The American Cancer Society 2035 challenge goal on cancer mortality reduction

CA Cancer J Clin. 2019 Sep;69(5):351-362. doi: 10.3322/caac.21564. Epub 2019 May 8.


A summary evaluation of the 2015 American Cancer Society (ACS) challenge goal showed that overall US mortality from all cancers combined declined 26% over the period from 1990 to 2015. Recent research suggests that US cancer mortality can still be lowered considerably by applying known interventions broadly and equitably. The ACS Board of Directors, therefore, commissioned ACS researchers to determine challenge goals for reductions in cancer mortality by 2035. A statistical model was used to estimate the average annual percent decline in overall cancer death rates among the US general population and among college-educated Americans during the most recent period. Then, the average annual percent decline in the overall cancer death rates of college graduates was applied to the death rates in the general population to project future rates in the United States beginning in 2020. If overall cancer death rates from 2020 through 2035 nationally decline at the pace of those of college graduates, then death rates in 2035 in the United States will drop by 38.3% from the 2015 level and by 54.4% from the 1990 level. On the basis of these results, the ACS 2035 challenge goal was set as a 40% reduction from the 2015 level. Achieving this goal could lead to approximately 1.3 million fewer cancer deaths than would have occurred from 2020 through 2035 and 122,500 fewer cancer deaths in 2035 alone. The results also show that reducing the prevalence of risk factors and achieving optimal adherence to evidence-based screening guidelines by 2025 could lead to a 33.5% reduction in the overall cancer death rate by 2035, attaining 85% of the challenge goal.

Keywords: breast cancer; cancer; colorectal cancer; lung cancer; mortality; prostate cancer; risk factor.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • American Cancer Society*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Early Detection of Cancer / standards
  • Female
  • Goals*
  • Humans
  • Male
  • Mass Screening / standards
  • Middle Aged
  • Models, Statistical*
  • Mortality / trends*
  • Neoplasms / diagnosis
  • Neoplasms / mortality*
  • Neoplasms / therapy
  • Practice Guidelines as Topic
  • Risk Factors
  • Risk Reduction Behavior
  • Sex Factors
  • United States / epidemiology


  • Antineoplastic Agents, Hormonal