The Status of Cancer 2012
Cancer Progress Report 2012: Contents
The number of cancer survivors in the United States (U.S.) continues to increase year after year, from 3 million in 1971, the year the U.S. Congress passed the National Cancer Act, to approximately 13.7 million in 2012 (1, 2). This success is the result of several factors – the investments in research by the federal government as well as philanthropic individuals and the private sector, and behavioral changes, especially the reduction of tobacco consumption. The decades of investments in basic and clinical cancer research and biomedical science, in particular the investments supported by public funds through the National Institutes of Health (NIH) and the National Cancer Institute (NCI), have spurred the development of new and better ways to prevent, detect, diagnose and treat cancer in all age groups, leading to decreases in incidence; cures for some patients with certain types of cancer; and higher quality, longer lives for many of those individuals whose cancers cannot yet be prevented or cured.
Now, more than any other time in our history, cancer researchers are maximizing the impact of the fundamental discoveries made during the past four-plus decades and are translating them into improved patient care. In the past 12 months alone (September 2011 through August 2012), the Food and Drug Administration (FDA) approved one new drug for treating precancerous lesions, nine new drugs for treating cancers and three new uses for previously approved drugs.
However, the vast complexity of cancer, which is in fact not one disease but more than 200 different diseases, has meant that advances have not been uniform for all forms of cancer. The good news is that the five-year survival rate for all cancers is now about 65%. Significant progress has been made against some cancers, such as breast cancer. The five-year survival rate for female breast cancer patients is now 90% compared with 63% in the early 1960s (3). Another example is childhood acute lymphocytic leukemia, where the five-year survival rate is now greater than 90% versus 58% in the mid-1970s (3). In contrast, the five-year survival rates for other cancers, such as pancreatic, liver and lung cancers, remain very low at 6%, 14% and 16%, respectively (3). Moreover, the burden of cancer is not distributed evenly across the population, due to numerous interrelated factors (see
Sidebar on Cancer Health Disparities in America). These differences in survival rates underscore the great need for continued research in discovery, translation and dissemination science.
Despite significant improvements in survival from many cancers, it is estimated that more than 577,000 Americans will die from cancer in 2012. Cancer will account for nearly one of every four deaths, making it the second most common cause of death in the U.S. If current trends continue, it will not be long before cancer is the leading cause of death for Americans. It is therefore urgent that our Nation continues to invest in the scientific research necessary to develop effective preventive interventions and treatments.
More than 1.6 million Americans will be diagnosed with cancer in 2012 (3), and it is estimated that more than 41% of individuals born today will be diagnosed with cancer at some point during their lifetimes, which is nearly one out of every two Americans (4). The number of cancer diagnoses is likely to increase dramatically in the next few decades because cancer is predominantly a disease of aging. The majority of all cancer diagnoses are among those aged 65 years and older (4, 5), a rapidly expanding segment of the population (6, 7). Compounding the problem is the growing prevalence of obesity and the continued practice of smoking, which are linked to an increased risk for several cancers (8). The combination of these trends will magnify the already huge economic burden of cancer.
The latest estimates from the NIH indicate that the overall economic cost of cancer in the U.S. in 2007 was $226.8 billion (3), making cancer the most costly disease to the Nation. Unless more successful preventive interventions, early detection tools and treatments can be developed, this cost will rise dramatically during the next two decades.
Cancer prevention, in particular, is an area of great promise because research has shown that about two out of every three cancer deaths in the U.S. are due to preventable causes (3). Almost one third are caused by tobacco use; about one third are related to patients being overweight or obese, physically inactive and consuming a diet poor in nutritional value; some are caused by infectious agents for which we have vaccines; and many of the deaths from melanoma are a result of prior excessive sun exposure or use of indoor tanning facilities. Developing evidence-based approaches to cancer prevention, including research related to tobacco cessation, remains an area of active investigation.
The number of newly diagnosed cases of cancer is rising not just in the U.S., but throughout the world, with global numbers predicted to rise from 12.7 million new cases in 2008 to 22.2 million by 2030 (9). Without major new advances in cancer research to facilitate the successful development of effective preventive interventions and treatments, this will translate into more than 13 million lives claimed by cancer in 2030 (10). Moreover, of all causes of death worldwide, cancer has the greatest economic impact from premature death and disability. This global economic toll is 20% higher than that from any other major disease, at $895 billion in 2008 (11), not including the direct costs of treating cancer. Collaborations between U.S. cancer researchers and the international cancer research community are essential to sharing knowledge and leveraging resources to hasten the reduction in cancer burden and improvement of global health.
At this point in time, continued progress in life-saving cancer research is in jeopardy. NIH and NCI budgets have been declining since 2003, and many promising scientific projects are not being funded. This report captures many of the remarkable recent advances that are the direct result of the dedicated work of thousands of researchers who are now poised to exploit the current scientific momentum to save more lives from cancer. This will only be achieved if Congress provides the required support for cancer research.
Progress Report 2012 Contents