Progress at a Price: The Global Cancer Burden

Progress at a Price: The Global Cancer Burden

Clifford A. Hudis, MD, FACP, FASCO

@CliffordHudis
Feb 04, 2020

As we celebrate the 20th anniversary of World Cancer Day this February 4, I believe it’s important to recognize that we are making progress in addressing cancer, thanks to the courage of oncologists, patients, and researchers. Yet many people can’t see the progress, either because they instead see the growing burden (more about that below) or because they can’t access treatments already proven to be effective. In the face of this paradox, progress and increased burden, I believe the bravest thing we can do about cancer is to build on our gains while acknowledging current limits. This means we must focus on the research and work being done to develop and deploy better treatments while simultaneously making sure that patients have access to current standards of care. There are many achievements to celebrate as we commemorate World Cancer Day and yet much more to be done.

We can see evidence of this progress in the recent American Cancer Society Cancer Statistics 2020 report, released just last month, which affirms that cancer death rates in the United States declined by 29% from 1991 to 2017 and 2.2% from 2016 to 2017, the largest single-year drop in cancer mortality ever reported. This significant decrease in death rates is likely multi-factorial. Declines in lung cancer and melanoma mortality contribute, but there are also multi-year trends toward lower death rates for the other three most prevalent cancers: colorectal, breast, and prostate.

Other countries have seen similar trends, but this is far from universal—we must redouble our efforts to see that this becomes the case.

Why do some not see this progress? First, growing global wealth, associated with increased longevity and obesity, and an increasing population size all conspire to increase the numbers of people with common cancers, and then too many of them lack access to the best curative and palliative treatments. This visible burden of disease can obscure the very real progress summarized above!

How will we meet this challenge? Research and improved care delivery are the only routes! We can look at our Clinical Cancer Advances 2020 report, just launched today, for a compilation of the most important developments in oncology care in the past year, including the refinement of surgical treatment of cancers and important research into cancer prevention, molecular diagnostics, and more. Advances in treatment approaches included successes with combination therapies that can potentially extend survival without increasing toxicity for patients with certain types of cancer. But of course, this progress is merely the foundation for the advances ahead. That is where we must focus our resources and efforts.

Prevention is, of course, an ultimate goal, and, where it is proven effective, clinical access is the key to progress. The past year saw renewed and increased focus on the role of vaccines in preventing cancer, particularly for human papilloma virus (HPV). According to the World Health Organization (WHO), cervical cancer, caused by HPV, is the fourth most common cancer for women, accounting for more than 6% of total female cancers and nearly 12% of all cancers in less-developed regions. In the U.S. we have some positive news on this front: A brief from the Centers for Disease Control and Prevention’s National Center for Health Statistics released last month found that the number of young adults age 18 to 26 who’d received one or more doses of the HPV vaccine nearly doubled from 22.1% to 39.9% between 2013 and 2018. Globally, the WHO announced a call to action in 2018 to eliminate cervical cancer as a public health problem. Researchers then modeled the impact of HPV vaccination rates in an article published in The Lancet Oncology last February and predicted that if vaccines were given to 80% or more of the population, there would be approximately 13 million fewer cases of the disease, a 29% decrease.

To accelerate our momentum and ensure more meaningful discoveries and treatment improvements, we should answer the statement that World Cancer Day has put forth: “I will...” with specifics. What will each one of us around the globe do to keep pushing for changes and evidence that will help us reduce the incidence and burden of cancer?

One action that we can take is voicing our support for funding and policies from our governments that support cancer research and patient care. We need to let our leaders know that cancer research, treatment, and care is a priority for us, and funding is needed for us to continue our progress.

That is why I say I will face the problem and take action to keep moving toward ASCO’s vision of a world where cancer is prevented or cured and every survivor is healthy. If we work together, our combined “I will” statements can transform into the type of collective accomplishments that can drive real change.

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