Cancer has been one of the leading causes of death for Americans for decades. According to the Centers for Disease Control and Prevention, it is currently the second leading cause of death in the United States, accounting for over 600,000 deaths in 2020. However, an annual report from the American Association for Cancer Research (AACR) has shown that significant progress has been made in recent years, as the US cancer death rate has declined by 32 percent from 1991 to 2019. This amounts to 3.5 million lives saved.
According to the study, the last decade specifically has been marked by “unprecedented progress” in research and treatment. This has allowed more people than ever to survive the disease. Let’s look at what is behind these improved survival rates.
Why Are Cancer Survival Rates Improving?
According to the AACR’s annual report, cancer researchers are steadily making findings that improve survival rates, along with the quality of life for people living with cancer. The report points to numerous data points that quantify the recent progress in improving cancer outcomes. For example, over 18 million people with a history of cancer are living in the United States as of January 2022. This demonstrates that more people are living longer after their diagnoses.
Additionally, cancer death decreased by an average of 2.3 percent each year between 2016 and 2019, showing a significant decline in cancer mortality rates. Moreover, in the period covered in the study (August 2021-July 2022), the US Food and Drug Administration (FDA) approved eight new anticancer therapeutics. These included the first medication capable of treating uveal melanoma (the most common type of eye cancer in adults); the first molecularly targeted therapy for treating cancer patients with a rare genetic disorder called Von Hippel-Lindau syndrome; and a new immune checkpoint inhibitor against a novel target. The latter was the first drug of its kind to be introduced in eight years.
Not only that, but the FDA also approved two new diagnostic imaging agents and expanded the use of ten existing anticancer therapeutics. Researchers have made progress on the use of AI in clinical studies. This has led to several FDA approvals for AI-based tools that clinicians can use to detect cancers at earlier stages and provide patients with better diagnoses. Advances like these could potentially lead to curative outcomes, employed singularly or in concert.
The Emergence of Immunotherapies
Immunotherapy uses the power of the patient’s own immune system to identify and treat diseases like cancer. It is part of a larger shift in cancer treatment towards precision medicine, which strives to provide more individualized treatment plans for each patient. Immunotherapy has quickly become one of the fastest-growing fields of cancer research. Studies have tested various forms of immunotherapies against nearly every type of cancer. According to Hopkins Medicine, immunotherapy has shown success as a treatment for 15 types of cancer as of this writing.
AACR President Lisa Coussens points to “a revolution in immune therapies” as one of the driving forces behind the improved outcomes for cancer patients in recent years. These promising new treatments are often combined with other common treatments like chemotherapy and radiation. According to the AACR, this has allowed patients who may have died within two years of a diagnosis to live as much as 15-30 years.
Disparities in Cancer Outcomes
Although these findings are certainly exciting and provide a reason for optimism, there remains a disparity in outcomes along demographic lines. According to the report, several populations continue to have disproportionately poor cancer outcomes.
The report found that Black populations have historically been disproportionately impacted by cancer and other health problems. In the 1990s, the cancer death rate for Black patients was 33 percent higher than that of white patients. While that disparity has declined in the past two decades, Black populations continued to show disproportionate death rates as of 2019.
Disparities in cancer outcomes can be found in a range of demographic groups, not just those based on race. For example, the report found that those living in rural counties are 34 percent more likely to die from lung cancer than urban area residents and that advanced lung cancer is more common among people with low education and income levels. Numerous factors contribute to these disparities, such as access to health insurance, systemic racism, structural inequities, location, and a lack of diversity in the healthcare field, according to the report.
Potential Hurdles in Cancer Treatment Progress
Along with the disparities in outcomes, cancer researchers may need to account for a number of other significant hurdles if cancer outcomes are to continue improving in the coming decades. The AACR has publicly stated that the recent Supreme Court decision on reproductive rights will likely have serious negative effects on health care access and that these implications will affect patients with cancer. Physicians could delay beginning cancer treatment if they believe it will lead to the termination of a pregnancy. This could lead to the cancer progressing and becoming more difficult to treat, and thus more likely to threaten the patient’s life.
Global crises like the COVID-19 pandemic and current ongoing wars have already affected all forms of cancer research and treatment. Researchers believe that with an aging global population, the global cancer burden could increase significantly in the near term. Other global crises, along with that increased burden, could harm outcomes. The AACR Cancer Progress Report 2022 has called for several policy recommendations to account for these and other challenges in cancer treatment.