AACR, ASCO Publish Reports Examining U.S. Cancer Care
By Conor Hale
Cancer research remains underfunded, and the U.S. cancer care system as a whole may be unprepared to handle an aging population, according to two separate reports from the American Association for Cancer Research and the American Society of Clinical Oncology.
In the AACR annual Cancer Progress Report, the association highlighted advancements in cancer research, progress in survival rates, and new approvals of drugs and technologies in the past year, as well as examining the current levels of federal research funding for research and delivered a call to action to members of Congress.
ASCO’s report, The State of Cancer Care in America, focused on the current problems facing the healthcare system as a whole, and trends that could lead to trouble in future treatment of cancer.
“By 2030, the number of new cancer cases in the United States will increase by 45 percent and cancer will become the nation’s leading cause of death,” the ASCO report said. “At the same time, the number of cancer survivors, now at 13.7 million, will continue to grow. Many of these individuals will require significant, ongoing care.”
The report went on to say that access to quality cancer care remains uneven across the country, with rates of access disproportionately lower for African Americans and Latinos, and that overall costs have risen throughout the healthcare system.
In cancer care, “annual costs are projected to rise from $104 billion in 2006 to more than $173 billion in 2020,” the report said, with demand for oncology services rising at least 42 percent by 2025. At the same time, the supply of trained oncologists will increase by only 28 percent, setting the potential for a shortage in the workforce.
“Shortfalls will be driven by tremendous growth in the number of Americans over the age of 65, along with the aging of the oncology workforce and large numbers of anticipated retirements,” the report said. “Furthermore, ASCO’s research indicates that these shortfalls may be further exacerbated by high levels of burnout, potentially leading to reduced clinical load or early retirement.”
Data from ASCO’s census of oncology practices was also presented, noting that the average size of practices increased from nine physicians to 15. Meanwhile in the same survey, 63 percent of small practices surveyed reported that they were likely to merge, sell or close within the next year.
The full report is available on the ASCO website and was published in the Journal of Oncology Practice.
The AACR Cancer Progress Report focused on making research count for patients, and included a special feature on immunotherapies. It also studied activities that carry a high risk of developing cancer, as well as the genetic basis of the disease. However, even with advancements in research, the AACR report remarked that cancer is soon to become the number one disease-related killer of Americans.
“Because more than 75 percent of cancer diagnoses occur in those aged 55 and older and this segment of the population is increasing in size, we face a future where the number of cancer-related deaths will increase dramatically,” said the AACR report. “This trend is being mirrored globally, and it is estimated that in 2030, more than 13 million people worldwide will lose their lives to cancer.”
“Yet, more than 50 percent of the 580,350 cancer deaths expected to occur in the United States in 2013 will be related to preventable causes,” the report continued. “Modifying personal behaviors to adopt a healthier lifestyle that eliminates or reduces these risks, where possible, could therefore have a remarkable impact on our nation’s burden of cancer. However, a great deal more research and resources are needed to understand how to best help individuals to change their lifestyle.”
The progress report applauded 11 FDA approvals of anticancer drugs from September 2012 to July 2013, as well as three new uses for previously approved drugs and three imaging technologies. The report also noted two drugs approved in conjunction with genomic diagnostics.
AACR called on members of Congress to make cancer research and biomedical science a national funding priority: “A new level of commitment by Congress to increase funding for the NIH will be required if we are to accelerate the pace of progress against cancer and meet the challenges described earlier in this report.”
“Sequestration dealt a 5.1 percent cut to the agency, slashing its budget by $1.6 billion,” the report said. “At the reduced fiscal year 2013 funding level of $29 billion, the NIH is now funding the lowest number of research projects since FY 2001.”
“The impact of sequestration on the NCI was a commensurate cut of $293 million,” it said. “These cuts have ramifications across the research spectrum—reducing the number of promising grant proposals that can be funded, potentially leaving the next cancer therapy or cure on the cutting room floor.”
AACR urged Congress to reinstate the cuts made by sequestration, and called upon the association’s members to encourage policymakers to provide sustainable funding increases to the NIH.
“If we are to ultimately transform scientific discoveries into therapies that improve and save the lives of cancer patients, it is going to require an unwavering commitment of Congress and the administration to invest in our country’s remarkably productive cancer research and biomedical research enterprise led by the NIH and NCI.”
From the AACR 2014 Cancer Progress Report