Cancer survival rates are better than ever. Here are 3 reasons why.

A cancer diagnosis once meant bracing for the worst. But today, more Americans than ever are living longer, fuller lives after hearing the word “cancer.”

Cancer deaths in the U.S. have dropped by more than one-third since 1991, a recent report by the American Cancer Society shows. This trend has pushed the survival rate for all cancers to an all-time high, with the annual report crediting these three reasons for the significant improvement:

• earlier detection through screenings
• reduced smoking
• better available treatments

About 111,000 new cancer diagnoses in North Carolina and South Carolina are projected for 2026, the report found. The lowest survival rates are for cancers of the lung, liver, esophagus and pancreas. And while cancer is the leading cause of death among women older than 40 and men older than 60, survival chances are greatest for those with thyroid, prostate, testicular and melanoma cancers.

Cancer mortality is also down for children and adolescents, the report states.

“For many people, cancer is no longer a terminal diagnosis,” said radiation oncologist Dr. Jimmy Broughman of Novant Health Coastal Carolina Radiation Oncology - Wilmington. “Cancer is increasingly treated as a chronic condition, allowing patients to focus on living well.”

Here, Broughman discusses some of the findings behind the latest cancer statistics.

How is smarter screening changing what survival looks like?

Our ability to find cancer through screening has dramatically improved. Some radiologists now have programs that use AI to help them when performing a computed tomography (CT) scan. AI can point out nodules that the radiologist may have otherwise missed, and even assign a risk score to determine whether a lesion is cancerous or benign.

Earlier, targeted diagnosis has helped improve survival rates for lung cancer, colorectal cancer and pancreatic cancer, among other types. Treatment advancements have also accelerated for many cancers, including breast cancer and liver cancer, due to immunotherapy and better overall disease management.

Even when cancer has spread, modern treatment is giving people the ability to live normal and longer lives.

Lung cancer is still the leading cancer-related death, even though its survival rate has improved. Why?

Smoking remains the leading cause of preventable death in the U.S., even as the survival rate for lung cancer has improved the most. Lung cancer is projected to kill more people in the U.S. in 2026 than colorectal and pancreatic cancers combined.

Many people have transitioned to vaping as an alternative to quitting nicotine entirely. While vaping carries its own potential risks, removing traditional cigarettes from the equation helps mitigate the specific cancer risks associated with tobacco.

Smoking increases the risk of many other different types of cancer, like bladder cancer, and can have a synergistic effect with other cancer risk factors like HPV (human papillomavirus). Smoking can accelerate the rate at which HPV can lead to other types of cancer, like cervical or anal cancer.

How is the advancement of treatment and modern therapies helping?

Treatment for lung cancer now is way different from it was in the 1970s. Fifty years ago, somebody with lung cancer that had spread received chemotherapy alone. But now we have advanced cancer treatments like immunotherapy which leverage your body’s immune system to track down and kill cancer cells. This allows us to more selectively target the tumor cells while protecting healthy cells.

(Current and former smokers between the ages of 50 and 80 with a 20 pack-year smoking history should get screened for lung cancer. Smoking a pack a day for 20 years, or two packs a day for 10 years, equals 20 pack-years.)

If a patient receives radiation, do they receive the same treatment every day? Or could it be adjusted if the tumor changes?

Most patients receiving radiation will undergo daily imaging that shows whether the tumor has changed. If it has, we can replan the radiation to accommodate those changes, which allows us to more accurately target the tumor while also protecting healthy tissue.

Why does the American Cancer Society now recommend a colonoscopy starting at age 45, which is earlier than the previous standard of age 50?

Colorectal cancer is the second-most common cause of cancer death in men and women combined, and the rate of colorectal cancer has been increasing in younger patients. (About 20,000 people younger than 50 were diagnosed in 2023.) It’s not totally clear what the cause is.

If polyps are discovered and removed during a colonoscopy, the patient gets a more rigorous screening schedule. That’s because polyps are precancerous lesions and tend to recur, so proactive monitoring is important. This does not mean a cancer diagnosis is inevitable, it just means you’re somebody who’s worth doing a bit more surveillance on.

How do you approach conversations with your patients?

Everybody approaches cancer from their own perspective, so I try to meet everybody where they are — physically, mentally and emotionally. To do that, I focus on the whole person rather than just a diagnosis. I view my role as a consultant who is there to give them the information they need to make the best decisions for themselves.