Incredible advances against cancer, but not everyone benefits

Cancer deaths in the United States have decreased by 26% in the 14 years since 2001, according to an annual report released today by the American Association for Cancer Research.

As there are fewer deaths, the number of Americans living with cancer – the survivors – has reached a record high. In 2015, more than 15.5 million people in the United States suffered from different varieties of the disease, and this number is likely to increase as the population ages. More people have cancer than ever before, but thanks to advances in treatment, these people are living longer. However, inequities in access to cancer treatment and prevention mean that not everyone in the United States benefits equally from these advances.

Years of scientific research, both at the molecular level and at the population level, have identified risk factors that can lead to cancer, and many types can be avoided if people can change their habits. Obesity, smoking, alcohol consumption and lack of exercise are risk factors that have all been the focus of national health initiatives. . As a result of sustained anti-tobacco advertising campaigns, for example, cigarette consumption rates dropped by about 30% between 1965 and 2015.

However, even with successful identification and risk prevention campaigns, it is still estimated that more than 40% of cancer cases diagnosed in the United States are the result of potentially modifiable causes.

In 2006, the HPV vaccine was approved to prevent human papillomavirus, which increases the risk of cervical cancer. Giving children, adolescents and young adults the vaccine can prevent almost all cases of cervical cancer later in life and even some cases of oral and anal cancer. Unfortunately, less than half of the children and adolescents in this country are aware of these blows. This is probably because pediatricians do not fully discuss benefits with parents and patients.

Yet, we are progressing. Studies on the best ways to screen for cancer, without excess screening, have led to earlier detection, thus improving outcomes for many.

Treatment options for different cancer diagnoses also continue to grow. In the United States, the Food and Drug Administration has approved 22 therapies over the past year, many of which are new approaches to the disease. And as scientists learn more about the human genome, they discover smart and accurate approaches to targeting the many small mutations in our genes that can cause cancer.

Despite our progress, the AACR report presents a poignant truth about cancer care: Not everyone benefits equally. The fight for better health outcomes for all segments of the population – regardless of gender identity, race, country of origin, sexual orientation or gender socioeconomic status – remains difficult.

"Much of the previous research … does not include data from various populations … the area of ​​disparities in cancer health goes beyond obvious epidemiological differences … to include topics for clinical trials and use samples of various topics "John Carethers, professor of human genetics at the University of Michigan and member of the steering committee of the annual report of the AACR, in a statement to ABC News.

Some groups are less likely to get screened, to participate in cancer trials or to get the treatment they need. For example, African-American, Latino and minority women are more likely to be diagnosed with advanced breast cancer than white women, a study indicating that women of color are 14% more likely to have stage 3 or higher cancer.

Genetic variables could contribute to the way the disease is experienced by different groups of people. For example, black and Latin women are more likely to have "triple negative" breast cancer, which means that their cancer cells do not respond to the three most common hormones that typically promote abnormal growth. Unfortunately, this also means that these types of cancers do not respond to available anti-hormonal therapies and are notoriously more aggressive. However, lack of access to health care, health literacy, and exposure to environmental hazards are also important issues for many vulnerable populations.

Work is under way to address these differences. AACR advocates for research efforts to address inequities and grassroots work in at-risk communities also makes a difference.

Karen Jackson, an African-American woman and breast cancer survivor, founded the Sisters Network, a national organization that works to reduce the cultural stigma associated with breast cancer in the African-American community. increase participation in screening and testing. "The breast cancer death rate remains too high among African American women," Jackson said in an interview published by AACR. "I came out on faith without any funding, just a borrowed desk and my home phone, and I formed the national fraternity to which I aspired … African-American women with resources and knowledge

The sister network now offers a shared space for women to support each other.

It is people like Jackson who could play a crucial role in bridging the gap so that everyone can participate in the victories of the fight against cancer.

Dr. Amisha Ahuja is an internist and writer at ABC News Medical Unit.