Cancer-related deaths in the United States have decreased by 26% in the 14 years since 2001, according to an annual report published today by the American Association for Cancer Research.
Because there are fewer deaths, the number of Americans living with cancer – survivors – has reached a historical high. As of 2015, more than 15.5 million people in the United States have suffered from different varieties of the disease and this number is bound to increase with the aging of the population. More people have cancer than ever before, but due to progress in treatment, these people live longer. However, inequalities in access to cancer treatment and prevention mean that not everyone in the United States is equally benefiting from these advances.
Years of both molecular and population-based scientific research have identified risk factors that can lead to cancer and many types are preventable if people are able to change their habits. Obesity, tobacco use, alcohol consumption and lack of exercise are risk factors that have all been the subject of national health policy initiatives. For example, after anti-smoking advertising campaigns, between 1
However, even with successful identification and prevention campaigns, it is estimated that over 40% of cancer cases diagnosed in the United States are the result of potentially modifiable causes.
In 2006, the HPV vaccine was approved to prevent human papillomavirus, which increases the risk of cervical cancer. Giving children, adolescents and young adults the vaccine can prevent almost all cases of cervical cancer later in life and even in some cases of oral and anal cancer. Unfortunately, less than half of the children and adolescents in this country are up to date on these shots. This is probably the result of pediatricians who do not fully discuss benefits with parents and patients.
However, we are making progress. Studies of the best ways to screen cancer – without over-shadowing – have led to early detection, improving results for many.
Treatment options for different cancer diagnoses also continue to grow. The US Food and Drug Administration has approved 22 therapies in the last year, many of which are completely new ways of dealing with the disease. And while scientists learn more about the human genome, they are finding expert and accurate approaches to address the many small mutations in our genes that can cause cancer.
Despite our progress, the AACR report shows a harrowing truth about cancer care: not everyone benefits in the same way. The struggle to achieve better health outcomes for all segments of the population – regardless of gender identity, race, country of origin, sexual orientation or socio-economic status – continues to be difficult.
"Much of previous research … does not include data from different populations … the field of cancer health disparities goes beyond the obvious epidemiological differences … to include subjects for clinical trials and to use samples from different subjects, "wrote Dr. John Carethers, professor of Human Genetics at the University of Michigan and member of the board of directors of the AACR Annual Report, in a statement to ABC News.
Some groups are less likely to screen, participate in cancer studies or get the treatment they need. For example, African American, Latin and minority women are more likely to be diagnosed with breast cancer at an advanced stage than white women, with a study that states that black women are 14% more likely to be diagnosed with stage 3 or higher cancer.
Genetic variables could contribute to the way in which the disease is experienced by different groups of people. For example, black and Latino women are more likely to have a "triple negative" breast cancer, which means their cancer cells do not respond to the three most common hormones that usually promote abnormal growth. Unfortunately this also means that these types of cancer do not respond to available anti-hormonal therapies and are notoriously more aggressive. However, the lack of access to health care, health literacy and exposure to environmental risks are also significant problems for many vulnerable populations.
We are working to address these differences. The AACR supports research efforts to tackle inequalities and even basic work in at-risk communities is making a difference.
Karen Jackson, an African-American woman and breast cancer survivor, founded the Sisters Network, a national organization that works to reduce the cultural stigma of breast cancer in the African-American community and increase participation in screening and tests. "The rate of death of breast cancer remains unacceptably high among African-American women," Jackson said in an interview published by the AACR. "I came out of faith without funding, just a borrowed desk and my home phone, and formed the national sisterhood I wanted … African-American women with resources and knowledge to navigate … breast cancer."
The Sisters Network now offers a shared space for women who support each other.
It is people like Jackson who could play a key role in narrowing the gap so that everyone can share the victories of the fight against cancer.
Dr. Amisha Ahuja is an internist and writer with the ABC News medical unit.