Past Progress Towards Control of Cancer Has Been Slow, Steady, and Incremental

Mortality rates for cancer have diminished slowly and steadily over the past few decades. This is a matter of prevention on the one hand and improvements in early detection of cancer on the other. When caught early enough, even comparatively crude approaches to therapy have a decent chance of controlling and eliminating the cancer. This trend will no doubt continue, but the more rapid, more effective progress that we'd like to see will only emerge given the advent of universal cancer therapies, those that strike at mechanisms, such as telomere lengthening, that are shared by many or all cancers. That is a plausible goal for the decades ahead, but is still a minority position in the research community.

The death rate from cancer in the US has declined steadily over the past 25 years. As of 2016, the cancer death rate for men and women combined had fallen 27% from its peak in 1991. This decline translates to about 1.5% per year and more than 2.6 million deaths avoided between 1991 and 2016. The drop in cancer mortality is mostly due to steady reductions in smoking and advances in early detection and treatment. A total of 1,762,450 new cancer cases and 606,880 deaths from cancer are expected to occur in the US in 2019. During the most recent decade of available data (2006 - 2015), the rate of new cancer diagnoses decreased by about 2% per year in men and stayed about the same in women. The cancer death rate (2007 - 2016) declined by 1.4% per year in women and 1.8% per year in men.

The most common cancers diagnosed in men are prostate, lung, and colorectal cancers. Together, they account for 42% of all cases in men, with prostate cancer alone accounting for nearly 1 in 5 new cases. For women, the 3 most common cancers are breast, lung, and colorectal. Together, they account for one-half of all cases, with breast cancer alone accounting for 30% of new cases. These cancers also account for the greatest numbers of cancer deaths. One-quarter of all cancer deaths are due to lung cancer.

Lung cancer death rates declined 48% from 1990 to 2016 among men and 23% from 2002 to 2016 among women. From 2011 to 2015, the rates of new lung cancer cases dropped by 3% per year in men and 1.5% per year in women. The differences reflect historical patterns in tobacco use. Breast cancer death rates declined 40% from 1989 to 2016 among women. The progress is attributed to improvements in early detection. Colorectal cancer death rates declined 53% from 1970 to 2016 among men and women because of increased screening and improvements in treatment.

Adults ages 85 and older represent the fastest-growing population group in the US. The group's numbers are expected to nearly triple from 6.4 million in 2016 to 19 million by 2060. Cancer risk increases with age, and the rapidly growing older population will increase demand for cancer care. People ages 85 and older represent 8% of all new cancer diagnoses, translating to about 140,690 cases in 2019. Cancer is the second-leading cause of death in the oldest old, following heart disease. 103,250 cancer deaths among this age group are expected in 2019, accounting for 17% of all cancer deaths. As of January 1, 2019, an estimated 1,944,280 people ages 85 and older were cancer survivors, representing 1/3 of all the men and 1/4 of all the women in this age group. They are the fastest-growing group of cancer survivors. Among adults age 85 with no history of cancer, the risk of a cancer diagnosis in their remaining lifetime is 16.4% for men and 12.8% for women.



That's winging quite a few small battles in the war on cancer. Of course even if had a magical medication or treatment that could cute any form of cancer like antibiotics could kill the bacteria, then it would be akin tuberculosis. Nasty, in some cases deadly and incurable, but a non issue in the grand scheme of things.

And it would probably add only a few rate to the life expectancy...

Posted by: Cuberat at January 23rd, 2019 6:34 AM

It's worth noting that Unity is heavily inspired by the cancer field with their approach to kill off senescent cells. Venetoclax a drug that blocks an anti-apoptotic protein of the BCL2 family and leads so to programmed cell death got recently approved. Unity thinks that senescent cells depend on the BCL2 family to survive and tries to inhibit them. There is, by the way, a great presentation up form Unity with Judy Campisi and van Dreusen

Posted by: Tom at January 23rd, 2019 11:36 AM

Death rates aren't much informative (too many factors contribute to them). I prefer 5-years or 10-years survival, but they are usually more difficult to find (they are included in the paper only for children and teenagers).

Posted by: Antonio at January 23rd, 2019 11:49 AM

"The group's numbers are expected to nearly triple from 6.4 million in 2016 to 19 million by 2060"

Well that's a pessimistic view. 2060? I think editor plans on being in his replacement, non-biological, body before 2060. I'm planning on being biologically younger than I am now and starting the sequel beyond the one I'm planning now. Even the conservative estimates for the Kurzweil Singularity are centered around 2060.

Posted by: Tom Schaefer at January 23rd, 2019 12:02 PM

Recent improvements in cancer treatment mean that there are people with advanced disease who aren't dying as they used to - so we already have more than just better prevention strategies or early detection. Immunotherapy is a game changer, but it will take a few more years (and a few more tweaks) before its impact is reflected in population-based data.

Posted by: Barbara T. at January 23rd, 2019 2:22 PM

"Cancer cells arise from bacteria"

"Evidences supporting the BOCC hypothesis:

There are 10× more bacterial cells than human cells in the human body [69].

Bacteria play a key role in carcinogenesis. Helicobacter pylori is a definite carcinogen for gastric cancer [70]. Many other bacteria are related with various cancers, such as Salmonella typhi [71], Chlamydia pneumoniae [72], Mycoplasma hominis [73], Bacteroides fragilis [74], Streptococcus bovis [75], Escherichia coli [76], Fusobacterium spp. [77]. and Neisseria gonorrhoeae [78].

Like bacteria and single-celled eukaryotes (protists, e.g., yeast), cancer cells can grow in agar medium and form colonies [79], proliferate in the absence of anchorage in vitro [80] and ferment glucose in the absence of oxygen (anaerobic fermentation) with the production of lactic acid [81].

Cancer cell genomes were assembled from DNA fragments all at once in a single catastrophic event (chromothripsis) [67].

Cancer cell genomes contain bacterial DNA [82-84].

Genes of ancient and unicellular origin are highly and preferentially expressed during tumorigenesis [85, 86]."

Posted by: Lee at January 23rd, 2019 3:29 PM
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