How do cancer rates in 2025 compare to the predicted rates from pre-2020 models?
Executive summary
The headline: estimated cancer burden in 2025 (about 2.04 million new cases and ~618,120 deaths) broadly matches revised post‑pandemic projections produced by major surveillance groups, but it does not cleanly map onto pre‑2020 model forecasts because the COVID‑19 disruption in 2020 created a large, anomalous dip in recorded incidence that prompted analysts to change methods and to exclude 2020 from baseline trend calculations [1] [2] [3]. Analysts therefore warn that comparisons between "actual" 2025 rates and strict pre‑2020 model predictions are fraught: much of the apparent mismatch reflects methodological fixes to account for the pandemic deficit rather than a sudden biological change in cancer risk [2] [3].
1. The numbers for 2025 and why they matter
The American Cancer Society and Surveillance/registry partners project about 2,041,910 new cancer cases and 618,120 cancer deaths in the United States in 2025, figures compiled from SEER, NAACCR and national mortality data and presented in the CA: A Cancer Journal for Clinicians and ACS facts and figures [1] [4]. Those estimates are age‑adjusted or presented as counts depending on the table, and mortality trends continue to show long‑term decline through 2022—a decline attributed largely to reductions in smoking‑related cancers and improved treatment [5] [4].
2. The pandemic created a large, one‑time hole in incidence that skews comparisons
Incidence data show an abrupt ~9% drop in overall cancer diagnoses in 2020 versus 2019—greatest for asymptomatic, localized tumors—attributed to closures, reduced screening and fewer incidental detections during the first year of COVID‑19 [2] [6]. That deficit did not fully rebound by 2021 for most sites (breast being a notable partial exception), so raw trend lines that include 2020 show an artificial trough; surveillance authors therefore treated 2020 as anomalous and adjusted models and projections accordingly [2] [7].
3. How pre‑2020 models differ from the 2025 estimates
Pre‑2020 projection frameworks (for example, NordPred and various CDC/academic projections) generally extrapolated existing age‑specific incidence trends and demographic shifts—predicting overall increases in absolute case counts driven by population growth and aging, and mixed effects on age‑standardized rates depending on cancer site [8]. The 2025 ACS estimates still reflect population aging and rising counts overall, but analysts explicitly excluded or down‑weighted 2020 when projecting incidence to avoid folding a pandemic‑related artifact into long‑term trend estimates [3] [7]. Thus, 2025 counts may be close to what pre‑2020 models would have forecast for a growing, aging population, but the age‑standardized rates and site‑specific patterns are being reported using pandemic‑aware adjustments [3] [6].
4. Mortality vs incidence: a diverging picture
Mortality has continued its multi‑decade decline—cancer death rates fell substantially since 1991 and continued down through 2022—so 2025 mortality projections remain lower than many historical peaks despite increasing case counts driven by demographics [5]. This divergence—more cases but fewer deaths per capita for many cancers—aligns with long‑standing pre‑2020 expectations about the impact of prevention and better therapy, though the pandemic’s diagnostic delays could worsen stage at diagnosis for some sites and complicate future mortality forecasts [5] [2].
5. Where uncertainty and disagreement remain
Surveillance teams are explicit that 2025 estimates are model‑based and sensitive to assumptions about pandemic recovery, reporting delays and cohort effects; some researchers warn cohort patterns (e.g., Generation X risk) or rising incidence in younger adults for specific cancers could produce different outcomes than either pre‑2020 models or the ACS’s pandemic‑adjusted projections [9] [8]. Internationally, modeling efforts show modest declines in age‑standardized mortality for 2025 in the EU versus 2020, illustrating that population composition and tobacco control remain dominant drivers of rate changes [10]. Because registry data through 2021 (and mortality through 2022) are what inform 2025 figures, final judgment about long‑term divergence from pre‑2020 expectations must await more complete post‑pandemic data [11] [3].