Will Record-High Cancer Survival Rates Continue?
Record five-year survival rates for cancers are owed to treatment advances and early detection, BU researcher Julie Palmer says. Photo by XiXinXing/iStock
Will Record-High Cancer Survival Rates Continue?
Boston University epidemiologist says early detection efforts must be made available to all Americans
Medicine started the new year with an encouraging first-ever milestone: 70 percent of all cancer patients now remain alive five years post diagnosis, according to a new American Cancer Society (ACS) report.
The biggest gains in survival have come for some of the most lethal cancers—myeloma (blood), liver, and lung. According to the ACS, which tracked data through 2023, the mortality rate has fallen a “total of 34 percent since its peak in 1991…averting 4.8 million cancer deaths.”
The Brink asked Julie Palmer (SON’80, SPH’85), a Boston University School of Public Health professor of epidemiology, what explains the good news—and whether the advances will continue. Palmer also directs the Slone Epidemiology Center at BU’s Chobanian & Avedisian School of Medicine and is a founder of the Black Women’s Health Study, the largest and longest running study of its kind in the United States.
Q&A
with Julie Palmer
The Brink: What accounts for this heartening increase in the cancer survival rate?
Palmer: This is an increase from a 63 percent, five-year survival in the 1990s. The biggest factor is improved treatments, including effective treatments for cancers diagnosed at later stages. Lung cancer is both common and often fatal; advances in treatments have doubled the five-year survival rate for lung cancer in the past 20 years. Immunotherapy treatments have greatly increased survival from melanoma. Other factors that have also driven increased survival are earlier detection, especially for lung, prostate, and breast cancer, and decreased incidence of lung cancer due to a lower prevalence of smoking.
The Brink: Is the survival rate more or less across the board, or are some people not living as long?
Palmer: Unfortunately, survival has not improved as much in some groups as others. For example, the statistics provided in this report show that for all cancers combined, five-year survival is 71 percent in white Americans, but only 66 percent in Black Americans. In particular, Black Americans have a markedly lower survival from cancer of the breast, uterine corpus [the body, or top, of the uterus], bladder, and from melanoma. All evidence points to later detection of the cancer and less access to the best treatments as the major reasons for the differences.
Unfortunately, survival has not improved as much in some groups as others.
For some cancers, rural patients appear to have poorer survival than urban patients; again, probably due to less access to early detection of lung cancer and less access to state-of-the-art treatments for other cancers. American Indians and Alaskan Natives experience the highest death rates for five of the nine most common cancers, prostate, breast, uterus, stomach, and lung.
The Brink: What needs to be done to improve these patients’ survival rates?
I suggest the following: one, continue efforts to reach all populations with tailored information about screening programs for breast, colorectal, and lung cancer. We’ve seen good results from efforts to increase breast and colorectal screening in the Black population; the same is needed for other underserved populations. Lung cancer screening—low-dose CT scan—is underutilized among everyone, but especially in underserved populations.
Two, develop multipronged efforts to extend the best treatments to all patients. This means addressing economic issues such as insurance coverage, co-pays, transportation, etc. It also means improving communication between providers and patients, such that patients from disadvantaged groups will be empowered to seek and receive the best treatments. Patient navigation programs for breast cancer have been a good first step, but more is needed. Medical mistrust often stems from the quality of patient encounters with healthcare providers. Continuing efforts to educate providers to treat all patients with respect and kindness may help.
The Brink: Do you anticipate increasing survival rates will continue upward or stall?
Depends on what we do—see my answers above.
