AACR Cancer Disparities Progress Report 2026 Reveals Narrowing Gaps but Persistent Inequities Across U.S. Populations
Key Insights
The overall U.S. cancer death rate has fallen 35% since 1991, translating to more than 4.8 million fewer cancer deaths, yet these advances have not reached all populations equally.
The disparity in overall cancer mortality between Black and White populations narrowed from 34% higher among Black individuals in 1991 to 9% higher in 2024, with lung cancer (search) mortality now approximately 4% lower among Black individuals.
Persistent disparities remain severe: rural residents face 27% higher colorectal cancer (search) mortality, and 93% of cancer disparities researchers report disruption from recent federal policy changes.
The American Association for Cancer Research (search) (AACR) today released its Cancer Disparities Progress Report 2026, a comprehensive biennial analysis documenting both measurable progress and persistent inequities in the cancer burden across the United States. First published in 2020, the report examines the disproportionate toll cancer exacts on racial and ethnic minority groups, sexual and gender minorities, and residents of rural areas and persistent-poverty regions, while issuing an urgent call to action amid threats to federal research funding.
Since 1991, the overall cancer death rate in the U.S. has fallen by 35%, translating to more than 4.8 million fewer cancer deaths and a growing population of more than 18.6 million cancer survivors. Yet these gains have not been distributed evenly.
Narrowing Disparities Signal Progress
The report highlights several encouraging trends in the reduction of cancer disparities. The gap in overall cancer mortality rates between Black and White populations has narrowed substantially—from 34% higher among Black individuals in 1991 to 9% higher in 2024. A major driver of this progress has been the dramatic shift in lung cancer (search) mortality: in 1991, the lung cancer mortality rate was 23% higher among Black individuals than White individuals; by 2024, the rate was approximately 4% lower among Black individuals.
Disparities in cervical cancer (search) mortality between Hispanic and White women declined from 70% higher among Hispanic women in 2000 to 10% higher in 2024. Similarly, stomach cancer (search) mortality disparities between Asian or Pacific Islander (API) and White populations narrowed, falling from 150% higher among API populations in 2000 to 81% higher in 2024.
Persistent and Emerging Challenges
Despite these gains, the report underscores that cancer disparities remain a major public health challenge. Black and American Indian or Alaska Native (AIAN) individuals continue to have the highest overall cancer death rates of all U.S. racial or ethnic groups. AIAN, API, and Hispanic populations experience significantly higher incidence and mortality rates for stomach, gallbladder, and liver cancers.
Geographic disparities are stark: residents of rural counties are 17% more likely to be diagnosed with colorectal cancer (search) and 27% more likely to die from the disease compared with residents of metropolitan or urban counties. Cervical cancer (search) death rates are 49% higher among women living in persistent-poverty counties compared with those in nonpersistent-poverty counties. The report also documents that lesbian women face nearly twofold higher incidence rates of thyroid cancer (search) and non-Hodgkin lymphoma (search) compared with heterosexual women.
Emerging concerns include rising incidence rates of early-onset colorectal cancer (search) across all racial and ethnic groups—with the largest increases occurring among AIAN populations—and increasing lung cancer (search) incidence among Asian women who have never smoked.
"Cancer remains one of the leading causes of death and a major driver of health care costs in the U.S. Decades of research have significantly increased our understanding of the causes of cancer, how to detect it early, and how to treat it more effectively. Unfortunately, these advances have not reached all populations equally," said Mariana C. Stern, PhD, chair of the report's steering committee and professor at the Keck School of Medicine of the University of Southern California.
Root Causes and Effective Interventions
The report traces cancer disparities to a complex interplay of structural, social, environmental, and biological factors. Structural inequities—rooted in a history of racism, segregation, and discrimination—continue to shape social drivers of health such as income, education, housing, and access to care. Communities affected by socioeconomic disadvantage or located near industrial or hazardous sites often face higher exposure to cancer-causing pollutants, chemicals, endocrine-disrupting substances, and ionizing radiation.
Access to clinical trials remains severely limited: in 2022, more than 70% of U.S. counties had no active cancer clinical trials, and 86% of nonmetropolitan counties lacked trials, compared with 44% of metropolitan counties. In 2023, breast, cervical, and colorectal cancer (search) screening were all lower among people without a usual source of care, those without recent wellness visits, and those facing barriers to medical access.
The report highlights several effective interventions, including culturally tailored messaging developed with input from Black churches that improved lung cancer (search) screening engagement, a community-based physical activity program that increased the proportion of underserved cancer survivors meeting activity recommendations from 29% to 60%, and a multilingual patient navigation program at safety-net clinics that increased treatment completion among underserved patients from 78% to 92% while improving quality of life and mental health outcomes. Medicaid expansion under the Affordable Care Act was associated with improved access to surgical resection and better survival outcomes for patients with pancreatic cancer (search).
Research Under Threat
A recent AACR survey of cancer disparities researchers reveals that 93% of respondents have been affected by recent federal policy changes. Among those affected, 78% reported impacts on their ability to apply for research funding, 59% said ongoing research projects were disrupted, 54% experienced loss or reduction in grant funding, and 50% reported reduced support for study personnel or collaborators. As a result, 56% of survey respondents have partially shifted away from disparities-focused research or are seriously considering changing their research focus.
"Eliminating cancer disparities must remain a national priority so that every American has a chance to benefit from advances in the prevention, detection, and treatment of cancer," said Margaret Foti, PhD, MD (hc), chief executive officer of AACR. "With sustained commitment, collaboration, and investment, we can continue to make progress for all cancer patients."
The AACR calls on policymakers to sustain and strengthen federal investments in cancer disparities research, including robust funding for the National Institutes of Health, National Cancer Institute, and Centers for Disease Control and Prevention (search); restore and protect federal cancer surveillance systems; ensure every cancer therapy is evaluated in the populations in which it is meant to be utilized; protect Medicaid coverage for cancer screening and follow-up care; and reinstate and finalize the FDA's proposed rule to prohibit menthol in cigarettes to meaningfully address tobacco-related cancer disparities.