Photo by Rhoda Baer
Cancer patient receiving chemotherapy
Deaths from cancer are on the decline in the US, but new cases of cancer are on the rise, according to the 7th annual American Association for Cancer Research (AACR) Cancer Progress Report.
The data suggest the cancer death rate declined by 35% from 1991 to 2014 for children and by 25% for adults, a reduction that translates to 2.1 million cancer deaths avoided.
However, 600,920 people in the US are projected to die from cancer in 2017.
And the number of new cancer cases is predicted to rise from 1.7 million in 2017 to 2.3 million in 2030.
The report also estimates there will be 62,130 new cases of leukemia in 2017 and 24,500 leukemia deaths this year.
This includes:
- 5970 cases of acute lymphocytic leukemia and 1440 deaths
- 20,110 cases of chronic lymphocytic leukemia and 4660 deaths
- 21,380 cases of acute myeloid leukemia (AML) and 10,590 deaths
- 8950 cases of chronic myeloid leukemia and 1080 deaths.
The estimate for lymphomas is 80,500 new cases and 21,210 deaths.
This includes:
- 8260 cases of Hodgkin lymphoma (HL) and 1070 deaths
- 72,240 cases of non-Hodgkin lymphoma and 20,140 deaths.
The estimate for myeloma is 30,280 new cases and 12,590 deaths.
The report says the estimated new cases of cancer are based on cancer incidence rates from 49 states and the District of Columbia from 1995 through 2013, as reported by the North American Association of Central Cancer Registries. This represents about 98% of the US population.
The estimated deaths are based on US mortality data from 1997 through 2013, taken from the National Center for Health Statistics of the Centers for Disease Control and Prevention.
Drug approvals
The AACR report notes that, between August 1, 2016, and July 31, 2017, the US Food and Drug Administration (FDA) approved new uses for 15 anticancer agents, 9 of which had no previous FDA approval.
Five of the agents are immunotherapies, which the report dubs “revolutionary treatments that are increasing survival and improving quality of life for patients.”
Among the recently approved therapies are 3 used for hematology indications:
- Ibrutinib (Imbruvica), approved to treat patients with relapsed/refractory marginal zone lymphoma who require systemic therapy and have received at least 1 prior anti-CD20-based therapy
- Midostaurin (Rydapt), approved as monotherapy for adults with advanced systemic mastocytosis and for use in combination with standard cytarabine and daunorubicin induction, followed by cytarabine consolidation, in adults with newly diagnosed AML who are FLT3 mutation-positive, as detected by an FDA-approved test.
- Pembrolizumab (Keytruda), approved to treat adult and pediatric patients with refractory classical HL or those with classical HL who have relapsed after 3 or more prior lines of therapy.
Disparities and costs
The AACR report points out that advances against cancer have not benefited everyone equally, and cancer health disparities are some of the most pressing challenges.
Among the disparities listed is the fact that adolescents and young adults (ages 15 to 39) with AML have a 5-year relative survival rate that is 22% lower than that of children (ages 1 to 14) with AML.
And Hispanic children are 24% more likely to develop leukemia than non-Hispanic children.
Another concern mentioned in the report is the cost of cancer care. The direct medical costs of cancer care in 2014 were estimated to be nearly $87.6 billion. This number does not include the indirect costs of lost productivity due to cancer-related morbidity and mortality.
With this in mind, the AACR is calling for a $2 billion increase in funding for the National Institutes of Health in fiscal year 2018, for a total funding level of $36.2 billion.
The AACR also recommends an $80 million increase in the FDA budget, bringing it to $2.8 billion for fiscal year 2018.
