HEALTH: U.S. Cancer Death Rate Continues to Fall As More Victims Survives

Americans are surviving cancer
than ever before, but as the
population ages, even more will
develop the disease.
That's the good and bad news from the 2017 Cancer Progress
Report from the American Association for Cancer Research,
released Wednesday.
According to the report, the cancer death rate dropped 35
percent among children and 25 percent among adults from
1991 to 2014. That translates to slightly more than 2 million
fewer cancer deaths.
On the flip side, new cancer diagnoses are predicted to rise
from nearly 1.7 million this year to 2.3 million in 2030, said
the association's president, Dr. Michael Caligiuri.
And this year alone, more than 600,000 Americans are
predicted to die from cancer, according to the report.
Caligiuri said the increase in cancer cases is simply a
consequence of more people living longer. As the report
noted, 53 percent of U.S. cancer diagnoses occur among
those aged 65 and older, and that population segment is
expected to grow from about 49 million in 2016 to just over
74 million in 2030.
"The longer people live, the higher the incidences of cancer
are going to be," Caligiuri said.
"The longer you live, the more likely are the chances for
serious genetic mutations that cause cancer, and the weaker
your system is in repairing your DNA when you do have those
genetic changes," he explained.
Dr. Anthony D'Amico is a professor of radiation oncology at
Harvard Medical School in Boston. He said, "The most likely
explanation for the progress in cancer survival is a
combination of advances in cancer treatment coupled with
early detection through screening."
The AACR report noted that death rates for many of the most
commonly diagnosed cancers in the United States -- including
breast, colorectal, lung and prostate cancer -- have been
declining for more than a decade. But deaths from other
forms of cancer -- brain, liver and uterine cancer -- have been
increasing.
And progress has not benefited every American equally, the
researchers noted. Disparities in cancer care continue
between whites and blacks, the insured and uninsured, the
poor and the elderly.
But there is progress in treatment. Between August 2016 and
July 2017, nine new anticancer drugs were approved by the
U.S. Food and Drug Administration, the report said. In
addition, the FDA approved the use of eight existing drugs for
fighting new cancers.
Two of the new drugs are immunotherapeutics, called
checkpoint inhibitors. These treatments increase survival and
improve the quality of life for patients with many types of
cancer.
Progress was also seen in drugs that target specific cancer
molecules. In fact, seven of the new drugs do just that, the
researchers said.
The FDA also approved a new optical imaging agent to help
doctors see brain tumors and more accurately guide their
removal.
The keys to more progress in preventing and curing cancer
include basic science to understand the biology of cancers,
Caligiuri said, then making those findings relevant to cancer
treatment through animal and early human trials. Next comes
testing on many people to see how safe and effective these
new treatments are, he added.
In addition, more studies are needed to better understand the
risks for cancer and to develop ways to lower those risks.
These include lifestyle changes -- such as not smoking, eating
a healthy diet and exercising -- and screening to detect cancer
early.
On the cancer prevention side, cigarette smoking declined by
nearly 39 percent from 2000 to 2015, which should mean
fewer cases of lung cancer in the future, the report said.
The researchers also said that, in the future, nearly all cases
of cervical cancer and many cases of oral and anal cancer
could be prevented if girls and boys received the human
papillomavirus (HPV) vaccine.
Yet, only 63 percent of girls and fewer than 50 percent of boys
had received at least one dose of HPV vaccine in 2015, the
study reported.

According to D'Amico, "There is still a lot more to do, but we
are going in the right direction in terms of discovery,
screening and biology."
Cancer is not an inexpensive disease. Direct medical costs in
2014 were nearly $88 billion, the report said. This does not
include the indirect costs, such as lost productivity from
cancer-related care and death.
Yet the U.S. National Institutes of Health (NIH) received only
$30 billion in funding for 2014, Caligiuri said. And of that total,
only about $5 billion went to the U.S. National Cancer
Institute.
Not surprisingly, Caligiuri believes that both the NIH and the
FDA need more money to spend on cancer research and
treatment if further progress in the fight against cancer is
going to happen.
"The limiting step for more progress against this beast called
cancer is funding," Caligiuri said. "The data clearly show that
when we have the funding, we can make phenomenal
progress."