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Saturday 25 January 2020

Death by cancer reducing: ACS

Atlanta, Georgia/New Delhi: The annual statistical reporting from American Cancer Society published in January 2018 has presented a highly optimistic outlook. The death rate from cancer has been falling consistently for the past two decades. As of 2015, the cancer death rates had fallen 26% from its peak in 1991, which translates to 2.4 million deaths averted during this period.

The reduction in instances of cancer-deaths can be attributed to lifestyle changes like reduction in smoking, scientific advancements in early detection and treatment. Significant drops in mortality rates were observed in four major cancers, namely lung cancer, breast cancer, prostate cancer and colorectal cancers.

  • Lung cancer:
    • Decline in death rates: 45% from 1990 to 2015 among men and 19% from 2002 to 2015 among women
    • Cause of decline: Decrease in tobacco use
  • Breast cancer:
    • Decline in death rates: 39% from 1989 to 2015 among women
    • Cause of decline: Improvements in early detection
  • Prostate cancer:
    • Decline in death rates: 52% from 1993 to 2015 among men
    • Cause of decline: Fewer cases of prostate cancer are now being detected
  • Colorectal cancer:
    • Decline in death rates: 52% from 1970 to 2015
    • Cause of decline: Increased screening and improvements in treatment

The ethnicity and race of an individual, however, appears to have a significant bearing on rates of new cancer detection and cancer deaths. The rates are the highest among African Americans and the lowest among Asian Americans.

This disparity is a reflection of several factors related to socioeconomic status.

  • People with lower socioeconomic status were found to be more likely to smoke and be obese because of targeted marketing by tobacco companies and fast food chains
  • According to 2016 data, the uninsured population among Hispanics/Latinos is the highest (16%), followed by Blacks (11%), Asians (8%) and Whites (6%)
  • Racial and ethnic minorities were found to receive lower quality of healthcare compared to their White counterparts

Significant among the various factors leading to positive statistics in cancer deaths are the improvements in available treatments. For instance, the relatively new entrant into cancer treatment, cancer immunotherapy is today a standard treatment option, thanks also to the progressive regulatory environment.

Immunotherapies for advanced forms of lung, kidney, bladder, and head and neck cancers as well as Hodgkin lymphoma have been approved in 2016.

Also, the personalisation of treatments of cancers has led to a significant improvement in the prognosis of cancer patients, which is enabled by precision medicine. In terms of the lay, even among patients with the same type of cancer, there exist differences in the form of molecular signatures they exhibit. Thus, scientists, being able to distinguish these molecular signatures, can predict if a particular patient will be responsive to particular treatment. This greatly improves the chances of survival of the patient.

The improved statistics of cancer deaths over the past few years is indeed an indication of the coming of age of better awareness, better prevention and better treatments for this dreaded disease. With immunotherapy getting a strong foothold, and the first CAR-T cell therapy already in the market, the future only looks brighter. The defining factors for treatment, however, will be defined by payer models for these prohibitively expensive treatments, at least for now.

 

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Chaitali Bhattacharjee
PhD in molecular biology, former Young Scientist, working in the life science and healthcare industry since 2007

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