More people in the U.S. are surviving with cancer and living longer lives than ever before, even as nearly 2 million Americans are estimated to receive cancer diagnoses in 2022 alone, according to a new report from the American Association for Cancer Research. The report was released on Wednesday and chronicles statistics on cancer occurrence and mortality, new therapies that have been approved by the Food and Drug Administration, and the impact of the COVID-19 pandemic on cancer care and research.
In 1971, 3 million Americans, or 1.4 percent of the U.S. population, were living with a cancer diagnosis; this year, that number is over 18 million, or 5.4 percent of the population. The increase may seem alarming at first, but it’s actually a good sign: Diagnostics have improved and are able to catch more cancer cases earlier these days. The overall incidence of cancer (the number of new cases diagnosed per year) has actually decreased in the past 50 years. That millions more Americans are living with cancer today also signifies that patients are now living longer, in part due to treatments including immunotherapies, targeted therapies like antibody-drug conjugates, and existing cancer drugs being repurposed for forms of cancers they were not initially designed to treat.
These advances have helped across the board, but some patient populations remain disproportionately affected by different cancers. For instance, non-whites are diagnosed with gastric cancer at twice the rate of non-Hispanic white populations, and lung cancer death rates are 34 percent higher among rural residents compared to city-dwellers. Access to health care, structural inequities like housing discrimination, and proximity to carcinogenic pollution all contribute to these disparities, according to the report. Individuals in racial and ethnic minorities are 61 percent more likely than white people to live in a county with unhealthy levels of air pollution, according to research cited in the report.
Additionally, while cancer rates have stabilized in recent years, the rates of new pancreatic, kidney, and uterine cancers are increasing. Progress in treating lung, colorectal, breast, prostate, and some skin cancers has resulted in reductions in age-adjusted mortality rates.
Certain forms of cancer remain highly deadly. “The overall five-year relative survival rates of nearly 91 percent for women with breast cancer and 97 percent for men with prostate cancer stand in stark contrast to the overall five-year relative survival rates of 21 percent for people with liver cancer and less than 12 percent for those with pancreatic cancer,” the report reads.
Still, new diagnostics and treatments are coming to the clinic for a wide range of cancers, particularly advanced forms that no longer respond to first-line chemotherapy and surgical options. Between August 2021 and the end of July 2022, eight new anticancer therapies were approved by the FDA; including Welireg, a cell-signaling inhibitor for tumors associated with von Hippel-Lindau disease; and CARVYKTI, an immunotherapy drug for patients who have received four or more lines of therapy for multiple myeloma. The use of 10 other previously approved treatments were expanded to include additional cancer types, such as Brukinsa for certain types of lymphoma (it was initially approved to treat another rare form of blood cancer), and Xalkori for a type of inflammatory myofibroblastic tumor (expanding its use beyond lymphoma and some lung cancers). Some others, like the immune checkpoint inhibitor Opdualag for advanced melanoma, consist of a combination of two drugs—combination therapy, according to the report, is an emerging approach that will soon become a cemented pillar of cancer treatment.
Other great strides include the use of artificial intelligence to predict cancer treatment success and diagnose precancerous lesions early. Still, a lack of representation in the training data for these computer algorithms can lead to biases that harm minorities. “Every effort must be made to reduce biases in technologies,” the report reads.
One thing the report does make clear is that the COVID-19 pandemic caused some significant setbacks across cancer care. Patients have had critical cancer screenings and diagnoses delayed—in 2020, for instance, 9.4 million Americans missed breast, colorectal, and prostate cancer screenings. At the same time, cancer patients have remained at serious risk of severe outcomes from SARS-CoV-2 infection. Research is underway to examine the long-term effects of COVID-19 on these populations, according to the report.
Looking to the future, the report identified several key areas that policymakers and clinicians can act on to impact cancer rates and treatments. Improving diversity in clinical trials will go a long way toward identifying cancer drugs that will be effective for all populations. More than 40 percent of all cancer cases are preventable, as their causes include lifestyle factors like tobacco use, poor diet, and physical inactivity. And of course, tobacco remains the leading preventable cause of cancer, and the report continues to urge bans on menthol cigarettes and prohibit youths from using e-cigarettes.