(NewsNation) — The rate at which people in the U.S. are dying from cancer has steadily declined over the past three decades, according to a new report from the American Cancer Society.

After peaking in 1991, the cancer mortality rate has fallen 33% — averting an estimated 3.8 million cancer deaths between 1991 and 2020 — according to the new findings published Thursday.

Much of that decline can be attributed to reductions in smoking, advances in treatment, and early detection methods, the report found.

Some recent developments in cancer prevention have been especially promising.

The report highlighted an “astounding 65% reduction in cervical cancer rates” from 2012 to 2019 among women in their early 20s, which is noteworthy because that cohort was the first to receive the human papillomavirus (HPV) vaccine.

“This gives us the first real-world evidence that the vaccine that was produced for men and women is effective at preventing HPV-induced cancers,” said Karen Knudsen, CEO of the American Cancer Society.

Knudsen said the success of the HPV vaccine means there could be other cancer prevention strategies that come from vaccines in the future.

But it’s not all good news.

After two decades of decline, prostate cancer — which is the second-leading cause of cancer death in men — increased 3% per year from 2014 to 2019. That increase is particularly concerning because it was largely driven by advanced-stage diagnoses.

Knudsen called it a “wake-up call” for men and their providers and encouraged those who are eligible to get screened.

The uptick in prostate cancer is especially concerning for Black men, whose incidence of prostate cancer is 70% higher than in White men, despite equal screening rates.

Lung cancer remains the most common cause of cancer death in both men and women, although death rates have fallen continuously since 1991 as smoking rates have declined.

The latest data tracks trends through 2020, so the effects of the COVID-19 pandemic are not yet reflected in the numbers. Statistics over the next several years will show how the disruption of health services and cancer screenings impacted Americans.

Survival rates

The report found that the five-year relative survival rate for all forms of cancer combined has increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses between 2012 and 2018.

But survival rates vary widely based on a number of factors, including cancer type, stage and age at the time of diagnosis.

The cancers with the highest survival rates today are thyroid (98%), prostate (97%), testis (95%) and melanoma (94%), according to the report.

Pancreatic cancers have the lowest five-year relative survival rate at 12%, followed by cancers of the esophagus and liver at 21%.

Regional differences

There continue to be significant regional differences in cancer death rates.

From 2016 to 2020, Mississippi, Kentucky and West Virginia had the highest death rates for men. Much of that is driven by higher incidence of lung cancer, which are correlated with higher smoking prevalence in those areas, the recent analysis found.

Kentucky, West Virginia and Oklahoma had the highest cancer death rates for women over the same time period.

Utah, Hawaii and Colorado had the lowest cancer death rates for both men and women from 2016 to 2020.