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The good news is that cancer in America was beaten back over the 25 years ending 2016, with death rates plummeting, particularly when it comes to the four most common types of the dreaded affliction.

There's a caveat, however. Those gains have been reaped mostly by the well-off. While racial disparities have begun to narrow, the impact of limited access to treatment for the poorest Americans has increased inequality based on wealth, according to the American Cancer Society's annual update on trends and statistics.

"Any time you have a disease as serious as cancer, when you have a substantial reduction in deaths, that's a notable achievement," said Len Lichtenfeld, the interim chief medical officer for the American Cancer Society. "But there are still a lot of areas for improvement."

Health insurance and access to care can be an issue in some poor and rural portions of the country, where there are higher death rates of colon, cervical and lung cancers, according to Cancer Statistics 2019. While poverty was actually associated with lower rates of cancer mortality prior to the 1980s, that trend has since reversed, due in part to changes in diet and smoking as well as screening and treatment rates, the health organization said.

There will be an estimated 1.8 million new U.S. cases of cancer diagnosed in 2019, with 606,880 Americans expected to die from the disease, according to Cancer Statistics. With the overall death rate declining by 1 percent to 2 percent annually between 1991 and 2016, the most recent year available, the nation has avoided about 2.6 million deaths over that period, the group found.

There are some approaches that can be easily implemented to further reduce cancer death rates, such as better screening, Lichtenfeld said. He was particularly struck by the fact that nine women aged 20 to 39 die each week from cervical cancer in the U.S., despite the fact that Merck & Co.'s Gardasil vaccine can prevent it from forming.

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"Losing nine young women every week to a disease that for the most part is preventable is something we need to pay attention to,'' he said.

The run of good news isn't likely to ebb any time soon, Lichenfeld said. The reductions seen since 1991 don't include most of the benefit from recent medical advances, such as drugs like Bristol-Myers Squibb's Opdivo and Merck's Keytruda, which help the human immune system attack tumors.

"A lot of what we see here is because of public health initiatives like smoking cessation and early screening," he said. "We haven't begun to see the impact of the changes that are occurring as we speak in the care of people with cancer."

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