die from colorectal cancer and 17% more likely to be diagnosed with it than urban residents. Additionally, women in persistent-poverty counties face cervical cancer death rates 49% higher than those in nonpersistent-poverty counties.

The AACR identified emerging threats, including rising early-onset colorectal cancer across all groups—with the largest increases in AIAN populations—and increased lung cancer among Asian women who’ve never smoked.

Expert Insight: Samantha Carter notes that the shift in research focus reported by 56% of surveyed scientists could create a critical gap in data. If researchers move away from disparities-focused work due to policy instability, the U.S. may struggle to address the root causes of the remaining mortality gaps.

Why do these cancer disparities exist?

The report attributes these disparities to a mix of biological, environmental, and structural factors. Structural inequities, including a history of discrimination and segregation, shape social drivers of health like housing, education, and income.

AACR Cancer Progress Report highlights

Environmental risks are higher for those in socioeconomically disadvantaged areas or near hazardous sites, where exposure to ionizing radiation and cancer-causing pollutants is more common. A study of adults in the southern U.S. found that reduced residential segregation was linked to fewer lung cancer cases among Black individuals.

Access to care remains a barrier. In 2022, 86% of nonmetropolitan counties lacked active cancer clinical trials, compared to 44% of metropolitan counties. The report also found that breast, cervical, and colorectal screenings were lower in 2023 for people without a usual source of care or recent wellness visits.

What could happen to cancer research and funding?

Federal policy changes may threaten current progress. A survey of cancer disparities researchers found that 93% had been affected by recent policy changes, with 78% reporting a hindered ability to apply for funding and 54% experiencing a loss or reduction in grants.

Mariana C. Stern, PhD, Steering Committee Chair, stated that these disparities slow overall progress against cancer and impact the entire country. To reverse these setbacks, the AACR is calling for sustained funding for the National Cancer Institute, the NIH, and the CDC.

The organization suggests that the FDA could address tobacco-related disparities by finalizing a rule to prohibit menthol in cigarettes. Other possible next steps include protecting Medicaid coverage for follow-up care and screenings to lower cost barriers.

Frequently Asked Questions

Who has the highest overall cancer death rates in the U.S.?

According to the AACR report, Black and American Indian or Alaska Native (AIAN) individuals have the highest overall cancer death rates.

How does rural living impact colorectal cancer outcomes?

Residents of rural counties are 17% more likely to be diagnosed with colorectal cancer and 27% more likely to die from the disease compared to those in urban or metropolitan counties.

What impact did the Affordable Care Act have on cancer treatment?

The report states that Medicaid expansion under the Affordable Care Act was associated with better survival outcomes and improved access to surgical resection for pancreatic cancer patients.

How can local communities better support access to cancer screenings in underserved areas?