Since 1971, when the U.S. government made defeating cancer a goal and put major funding behind it, death rates for many cancers have plummeted, but some are increasing, according to a new American Cancer Society report. Death rates for all cancers combined have declined since passage of the National Cancer Act of 1971, according to the report. For example, in 2019, deaths from lung cancer were down 44% from the 1993 peak. But death rates were higher than in 1971 for cancers of the pancreas, esophagus, and brain. “We are making progress because of increased investment in cancer prevention, in early detection, and also improved treatments, but there are still gaps in reducing [death rates],” senior author Dr. Ahmedin Jemal, a senior vice president at the American Cancer Society, said in an article published by Medical Xpress. ln addition to differences by types of cancer, deaths also differed by geographic region. Notably, cancer deaths in the southern United States were higher than in other parts of the country. Explaining the disparity, Jemal noted that many people in the South are poor and lack access to quality care. They also may have trouble finding doctors who take Medicaid, he added. One factor contributing to the declining death rates overall is smoking cessation, according to the report. In 1965, 42% of Americans smoked, compared to 14% in 2018. Declines in deaths from breast, cervical, colon and prostate cancers owe in part to screening and early detection. In particular, the report noted that colon cancer screening accounted for 50% of the decline in deaths from that cancer between 1975 and 2002. The report dovetails the 50th anniversary of the National Cancer Act. With the funding it provides, the National Cancer Institute’s budget increased 25-fold over the period, from $227 million in 1971 to $6 billion in 2019. Improvements in surgery, radiotherapy, chemotherapy, precision medicine and combination therapies have helped improve survival, according to the report. Another likely contributor to the lower death rates: the Affordable Care Act may have improved access to cancer care for many Americans who had been uninsured, the report said.