Why 2024 could be a record year for cancer cases

A record 2 million new cancer cases are projected to occur in the U.S. in 2024, with incidences of six out of the top 10 cancers expected to rise, according to new projections from the American Cancer Society (ACS).

ACS released its “Cancer statistics, 2024” report last week in which it projected 2,001,140 new cancer cases would occur in the U.S. in 2024 along with 611,720 cancer deaths. While cancer mortality continued to trend downward in 2021 — the most recent year from which data can be sourced — ACS said that progress was threatened by gains in some of the top 10 cancers.  

In 2023, the ACS estimated that 1,958,310 new cancer cases and 609,820 cancer deaths would occur. The actual figures are yet to be finalized.  

According to Ahmedin Jemal, ACS senior vice president of surveillance and health equity science, a growing, aging population plays a large part in the trends.

“Cancer more frequently occurs in the older age group, and the U.S. population is aging. Life expectancy continues to increase,” Jemal said.  

One of the key estimates from the report, however, indicated that the proportion of people over the age of 65 getting cancer in 2024 would actually decrease, with the proportion of adults aged between 50 and 64 who are diagnosed with cancer expected to increase from 25 to 30 percent.  

The report indicated this shift in anticipated demographics is due to a decrease in cancer incidences among older adults — particularly prostate and smoking-related cancers among men — and not a rise in cancers among middle-aged adults.  

“This is not an increased incidence rate, just only the distribution of cases by age,” Jemal explained. 

Lung cancer rates are also decreasing among seniors, further contributing to this group’s shrinking proportion of cases. 

But cancer cases are rising among people under 50, who are taking up a larger share of cancer incidents and are the only age group that experienced “an increase in overall cancer.”  

Colon cancer has become the leading cause of cancer death among young men and the second-leading cause of cancer death for young women.  

Lung cancer remains the deadliest type of cancer across all age groups. Of the 125,070 lung cancer deaths projected to occur in 2024, 81 percent will be a direct result of cigarette smoking. 

ACS noted that detection bias certainly could play a part in rising cancer incidences, with screenings becoming more commonplace and cancer-detecting technology growing more sophisticated. Though screening rates took a hit during the early part of the pandemic, the true impact is yet to be seen.

The National Cancer Institute previously warned that cancer screenings dropped “dramatically” in 2020, with an estimated 9.4 million screening tests that would normally have occurred being missed. Oncologists have expressed concerns that interruptions in screenings brought on by the pandemic may contribute to more later-stage cancers being diagnosed.  

According to Jemal, the finalization of the 2021 data on cancer screenings will soon be available to give a clearer picture of how the outbreak affected cancer care and prevention. The “very, very limited” 2021 data seems to indicate there was a rebound in screenings after 2021, Jemal said, though probably not enough to account for the missed screenings early in the pandemic.  

The report also noted that while it may take “many years” to determine the effects of the pandemic on cancer mortality, “the disproportionate direct and indirect impact of the pandemic on communities of color” has already been well-established.  

The COVID-19 pandemic magnified preexisting health disparities across racial and ethnic groups. A national 2022 survey found that Black and Latino participants experienced higher rates of modifications in their cancer care — delays in testing and screenings — due to the pandemic.

Cancer mortality has been steadily dropping since peaking in 1991 thanks to reductions in smoking, improvements in disease management and increases in screenings. As of 2021, cancer mortality has dropped by 33 percent since 1991.  

“Mortality rates are a better indicator of progress against cancer than incidence or survival because they are less affected by detection biases,” the ACS noted in the report.   

“I think we have to really highlight the progress that we have made,” said Jemal. “Death rates declined by 33 percent. We translate it to averting or avoiding of over about 4.1 million.”  

“The progress is because of improved detection,” he added. “But still we shouldn’t be satisfied with that. Because we have proven early detection [methods] … only for select cancer sites like breast, cervix, colorectal and prostate. Now we have one for lung cancer, but for the majority of cancer, we don’t know how to detect.” 

Like so many medical resources, screenings and preventive services are effectively useless if they can’t be accessed. And with an estimated 25.6 million nonelderly people uninsured in the U.S. during 2022, potentially lifesaving tests are still out of reach for many.