Big progress and big gaps

Despite “remarkable advances” in cancer research and treatment, cancer remains a “persistent public health challenge” that requires significant attention and funding, it said. Cancer Progression Report 2024 From the American Association for Cancer Research (AACR).

The AACR's 216-page report, an annual effort now in its 14th year, highlights “tremendous” advances in cancer treatment, prevention and early detection and identifies areas that need further research and attention.

One key area is funding: For the first time since 2016, federal funding to the National Institutes of Health (NIH) and the National Cancer Institute (NCI) fell last year. AACR CEO Margaret Foti, MD, PhD, said at a press conference that the cuts follow nearly a decade of funding increases that expanded the NIH budget by nearly $15 billion and enabled “rapid and broad-reaching” advances in cancer research.

Foti said recent budget cuts “have stunted recent medical advances and threaten to undermine future progress,” and called on Congress to commit to significant and consistent funding for cancer research to “maintain the momentum in defeating cancer.”

Inside the report: Big progress

Overall, advances in prevention, early detection and treatment have allowed us to catch more cancers earlier and save lives.

According to the AACR report, age-standardized overall cancer mortality rates in the United States have decreased by 33% between 1991 and 2021, resulting in approximately 4.1 million cancer deaths averted. Overall cancer mortality rates among children and adolescents have decreased by 24% over the past 20 years. The 5-year relative survival rate for children diagnosed with cancer in the United States has improved from 58% for children diagnosed in the mid-1970s to 85% for those diagnosed between 2013 and 2019.

There have been many new approvals of cancer drugs, diagnostics, and screening tests over the past year. According to the report, between July 1, 2023 and June 30, 2024, the U.S. Food and Drug Administration (FDA) approved 15 new anti-cancer drugs, 15 new indications for previously approved drugs, one new imaging diagnostic agent, several artificial intelligence (AI) tools to improve early cancer detection and diagnosis, and two minimally invasive tests for assessing hereditary cancer risk or early cancer detection.

“Cancer diagnosis is becoming increasingly sophisticated,” AACR President Patricia M. LoRusso, PhD, said during the briefing. “New techniques such as spatial transcriptomics help us study tumors at the cellular level, revealing things we didn't initially understand or consider. AI-based approaches are beginning to transform cancer detection, diagnosis, clinical decision-making and monitoring treatment response.”

LoRusso noted that the report also highlighted major advances in a number of pediatric and adolescent/young adult cancers, including tovorafenib for children with certain types of brain tumors; Repotrectinib For children with various types of cancer who have specific genetic mutations NTRK Gene fusion. Also, Eflornithine To reduce the risk of recurrence in high-risk children Neuroblastoma.

“Decades — Decades “The accumulation of basic research discoveries has led to these clinical breakthroughs,” she emphasized. “These advances against cancer are fueled by rapid advances in our ability to sequence cancer genomes, which have opened innovative new avenues for drug development.”

gap

Despite advances in prevention, early detection, and treatment, cancer remains a significant problem.

“In 2024, it is estimated that more than 2 million new cases of cancer will be diagnosed in the United States, and more than 611,000 people will die from the disease,” according to the report.

The 2024 report found that the incidence of several cancers, including vaccine-preventable cancers, is rising in the United States. Human papillomavirus HPV-related oral cancer and cervical cancer in young adults have been reported. Cervical cancer Incidence rates in women aged 30-34 years increased by 2.5% per year between 2012 and 2019.

Additionally, despite clear evidence showing that the HPV vaccine reduces the incidence of cervical cancer, vaccination rates in the United States remain low, with only 38.6% of children and adolescents ages 9-17 receiving at least one dose of the vaccine in 2022.

Early-onset cancers are also on the rise: Incidence rates of breast, colon and other cancers are rising in adults under age 50, the report said.

The report also states: 40% of cancer cases Cancer deaths in the United States can be attributed to preventable factors such as smoking, being overweight, and alcohol, but our understanding of these risk factors is improving. For example, excessive alcohol consumption is known to increase the risk of six types of cancer. Head and neck canceresophageal squamous cell cancer, breast cancer, colon cancer, liver cancer, and stomach cancer.

Financial toxicity also remains prevalent.

The report explains that financial hardship after a cancer diagnosis is widespread and its effects can last for years. In fact, more than 40% of patients may use up all of their lifetime savings in the first two years of cancer treatment. Among adult childhood cancer survivors, 20.7% struggled to pay medical bills, 29.9% said they were sent to a debt collection agency for unpaid bills, 14.1% missed out on medical care, and 26.8% said they could not afford nutritious food.

For younger cancer survivors, the lifetime costs associated with a cancer diagnosis are substantial, averaging $259,324 per person.

At the global level, the cumulative economic burden of cancer is estimated to reach $25.2 trillion between 2020 and 2050.

The way forward

Despite these challenges, LoRusso said, “There's no question that this is a time of unprecedented opportunity in cancer research.”

“I'm excited to see what the future holds for cancer research and especially patient care,” she said.

But funding commitments are needed to avoid disrupting this momentum and losing the “talented, creative young workforce” that brings new ideas and new technologies.

Continued strong funding will help “significantly improve cancer care, increase cancer survival rates, spur economic growth, and maintain America's position as a world leader in scientific and medical research,” she added.

The AACR report specifically calls on Congress to:

• Allocate at least $51.3 billion in FY2025 for the NIH base budget and at least $7.934 billion for the NCI.
• Consistent with the President's FY 2025 budget, we are providing $3.6 billion in dedicated funding for Cancer Moonshot activities through FY 2026, in addition to other funding.
• Allocates at least $472.4 million in FY2025 to CDC's Division of Cancer Prevention to support comprehensive cancer control, central cancer registries, and screening and awareness programs for certain cancers.
• Allocating $55 million in funding for FDA's Oncology Centers of Excellence in fiscal year 2025 to provide the regulator with the staff and tools it needs to conduct expedited reviews of cancer-related drugs.

By working with Congress and other stakeholders, “we can accelerate the pace of progress and make great strides toward our life-saving goal of preventing and treating all cancers at the earliest possible date,” Foti said. “If we do that, I believe we can one day win the war against cancer.”

Sharon Worcester, MA, is an award-winning medical journalist based in Birmingham, Alabama who has written for Medscape, MDedge, and other related sites. She currently specializes in oncology, but also writes about a variety of other medical specialties and health care topics. She can be reached at email address Or on Twitter: Translator.