16.9M people and counting are surviving cancer each year — but we can do better

16.9M people and counting are surviving cancer each year — but we can do better
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Chances are, you know someone who has survived cancer. 

Advances in cancer detection and treatment have helped swell the ranks of American cancer survivors to more than 16.9 million. 

Some of these survivors shared their stories in the "AACR Cancer Progress Report 2019," released by the American Association for Cancer Research. Thanks to new treatment options developed through basic, translational, and clinical research, patients are leading fuller, more active lives for years or even decades after receiving a cancer diagnosis. 

By some measures, this was a thrilling year of accomplishments for the cancer field. From Aug. 1, 2018, to July 31, 2019, the U.S. Food and Drug Administration (FDA) approved 27 cancer treatments. This is the highest number ever reported in the nine editions of the annual Cancer Progress Report.

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One of the most exciting new treatments is larotrectinib (Vitrakvi), approved for use in pediatric and adult patients whose tumors test positive for an NTRK gene fusion, regardless of where in the body the tumor is located. 

Such “tissue-agnostic” treatments, already changing practices and saving lives, will undoubtedly provide fertile ground for the next wave of cancer research and drug discovery. This approval also validates new clinical trial paradigms that provide registration data for FDA approvals in multiple tissue sites.

Also in the past year, the FDA approved the immunotherapy drug atezolizumab (Tecentriq) for the treatment of triple-negative breast cancer. This subtype of breast cancer got its name because it lacks three things — the receptors for the hormones estrogen and progesterone and the protein HER2 — that drive other breast cancer subtypes.

Drugs that target those three drivers are not effective for triple-negative breast cancer, so the new approval of Tecentriq brought hope to many women for the first time, including women of African American heritage, who are disproportionately affected by triple negative breast cancer. 

On another front, this past year brought the excellent news that overall, the cancer mortality gap between black and white Americans has narrowed. For some cancer types and in some age groups, longstanding disparities have almost vanished. 

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But overall figures show that we still have work to do. Today in America, the overall cancer mortality rate is 161 per 100,000 people per year. For whites, the rate is 161.5 per 100,000, and for blacks, the death rate is 185.6 per 100,000. 

A look beneath the surface shows that cancer health disparities cut across racial, ethnic, socioeconomic, gender, sexual, and geographic lines, and they influence every element of cancer risk, diagnosis, and treatment. For example: 

1. Whites are significantly more likely to be up to date with colorectal cancer screening than Hispanics — 70.4 percent compared with 53.4 percent. 

2. Hispanic children who have acute lymphocytic leukemia are 2.6 times more likely to relapse than non-Hispanic children.

3. Men living in the poorest counties in the United States have a colorectal cancer death rate that is 35 percent higher than the rate for men living in the most affluent counties. 

4. Women with ductal carcinoma in situ who live in rural areas are 29 percent less likely to receive radiotherapy after breast-conserving surgery — a standard protocol known to reduce the risk of recurrence — compared with women who live in urban areas.

5. Gay men are 54 percent more likely to be diagnosed with cancer than heterosexual men. 

How can we narrow these disparities? A first priority is scientific research that considers the needs of all U.S. population groups. The funding for such research comes largely through the National Institutes of Health (NIH), and the AACR works tirelessly to ensure that U.S. policymakers provide the NIH with sufficient funding to study cancer in all populations. 

This is why we helped establish the Rally for Medical Research, an annual event taking place this Thursday in Washington. We’ll be one of approximately 350 organizations urging Congress to provide robust, sustained, and predictable funding for the NIH. 

A continuing priority is understanding more about the factors that create health disparities. Beginning Friday, the AACR will host its annual Conference on Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved. Researchers, industry and policy leaders, and advocates will gather in San Francisco to discuss the latest research on this major public health problem. We’ll follow this up in 2020 with the debut of the AACR’s first progress report on cancer disparities. 

All Americans should benefit equally from the progress heralded in the Cancer Progress Report. Science will lead the way to reducing cancer incidence and mortality.

Elaine Mardis, Ph.D., is the president of the American Association for Cancer Research (AACR); chair of the AACR Cancer Progress Report 2019; and co-executive director at The Institute for Genomic Medicine at Nationwide Children’s Hospital, Columbus, Ohio.