AACR Cancer Progress Report 2023: Advancing the Frontiers of Cancer Science and Medicine

The annual American Association for Cancer Research (AACR) Cancer Progress Report is a cornerstone of AACR's efforts to educate the public and Congress about the latest advances against cancer and the importance of medical research and to advocate for increased federal funding for the NIH, NCI, FDA, and CDC.This 13th edition of the report, which covers the 12-month period from August 1, 2022, to July 31, 2023, documents how breakthroughs across basic, translational, and clinical research and population sciences have advanced the frontiers of cancer science and medicine. This report, and all previous editions, are freely available at https://cancerprogressreport.aacr.org/progress/.There has been remarkable progress against cancer in the United States, which has led to a steady decline in the overall cancer mortality rate. Between 1991 and 2020, the age-adjusted overall cancer mortality rate declined by 33%, a reduction that translates into 3.8 million cancer-related deaths avoided. The decline in cancer mortality can be attributed largely to improvements in prevention, early detection, and treatment, with the most progress made against cancers of breast, prostate, colon and rectum, as well as against previously intractable cancers such as advanced lung cancer and metastatic melanoma.Research in basic sciences is vital to our knowledge of how cancers develop. Advances in basic research along with technological innovations have led to a revolution in molecular profiling approaches such as spatial transcriptomics while also expanding the applications of proteomics and epigenetics to further our understanding of the complex disease we call cancer.Advancements in the areas of cancer prevention and early detection are helping to reduce the risk of cancer development. Forty percent of all cancers in the United States are attributable to preventable causes. Modifying behaviors such as eating a healthy diet and participating in physical activity, refraining from tobacco use, managing chronic conditions such as diabetes and infections, receiving recommended immunizations to prevent pathogenic infections such as those with the human papillomavirus (HPV), and protecting skin from UV radiation are ways to reduce the risk of developing cancer.Screening for breast, prostate, cervical, colorectal, and lung cancer has helped to reduce mortality from these cancers. Cancer screening recommendations are developed for individuals who are at an average or higher-than-average risk of being diagnosed with cancer and are based on gender and age, as well as genetic, environmental, behavioral, and social influences. Notably, during the 12 months covered in the report, the United States Preventive Services Task Force issued a draft recommendation for breast cancer screening to lower the age of eligible individuals from 50 to 40, which is estimated to save 19% more lives from breast cancer. New technologies, including artificial intelligence and liquid biopsies, that are rapidly moving from the bench to the clinic have the potential to improve detection of early-stage cancers or precancerous lesions while potentially increasing safety of screening tests. Although liquid biopsy–based tests have shown great potential for early detection of cancer, large prospective studies must demonstrate that screening using these methods can extend lives before they can be used routinely in the clinic.The report documents major progress made across the five pillars of cancer treatment – surgery, radiotherapy, cytotoxic chemotherapy, molecularly targeted therapy, and immunotherapy. Between August 1, 2022, and July 31, 2023, the FDA approved 14 new anticancer therapeutics (Table 1) and two new imaging agents and expanded the use of 12 previously approved anticancer therapeutics to treat additional cancer types. Included in the FDA approvals are the first antibody–drug conjugate for the treatment of ovarian cancer, multiple new immunotherapeutics to treat rare cancers including blood cancers, two new immune checkpoint inhibitors, and a first-of-its-kind gene therapy to treat bladder cancer. Decades of basic and translation research in immunology and cancer biology is fueling a surge in the applications of immunotherapy, one of the most exciting new areas in cancer medicine, as highlighted in a spotlight in the report titled "Immunotherapy: Pushing the Frontier of Cancer Medicine." Furthermore, precision medicine approaches are leading to the development of personalized treatments for patients with previously intractable cancers such pancreatic cancer and glioblastoma.Advances across the cancer continuum have led to many more people living with and beyond their cancer. As of January 1, 2022, there are more than 18 million people living with a history of a cancer diagnosis, which equates to about 5% of the U.S. population. Understanding and addressing their physical, psychosocial, and financial challenges are important priorities as the number of survivors in the United States is expected to grow to 26 million by 2040. Innovative approaches in the areas of palliative care, psycho-oncology, new technologies such as mobile phone apps that help with continuity of care, and other evidence-based strategies that improve quality of life are active areas of research. Coordination of care using patient navigators and patient advocates as well as the increased use of patient reported outcomes, specifically in clinical trial research, are collectively improving the survivorship experience. It is estimated that 4 million individuals in the United States are caring for an adult with cancer. Supporting these caregivers by addressing their physical, psychologic, and financial needs is also paramount.Despite major progress, cancer continues to be an ongoing public health challenge. In the United States, a disproportionate burden of cancer is shouldered by patients from racial and ethnic minorities and other medically underserved populations. If we are to achieve the President's Cancer Moonshot goal of reducing the U.S. cancer-related death rate by 50% by the year 2047, continued federal investments in NIH, NCI, FDA, and CDC must be secured to sustain the momentum of scientific progress. The returns on these investments have been extraordinary. As one example, patients with cancer in the United States have collectively gained nearly 14 million years of life since 1980, thanks to the clinical research funded by NCI.Therefore, AACR urges Congress for its unwavering and historically bipartisan support to make medical research a long-term strategic priority for our nation. All stakeholders in the cancer research and care community can seize today's unprecedented scientific opportunities to advance the frontiers of cancer science and medicine for the benefit of all patients with cancer.No disclosures were reported.