Comment: Cure for cancer still eludes us, but progress made

By Lisa Jarvis / Bloomberg Opinion

Let’s take a moment to celebrate some good news: Although we still don’t have a cure for cancer, we’re getting better and better at preventing and treating it.

The U.S. has made substantial progress in the battle against cancer, cutting the number of deaths from the disease by 33 percent since 1991. According to a new analysis from the American Cancer Society, that’s 3.8 million cancer deaths averted. People are living longer with cancer, too. The five-year survival rate across all kinds of cancers has increased from 49 percent in the mid-1970s to 68 percent for someone diagnosed between 2012 and 2018.

The report affirms the old maxim about an ounce of prevention being worth a pound of cure. Over the last few decades, many cancers have been caught early enough or prevented altogether thanks to a combination of screening, lifestyle changes (most prominently, the downward trend in smoking) and vaccination.

The most stunning statistic in the report is a testament to the power of prevention: Cervical cancer rates dropped by 65 percent during the period between 2012 and 2019 among women in their early 20s. Not coincidentally, those women were the first group to be eligible for vaccination against human papillomavirus (HPV), the leading cause of cervical cancer. A recent study from the Centers for Disease Control and Prevention suggest vaccinations are helping lower rates of HPV infections among unvaccinated women, too, suggesting the U.S. is seeing a herd immunity effect.

Cancer treatments are getting better, too. Therapies like Merck & Co.’s Keytruda and Bristol-Myers Squibb’s Opdivo, which block a protein that cancer cells use to hide from immune cells, have had profound impact on the lives of people with skin and lung cancers.

The ACS report showed that in less than a decade, these drugs have contributed to nearly double the three-year survival rates for metastatic melanoma, which increased from 20.6 percent for people diagnosed between 2004 and 2006, to 39.3 percent for people diagnosed between 2016 and 2018. During those same periods, the drugs, alongside earlier detection and advances in surgical procedures, caused three-year lung cancer survival rates to improve from 22 percent to 33 percent.

There’s reason to be optimistic that those wonderful advances could get even better. A recent study suggested that an experimental mRNA cancer vaccine, when used in combination with Keytruda, might prop up those numbers in melanoma even further; and hopefully, extend to other types of cancers.

This is all amazing progress. But there’s obviously still plenty of room for improvement.

Consider cervical cancer. States with fewer available resources (Kentucky, Oklahoma and Alabama) had twice the rate of cervical cancer as ones with better preventive care (Vermont, New Hampshire, Massachusetts and Maine). The ACS report noted that differences in state coverage of HPV vaccines could exacerbate those differences over time.

And during the three pandemic years, many kids missed out on routine vaccinations, including HPV. As I’ve noted before, a concerted public health campaign is needed to ensure adolescents get back on track with HPV shots. This monumental advance against cervical cancer, which could also lessen incidence of other cancers, is too important to let slip away.

Prostate cancer rates also offer an unfortunate lesson in what happens when prevention falls short. Cases of prostate cancer rose by 3 percent, annually, from 2014 through 2019; a reversal from decreasing rates of the disease over the previous 20 years. That has led to nearly 100,000 more cases, about half of which were advanced, the ACS said.

That reversal seems related to changes in recommendations for who should be screened with the prostate-specific antigen (PSA) test. Once widely used, the United States Preventive Services Task Force in 2012 recommended against screening all men for PSA because of worries about overdiagnosis and unnecessary procedures.

The ACS acknowledged a need to strike a better balance between overly aggressive screening and testing at a level that captures cases that could lead to more serious disease. That could mean integrating other types of tests in at-risk groups, such as Black men, who are at a much higher risk of dying from prostate cancer than other groups.

Cancer remains the second-leading cause of death in the U.S., but the ACS report is a reminder that although progress in public health often feels slow, the rewards do come. Addressing disparities in cancer prevention and care will give us even more to celebrate in years to come.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.