Cancer burden increasing among younger women, report shows
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Key takeaways:
- An annual American Cancer Society report highlighted trends in cancer incidence and mortality by age, sex and race.
- Cancer incidence among women aged 50 to 64 years has surpassed incidence among men of the same age.
Cancer incidence has continued to rise in the U.S. since the 1990s — particularly among women and younger adults, according to an American Cancer Society report.
Conversely, cancer mortality has steadily declined during that time, with smoking reductions and improvements in screening and treatments credited for saving approximately 4.5 million lives.
A new trend also has emerged regarding differences in cancer risk by sex, the Cancer Statistics 2025 report showed.
“For the first time, if you’re a woman [younger than] the age of 65, you’re now more likely to develop cancer than a man [in] that same age group,” William L. Dahut, MD, the cancer society’s chief scientific officer, said during a press briefing.
Incidence and mortality
The American Cancer Society estimates 2.04 million new cases of cancer will be diagnosed in the U.S. in 2025, and 618,120 cancer deaths will occur this year.
Cancer incidence is increasing for six of the top 10 malignancies in the U.S. — breast, colorectal, pancreas, prostate and uterine corpus cancers, plus melanoma.
The proportion of new cancer cases diagnosed among adults aged 65 years and older decreased from 61% in 1995 to 59% in 2021; however, the proportion of cases diagnosed among individuals aged 50 to 64 years increased from 25% to 29% during that same period.
“The only age group where we’re seeing actually an increase in cancer risk — in [terms of] incidence going up — is under the age of 50, but because that population is smaller, it has not impacted the total number of cancer cases percentages in the same way,” Dahut said.
The most common cancer diagnoses in the U.S. this year are expected to be breast cancer (319,750 cases projected), prostate cancer (313,780), and lung and bronchial (226,650).
The cancer types projected to cause the most cancer-related deaths are lung and bronchial (124,730), colorectal (52,900), and pancreatic (51,980).
Pancreatic cancer mortality has increased over time, with only 8% of patients diagnosed with pancreatic exocrine tumors surviving 5 years.
“The [mortality] numbers are significantly higher than they were a century ago and, because it’s such a lethal cancer, incidence-mortality numbers are tied very closely together,” Dahut said. “This is now the third leading cause of cancer mortality, and potentially over time that could go even higher.”
Changes by sex
The male-to-female ratio of cancer incidence in the U.S. declined from 1.6 to 1 in 1992, to 1.1 to 1 in 2021.
A significant shift occurred over the past 2 decades for women aged 50 to 64 years.
That group had a 21% lower incidence of cancer than men in 2007; however, incidence in that group has now surpassed that for men.
Additionally, women younger than 50 years have an 82% higher cancer incidence rate than men, up from a 51% difference in 2002.
Breast and thyroid cancers have accounted for a substantial portion of this increase. Endometrial cancer and melanoma also contributed.
“We are not seeing an increase in mortality rates in women younger than 50, so that is good news, and we’re not seeing an increase in advanced cancer diagnoses,” Rebecca L. Siegel, MPH, senior scientific direct of surveillance research at American Cancer Society, said during the press briefing.
For the first time, women aged younger than 65 years have higher rates of lung cancer than men (15.7 vs. 15.4 per 100,000; P = .03).
“This is really a transformational change,” Dahut said. “We think this is largely due to a difference in peak time of tobacco use, where we saw women actually begin smoking heavily later on — more likely in the mid to late [1960s] — while men peaked earlier on, and women were slower to quit. We think this is largely still driven by tobacco use, although we do see about 20% of the lung cancer diagnoses in women being nonsmokers.
“Overall, in this country, nonsmoking lung cancer by itself would be the eighth leading cause of cancer mortality, and worldwide it would be the fifth leading,” Dahut added. “Thinking about lung cancer in nonsmokers is something that we and others are focusing on more over time.”
Among men, rates of leukemia and colorectal, testicular and kidney cancers have increased, whereas rates of melanoma, non-Hodgkin lymphoma and prostate cancer have declined.
Other key findings
American Indian and Alaska Native individuals have a higher mortality for colorectum, kidney, liver, lung, stomach and cervical cancers than any other racial or ethnic group, according to the report.
Native American individuals have a two to three times higher likelihood for dying of kidney, liver, stomach or cervical cancers compared with white individuals.
Black individuals have twice the likelihood of prostate, stomach or uterine corpus cancer mortality compared with white individuals, and 50% greater odds of cervical cancer death.
Keys to reducing disparities include improving communication about screening and early detection, availability of home-based testing, and removing stigma of certain cancer types, Dahut said.
“Lots of barriers, lots of things that need to be done,” he added. “We’re very committed to this space.”
Cervical cancer rates among women aged 30 to 44 years increased, as did colorectal cancer incidence for all adults aged younger than 65 years.
“We’re seeing increased cases of cervical cancer in the population over the age of 30, but we’re seeing decreases significantly in patients between 20 to 24,” Dahut said. “The younger ages are one that are clearly impacted by HPV vaccination, which I think is important. There is a wide range of vaccination rates when you go state by state. In Rhode Island, it’s about 85%; in the District of Columbia, it’s about 78%. But in some states, such as Mississippi, it’s under 40%, so this will have an impact over time on cervical incidence.”
For years, colorectal cancer incidence only had been increasing among people younger than 50 years, Siegel said.
“Now that has extended,” Siegel added. “If we look separately at ages 50 to 64, rates are increasing in that age group, which is pretty shocking because screening rates are fairly high. Two-thirds of the population is current for screening. The overall declines that we see now for colorectal cancer are completely driven by older folks — older than 65 — and rates are increasing in under-65 age group.”
Dahut described stats on pediatric cancers as “hopeful.”
Since 1970, cancer mortality declined by 70% among children aged 14 years or younger, and by 63% among adolescents aged 15 to 19 years).
Cancer incidence has decreased among children but increased among adolescents.
A final word
There are several steps people in the United States can take to “proactively” reduce risk for cancer incidence or mortality, Dahut said.
“There’s a really important link between cancer risk and family history,” Dahut said. “We and others would much rather [have precision-based and personalized screening]. This is really a call for people to think about understanding their family history better. Also, being proactive on your diet, on your exercise, avoiding tobacco, getting your vaccinations and monitoring your alcohol are really all important ways to prevent cancer.”
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