The quiet revolutions that have prevented millions of cancer deaths

From the article:

The age-adjusted death rate in the US for cancer has declined by about a third since 1991, meaning people of a given age have about a third lower risk of dying from cancer than people of the same age more than three decades ago. That adds up to over 4 million fewer cancer deaths over that time period. Thanks to breakthroughs in treatments like autologous stem-cell harvesting and CAR-T therapy — breakthroughs Jon himself benefited from, often just in time — cancer isn’t the death sentence it once was.

…

While anti-smoking policy has been the single biggest lifesaver, other interventions have helped reduce people’s cancer risk. One of the biggest successes is the HPV vaccine. A study last year found that cervical cancer deaths in US women under 25 fell about 62 percent between 2013–2015 and 2019–2021, a decline researchers attribute largely to the HPV vaccine. Other cancers have been linked to infections, and there is strong research indicating that vaccination can have positive effects on reducing cancer incidence.

The next revolution is better and earlier screening. It’s generally true that the earlier cancer is caught, the better the chances of survival, as Jon’s own story shows. According to one study, incidences of late-stage colorectal cancer in Americans over 50 declined by a third between 2000 and 2010 in large part because rates of colonoscopies almost tripled in that same time period. And newer screening methods, often employing AI or using blood-based tests, could make preliminary screening simpler, less invasive and therefore more readily available. If 20th-century screening was about finding physical evidence of something wrong — the lump in the breast — 21st-century screening aims to find cancer before symptoms even arise.

Most exciting of all are frontier developments in treating cancer, much of which can be tracked through Jon’s own experience. From drugs like lenalidomide and bortezomib in the 2000s, which helped double median myeloma survival, to the spread of monoclonal antibodies, real breakthroughs in treatments have meaningfully extended people’s lives — not just by months, but years.

Perhaps the most promising development is CAR-T therapy, a form of immunotherapy. Rather than attempting to kill the cancer directly, immunotherapies turn a patient’s own T-cells into guided missiles. In a recent study of 97 patients with multiple myeloma, many of whom were facing hospice care, a third of those who received CAR-T therapy had no detectable cancer five years later. It was the kind of result that doctors rarely see.