( CNN ) -- The death rate from cancer in the United States has dropped dramatically in the last two decades , according to a new report from the American Cancer Society . American cancer death rates have risen consistently since the 1900s ; they peaked in 1991 at 215.1 deaths per 100,000 in the population . The 2009 death rate , which just became available , is 173.1 per 100,000 . That 's a 20 % decline in cancer death rates from 1991 . The report also includes grim news . The ACS estimates 1.6 million Americans will be diagnosed with cancer and more than 580,000 will die of cancer in 2013 . As has been the case for decades , only cardiovascular disease will kill more Americans . The report , released Thursday , compiles the most recent data on cancer incidence , mortality and survival . It is based on data gathered by the National Cancer Institute , the Centers for Disease Control and Prevention , and the North American Association of Central Cancer Registries . The decline in deaths from 1991 to 2009 is clear evidence of progress in the fight against cancer . It is far more powerful than other statistics such as increasing survival rates or declining incidence rates . The 20 % decrease translates into the prevention of 1.18 million cancer deaths . In 2009 alone , nearly 153,000 cancer deaths were prevented . Cancer now No . 1 killer of U.S. Hispanics . There were declines in the death rates for a number of major cancers . Lung , colorectal , breast and prostate cancer make up nearly half of all cancers diagnosed in the United States . All four had greater than 30 % decreases in mortality rates . The single biggest reason for this good news is reduction in smoking rates . Improvements in early detection and cancer treatment also contributed to the decline . Analysis of the data tells us that we can do better . Substantially more lives could be saved if existing methods of cancer prevention and treatment were practiced more widely . This is incredibly important as the U.S. population increases in size and the proportion of older Americans grows . The leading cause of cancer in the United States is smoking . More than one in five Americans still smoke . In some states , such as Kentucky and Missouri , nearly 30 % of residents smoke . These states have the highest cancer death rates . In other states , such as California and Utah , smoking rates are as low as 10 % . These states have the lowest cancer death rates . The obesity epidemic is also affecting cancer rates in a very negative way . Indeed , obesity is the second leading cause of cancer . More than a dozen cancers -- from breast and prostate cancer to pancreatic and colon cancer -- have been linked to America 's epidemic of high caloric intake and lack of physical activity . While 15 % of adults were obese in 1970 , more than 35 % were obese in 2010 . Even more concerning , 4 % of children aged 6 to 11 were obese in 1970 ; 20 % of that group were obese in 2010 . While overall there is a significant decline in cancer mortality , the obesity epidemic is continuing to push the cancer mortality rate upward . A substantial proportion of Americans do not receive the high-quality preventive and treatment services that experts agree people should get . More than a third of women over 50 are not getting routine breast cancer screening . Nearly half of Americans over 50 are not getting colon cancer screening . These are interventions about which there is no controversy . Value of mass prostate cancer screenings questioned . Even more unsettling , a substantial number of Americans diagnosed with cancer are unable to get adequate treatment . If we simply get adequate medical care to those who need it , more lives could be saved . More from Brawley : How doctors do harm .
American Cancer Society releases annual report on mortality , survival . Comment: Smoking and obesity still play a major role in causing cancer , Brawley says .