Cancer death rates continue to fall, thanks to new treatments and improved screening
Significant advances in cancer treatments, diagnostic tools and prevention strategies continue to lower cancer death rates, according to a report released Wednesday by the American Association for Cancer Research.
Cancer death rates have fallen over the past two decades, particularly in recent years, according to the group’s annual Cancer Progress Report. As a result, there are now more than 18 million cancer survivors in the United States, up from 3 million in 1971.
“This is a really exciting time in cancer management,” said Dr. Stephen Ansell, senior associate director for the Midwest at Mayo Clinic Comprehensive Cancer Center in Rochester, Minnesota, who was not involved in the report. “We’re seeing the cancer death rate keep going down.”
President Joe Biden relaunched his “Cancer Moonshot” initiative this year, and last week outlined new steps to expand the program.
The initiative expands funding for cancer research, particularly immunotherapies.
Dr Lisa Coussens, president of the American Association for Cancer Research, said: “You can’t stop funding basic science now with the belief that current treatments will be good enough. Investing in basic science brings enormous returns to the public.
Mobilize the immune system to fight cancer
Coussens pointed to the growing use of immunotherapies as an example of improving cancer treatments.
“Our ability to use or harness the power of the immune system to fight cancer is enormous,” Coussens said. “That’s why you see much higher survival rates in many cancers, such as lung and kidney cancers and melanoma.”
Immunotherapies use a person’s own immune system to fight cancer.
“Cancer cells are mavericks, but they are your own cells. Your immune system is designed not to attack your own cells,” said Dr. Larry Norton, medical director of the Evelyn H. Lauder Breast Center at Memorial Sloan Kettering Cancer Center in New York. “But new drugs called immune checkpoint inhibitors allow your immune system to attack its own cancer cells.”
The Food and Drug Administration approved the first immune checkpoint inhibitor in 2011 – a drug called ipilimumab, used for metastatic melanoma. Since then, it has approved eight other immune checkpoint inhibitors for 18 types of cancer, according to the report.
In March, the FDA approved the first new immune checkpoint inhibitor in eight years. The drug, called relatlimab, is used for melanoma.
Additionally, the agency has approved seven other cancer treatments in the past year, including the first drug to treat uveal melanoma, the most common form of eye cancer in adults. It also extended the use of 10 existing drugs to other cancers.
Coussens also pointed to developments in cancer drugs that work by targeting specific DNA mutations in cancer cells, but noted that more work is still needed.
“The development of molecularly targeted drugs has certainly been a game-changer, but hasn’t been enough to drive real meaningful changes in overall survival,” she said.
Catch cancer early
Catching the disease as early as possible is also key to reducing cancer death rates.
“Early diagnosis is absolutely essential,” Coussens said. “A patient has the best chance of surviving a cancer diagnosis if detected very early in a precancerous stage or before the primary tumor has spread to other parts of the body.”
Efforts to get more people routinely screened for common cancers, such as breast, cervical, colon and prostate cancer, are having an impact. According to the report, the Centers for Disease Control and Prevention’s Colorectal Cancer Program has increased colorectal cancer screening rates by more than 12% over the past four years.
Researchers remain optimistic about so-called liquid biopsies – tests that would detect cancer using a simple blood test, as opposed to traditional imaging or a biopsy.
New research presented this month at ESMO 2022, a European cancer conference, showed promising data for the technique, called the early detection of multiple cancers blood test. Scientists around the world are still perfecting the new diagnostic method, which is likely to play a huge role in the future of cancer diagnosis and treatment, Norton said.
Equal access remains a challenge
Despite advances in new therapies, racial disparities, managing preventable risk factors, and getting people to schedule routine cancer screenings remain major barriers to cancer care.
Black Americans still have the highest death rate and the shortest survival rate for most cancers of any racial or ethnic group. Hispanic Americans and Alaska Native Americans are also largely excluded from the improvements in cancer management available to white and Asian American Pacific Islanders.
“Not all of these advances are evenly distributed across the American population,” Norton said.
New cancer therapies are often only available in specialized centres, which are difficult to access for people who do not live nearby and cannot afford to travel for treatment. They also often require long hospital stays, which takes people away from work and requires extra money for housing, Ansell said.
Minimally invasive surgical techniques that do not require overnight hospital stays and new therapies that can be administered at home rather than in the clinic are being developed. Both could break down access barriers.
“While it’s exciting to see the progress, there’s so much more work to do,” Ansell said. “We’re not done until we beat cancer for everyone.”
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