Cancer in 2016

In this section you will learn: 

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RESEARCH: POWERING PROGRESS AGAINST CANCER

Research improves survival and quality of life for people around the world because it powers the development of new and better ways to prevent, detect, diagnose, treat, and cure some of the many diseases we call cancer.

Each clinical and legislative advance against cancer is the culmination of many years of hard work by individuals from all segments of the biomedical research community (see sidebar on The Biomedical Research Community: Powering  Progress  Together​).

Among the most prominent clinical advances against cancer are the new medical products approved for use by the U.S. Food and Drug Administration (FDA). Bringing a new medical product from initial research discovery through development, approval by regulatory agencies, and then into the clinic is a complex, multifaceted process (see Biomedical Research). From Aug. 1, 2015, to July 31, 2016, the FDA approved 18 new medical products for use in oncology—13 new anticancer therapeutics, one new cancer screening test, one new diagnostic test, two new diagnostic imaging agents, and a new medical device (see Table 1). During this period, the FDA also approved new uses for 11 previously approved anticancer therapeutics.

Clinical advances such as those listed in Table 1 are helping drive down U.S. cancer incidence and death rates and increase the number of children and adults who survive a cancer diagnosis (see Table 2, for data on childhood cancer) (2-5). In fact, the age-adjusted U.S. cancer death rate declined by 23 percent from 1991 to 2012, a reduction that translates into 1.7 million cancer deaths avoided (3). In addition, the U.S. 5-year relative survival rate for all cancers combined rose from 49 percent in the mid-1970s to 69 percent in 2011 (3).

The research that powers the significant advances that have been and continue to be made against cancer is made possible by investments from governments, philanthropic individuals and organizations, and the private sector the world over. Of particular importance in the United States are federal investments in biomedical research and government agencies conducting research such as the FDA and the Centers for Disease Control and Prevention (CDC). Most U.S. government investments in biomedical research are administered through the 27 institutes and centers of the National Institutes of Health (NIH). The largest component of the NIH is the National Cancer Institute (NCI), which is the federal government’s principal agency for cancer research and training.

CANCER: AN ONGOING CHALLENGE

   

Although we have made tremendous progress against cancer, this collection of diseases continues to be an enormous public health challenge worldwide, accounting for one in every seven deaths that occur around the world (6) (see Figure 1). In the United States alone, it is predicted that 595,690 people will die from some form of cancer in 2016, making it the second most common cause of death after heart disease (3).

One of the challenges we face is that advances have not been uniform for all forms of cancer (see Table 3). For example, while the incidence 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, those for other forms of cancer—most notably kidney, liver, and pancreatic cancer, as well as melanoma and childhood cancer—have been increasing (2). Overall 5-year relative survival rates for U.S. patients also vary widely depending on the form of cancer diagnosed (3). Overall 5-year relative survival rates for women with invasive breast cancer and men with prostate cancer are 89 percent and 99 percent, respectively, while those for U.S. adults with liver or pancreatic cancer are just 17 percent and 7 percent, respectively (3).

Another challenge is that advances have not been uniform for all patients diagnosed with a given form of cancer. Five- year relative survival rates vary with stage at diagnosis and among different segments of the population (see sidebar on What Are Cancer Health Disparities? and the sidebar on U.S. Cancer Health Disparities).

Of concern is the fact that the devastating toll of cancer is predicted to increase significantly unless more effective strategies for cancer prevention, early detection, and treatment are developed. This is largely because cancer is primarily a disease of aging (9), and the segment of the world population age 65 and older is expected to almost double by 2035, rising from 616 million in 2015 to 1.157 billion in 2035 (15). During this period, the number of global cancer cases is anticipated to increase dramatically, reaching 24 million in 2035 (8). Also contributing to the projected increase in the number of cancer cases are high rates of tobacco use, obesity, infection, and physical inactivity, which are linked to some common types of cancer (6).

The United States is not immune to the rising burden of cancer (see sidebar on The Growing Public Health Challenge of Cancer in the United States​). Thus, it is imperative that we work with the global biomedical research community to address cancer incidence and mortality and power more progress against cancer.

CANCER: A COSTLY DISEASE. RESEARCH: A VITAL INVESTMENT

Cancer exerts an immense global toll that is felt not only through the number of lives it affects each year, but also through its significant economic impact. With the number of cancer cases projected to increase substantially in the next few decades, it is anticipated that the economic burden will rise, too. One study estimates that the global cost of new cancer cases will increase from $290 billion in 2010 to $458 billion in 2030 (21).

In the United States, the direct medical costs of cancer care are projected to rise from nearly $125 billion in 2010 to $156 billion in 2020. These costs stand in stark contrast to the NIH budget for fiscal year (FY) 2016, which is $32.31 billion, of which $5.21 billion is dedicated to the NCI.

The increasing personal and economic burden of cancer underscores the urgent need for more research so that we can accelerate the pace of progress against cancer. Recent advances, some of which are highlighted in this report, were made as a direct result of the cumulative efforts of researchers from across the spectrum of research disciplines. Much of their work, as well as the federal regulatory agency that ensures the safety and efficacy of medical device and therapeutic advances—the FDA—is supported by funds from the​ federal government. Although the $2 billion increase to the NIH budget in FY 2016 was a welcome boost, it is imperative that Congress and the Administration provide sustained, robust, and predictable increases in investments in the federal agencies that are vital for fueling progress against cancer, in particular the NIH, NCI, and FDA, in the years ahead.