Cancer disparities narrow—but gaps persist across U.S. populations

Clinical Takeaway: Proactively address barriers to screening, treatment access, and clinical trial participation—especially for patients from underserved, rural, and minority populations—to help close persistent cancer outcome gaps.

Despite decades of advances, unequal access to prevention, screening, and treatment continues to drive worse outcomes for many patients—highlighting urgent opportunities for clinicians to improve equity in care delivery.

The American Association for Cancer Research (AACR) Cancer Disparities Progress Report 2026 highlights meaningful progress in reducing some long-standing cancer inequities in the U.S., while emphasizing that disparities remain widespread and, in some cases, are worsening.

Since 1991, overall cancer mortality has declined 35%, with more than 4.8 million deaths averted. Encouragingly, key racial and ethnic gaps have narrowed: the mortality difference between Black and White populations decreased from 34% in 1991 to 9% in 2024, driven in part by improvements in lung cancer outcomes. Lung cancer mortality among Black individuals, once 23% higher than in White individuals, is now approximately 4% lower. Disparities in cervical cancer mortality between Hispanic and White women fell sharply (70% higher in 2000 to 10% in 2024), and gaps in stomach cancer mortality between Asian/Pacific Islander and White populations also narrowed.

However, the report underscores that major inequities persist across the cancer continuum. Black and American Indian or Alaska Native (AIAN) populations continue to experience the highest overall cancer death rates. Rural residents are 27% more likely to die from colorectal cancer and 17% more likely to be diagnosed than their urban counterparts. Cervical cancer mortality is nearly 50% higher in persistent-poverty counties, and lesbian women face nearly double the incidence of thyroid cancer and non-Hodgkin lymphoma compared with heterosexual women.

Emerging disparities also raise concern. Early-onset colorectal cancer incidence is increasing across all racial and ethnic groups, most sharply among AIAN populations, while lung cancer incidence is rising among never-smoking Asian women.

The report attributes these disparities to a complex interplay of structural inequities, social determinants of health, environmental exposures, and unequal access to care. Screening rates remain lower among patients without a usual source of care, and more than 70% of U.S. counties lack active cancer clinical trials—rising to 86% in nonmetropolitan areas.

Interventions such as culturally tailored outreach, patient navigation programs, and Medicaid expansion have demonstrated measurable benefits, improving screening uptake, treatment completion, and survival outcomes in underserved populations.

“Unfortunately, these advances have not reached all populations equally,” said report chair Mariana C. Stern, PhD. “Much work remains before the full benefits of cancer research reach everyone in the U.S., but the progress to date demonstrates what is achievable.”

The AACR calls for sustained federal investment in disparities research, expanded screening and prevention access, equitable trial representation, and policies to reduce structural barriers to care.

Source: American Association for Cancer Research (AACR). 2026 June 24. Cancer Disparities Progress Report 2026