Cancer death rate drops by 33%, AACR report shows
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Results from the American Association for Cancer Research’s annual Cancer Progress Report revealed that the age-adjusted overall cancer death rate in the U.S. fell by 33% between 1991 and 2020.
The report also detailed FDA approvals related to anticancer therapeutics over the past year, the impact of immunotherapy on cancer care in the 21st century and key challenges needed to overcome obstacles patients with cancer still face moving forward.
“The advances in cancer research — particularly in the last 2 decades — have been breathtaking,” Philip D. Greenberg, MD, FAACR, president of AACR, said in a press release. “We are in an era of unparalleled opportunity to make even more breakthroughs for patients. For the cancer research community to achieve these breakthroughs, however, our representatives in Congress must continue to prioritize funding for biomedical research — from basic research to clinical trials.”
Encouraging trends, cancer care progress
From August 2022 to July 2023, the FDA approved 14 new anticancer therapeutics that are now currently helping patients with a variety of different cancer types across the U.S., according to the report.
Twelve previously approved therapies have received expanded indications, in addition to the approval of two new imaging agents.
Such large contributions to the fight against cancer have helped reduce the age-adjusted overall cancer death rate within the United States by 33% from 1991 to 2020, with an estimated 3.8 million cancer deaths having been averted, according to the AACR.
Most notably, breast cancer mortality declined by 43% over the last 3 decades, with an estimated 460,000 fewer deaths.
In addition, the decrease in lung cancer mortality accelerated in recent years — from 0.9% per year from 1995 to 2005 to almost a 5% per year decrease from 2014 to 2020 — attributed to a decrease in smoking rates and increased development of molecularly targeted and immunotherapies.
Notably, the report disclosed that patients with cancer aged 14 years and younger have experienced a 70% decline in overall cancer death rates between 1970 and 2020. Adolescent patients aged 15 to 19 years experienced a 64% decrease over the same time span.
Impact of immunotherapy
The report also highlighted cancer immunotherapy’s emerging role as a game-changing treatment modality.
The FDA has approved 11 immune checkpoint inhibitors since 2011, with indications for at least 20 different cancer types. The agency has also approved six chimeric antigen receptor T-cell therapies to treat certain hematologic malignancies.
Cancer treatment has been transformed through these novel agents. Nevertheless, according to the report, challenges persist because immunotherapies only benefit a small fraction of patients. Issues related to development of treatment resistance, adverse events and limited understanding of how to integrate with standard cancer therapies means more research is still required to optimize the potential benefits of immunotherapy, the report concluded.
“The progress that’s been made is really a consequence of federal investment in the NIH, NCI, the FDA and the CDC,” Greenberg said. “Just as an example of how effective and critical NIH-funding is, 354 out of 356 drugs that have been approved for use in patients in the US in the last decade are a consequence of investment in research from the NIH.
“This is the engine that’s driving innovation and it’s just a highlight of how essential sustaining that is going to be,” he added.
Call for additional funding
Despite the great strides made by researchers, oncologists and the greater health care community, AACR estimated that nearly 2 million new cases of cancer will be diagnosed within the U.S. in 2023.
Cancer research progress has not been even across all forms of cancer, according to the report.
Patients diagnosed with pancreatic cancer or glioblastoma face poor 5-year relative survival rates due to few treatment options. Meanwhile, incidence rates for certain forms of cancer — such as early-onset colorectal cancer, pancreatic cancer and uterine cancer — continue to rise, while the cost to treat these diseases continues to soar.
For that reason, AACR representatives called on Congress to support increases of at least $3.465 billion to NIH and $2.6 billion to NCI to combat challenges facing the cancer care community.
Additionally, the AACR requested that Congress:
- provide $1.7 billion for Cancer Moonshot activities in fiscal year 2024 across the NCI, FDA and CDC, with assurance that funding will supplement, and not supplant, NIH funding in fiscal year 2024;
- appropriate no less than $472.4 million during fiscal year 2024 for the CDC Division of Cancer Prevention to support comprehensive cancer control, central cancer registries, and screening and awareness programs for specific cancers; and
- set aside $50 million in funding for FDA’s Oncology Center of Excellence in fiscal 2024 to allow regulators with the necessary staff and tools to conduct expedited review of cancer-related medical products.
“It is our hope that this [report] will help to increase knowledge about the myriad diseases we call cancer, as well as the innovative research that is improving and extending lives,” Margaret Foti, PhD, MD (hc), CEO of AACR, said in the release. “The findings in this report....underscore the enormous impact that robust, sustained and predictable funding for cancer research has had on Americans’ health, and why that support must continue.”
References:
- AACR Cancer Progress Report details exciting advances in cancer research and treatment (press release). Available at: https://www.aacr.org/about-the-aacr/newsroom/news-releases/aacr-cancer-progress-report-details-exciting-advances-in-cancer-research-and-treatment/. Published Sept. 13, 2023. Accessed Sept. 13, 2023.
- AACR Cancer Progress Report 2023: Advancing the frontiers of cancer science and medicine. Available at: https://cancerprogressreport.aacr.org/progress/. Accessed Sept. 13, 2023.
Perspective
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Vamsidhar Velcheti, MD
AACR's report delineates significant strides made in understanding and combating cancer, with a palpable decrease in mortality rates as a testament. Although progress is evident in areas like lung, melanoma and breast cancers, disparities remain — notably in malignancies such as pancreatic and uterine cancers. These disparities — coupled with the increasing burden on health systems — make it paramount to sustain and amplify funding for medical research, especially for NIH. A consistent investment trajectory is vital to further breakthroughs and to fortify the multifaceted approach to cancer, from understanding its genesis to survivor support. The call for sustained federal funding by the AACR is both pertinent and crucial.
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