30% in 2018 alone, the most recent year for which we have data. The decline was 2.4%. That is the biggest single year decline ever recorded. This is all good news. But it's also a long, long way from the Nixon era, hope that cancer was about to be cured within five years. There are, however, some things hidden in the cancer data that makes that 30% decline even more impressive. For one. The survival rate for younger cancer patients has improved dramatically. And one reason so many older people are still dying from cancer is that they are not dying from cardiovascular diseases, thanks to a huge drop in mortality there. In other words, many people who in previous generations would have died from heart disease are now living long enough to die instead from cancer. But you know, as I said, it's uneven. There are certainly cancers where we're making a lot less progress. Okay, where is less progress being made from 2014 to 2018 death rates for women decreased for 14 of the 20 most common cancers, including lung, breast and colorectal, but increased for several types, including cancer of the uterus and liver. For men. Over that same period, Death rates decreased for 11 of the 19 most common cancers, but increased for several others, including oral cavity and pancreatic cancers. Lot of those data perceived a lot of the widespread use of immuno oncology drugs, So you know as good as those data are, they don't include a lot of the new therapies that we've developed immuno Oncology, harnessing the body's own immune system to treat cancer. This has a long history. In the 19 seventies, for instance, there was a lot of enthusiasm about naturally occurring proteins called interfere ons. Was going to Jack up your immune system to fight cancer. And this was going to be this universal secure for cancer. And it was really a failure. It didn't work and because of that experience and other experiments like that. The cancer research community. Medical oncologists like me became very skeptical of the idea that the immune system could treat cancer. In fact, skeptical is probably not strong enough. We thought a lot of these people working immune system were literally crazy. You know, we thought they were harming patients and irresponsible and so it was really a vilified field. For many years, and but a few great scientists persevered and start identify ways to coach the immune system into fighting cancer. This is hardly the first time in medical history that the supposedly crazy people turned out to be brilliant. In fact, it happens all the time in medicine. In 2000 and 16. The Nobel Prize in physiology or medicine went to two researchers Jim Allison and Tasuku Honjo for immunotherapy research. And then those therapies started to work. And so that's really become a successful and very important way to treat cancer that most in the field myself included were very skeptical of in the early days. Let's talk about lung cancer for a second. Still the most fatal cancer but decreasing Yes, I guess you could look at it from either side that there has been progress. Or you could say, Wow, it's still killing a lot of people. Yeah. So the first thing to say is even today, after a lot of progress against lung cancer that reflects various advances. It still kills more people than pressed prostate and colon combined in the United States every year, so it's a highly lethal malignancy where we definitely need to make additional advances. And also one of the major things that shaped lung cancer is the use of cigarettes as tobacco and so tobacco control over the last few decades is starting to have some success. And then on top of that, we have some interesting new developments. So we have These drugs called kindness inhibitors that target specific subsets of lung cancer. Maybe 15 or 20% of one cancer. United States are targeted by these pills that are quite effective and not very toxic. And then we've also had the introduction of immunotherapy. So these checkpoint inhibitors that are quite active against an even larger fraction of lung cancer and have produced some really marvelous responses. And so now we're seeing Lung cancer mortality declined at the fastest rate in the history that we've kept statistics about lung cancer. Once.