AACR Cancer Progress Report 2024: Inspiring Science—Fueling Progress—Revolutionizing Care

The spectacular progress being made against cancer has resulted in a steady decline in cancer death rates and a consistent rise in the number of people who are living longer and fuller lives after a cancer diagnosis. In fact, the overall cancer death rate in the United States has fallen by 33% between 1991 and 2021, a reduction that translates into averting more than 4.1 million deaths from cancer (1). These reductions are attributable to decreases in deaths from cancers of the colon and rectum and female breast, largely due to screening efforts, as well as reductions in death rates for leukemia, lung cancer, melanoma, and kidney cancer attributable to breakthroughs in precision medicine (1, 2). In spite of this progress, many challenges remain, with the incidence of certain cancer types, such as pancreatic cancer, uterine cancer, and human papillomavirus–associated oral cancers, on the rise and persistent cancer disparities among racial and ethnic minorities and other medically underserved populations (1).

In the United States in 2024, 14,910 children and adolescents will be diagnosed with cancer, the leading cause of disease-related death among children (3). The most diagnosed cancers in children were leukemia and cancers of the nervous system, including brain tumors. Furthermore, 84,100 AYA individuals will receive a diagnosis of cancer in 2024, with the most common types of cancers among this population being solid tumors, including thyroid cancer, melanoma, and breast cancer (3).

Hallmarks of cancer cells include genome instability, unlimited divisibility, uncontrollable growth, resisting cell death, metastasis, evading destruction by the immune system, and influencing angiogenesis to promote the delivery of nutrients and oxygen. These hallmarks are primarily driven through genetic mutations, which can be either inherited or somatic. Somatic mutations are responsible for 90% of cancer cases. Conversely, inherited mutations are responsible for 10% of all cancers. Inherited mutations, as well as structural alterations such as chromosomal translocation, play critical roles in childhood cancers (4–6), which has prompted a large amount of research in this area, including the development of genetic tests to monitor children who may have inherited cancer risk factors such as those associated with Li-Fraumeni Syndrome.

An estimated 40% of all cancer cases in the United States are attributable to preventable risk factors that include cigarette smoking, unhealthy diet, physical inactivity, ultraviolet exposure, excessive alcohol consumption, and pathogenic infections (7). Other risk factors include environmental exposures due to air and water pollution, radon, and endocrine-disrupting chemicals (8–14). Furthermore, certain occupations, such as firefighting, mining, agriculture, and construction, can lead to excessive exposure to carcinogenic compounds, which increases the risk of certain types of cancer (15, 16).

Although risk factors play a far less critical role in cancer development in children and AYA populations, exposure to certain risk factors, such as cigarette smoke during pregnancy or in combination with genetic mutations linked with cancer predisposition syndromes, such as Lynch syndrome, can increase cancer risk in these populations (17–20).

Cancer screening—detection of cancers at the earliest possible stage when the likelihood of successful treatment and even cure is high—saves lives and reduces the burden of the disease at a population level. Recent estimates show that routine cancer screening has saved the US economy about 6.5 to 8.6 trillion dollars since the introduction of the US Preventive Services Task Force (USPSTF)-recommended screening guidelines in 1996 (21). USPSTF issues screening recommendations for the cancers of colon and rectum, breast, cervix, and prostate for individuals who have an average lifetime risk of developing cancer and for cancers of lung and bronchus for those who have a higher than average lifetime risk of developing cancer because of smoking. While there are no routine cancer screening tests for children, the focus is instead on genetic testing and surveillance for hereditary cancers, which can help cancer care teams tailor specific screening and prevention strategies, leading to more effective management of cancer risk among this population.

This section covers the advances made in cancer science and medicine between July 1, 2023, and June 30, 2024, including the 15 new anticancer therapeutics approved for use by the FDA as well as a new imaging agent to aid breast cancer surgery and the expanded use of 15 previously approved anticancer therapeutics. Included among the new approvals are the first tumor-infiltrating lymphocyte-based cellular immunotherapy, a new T-cell-engaging bispecific antibody against a novel target for patients with small cell lung cancer, and the first AKT-targeted therapeutic for patients with breast cancer. Also included is the first KRAS-targeted therapy for certain patients with colorectal cancer, several new molecularly targeted therapeutics, and an immunotherapeutic for the treatment of patients with an array of blood cancers.

Unprecedented improvements in treatment options have led to significant progress against childhood and AYA cancers. Just in the 12 months covered by the Report, the FDA approved a new molecularly targeted therapeutic for the treatment of children with certain types of brain tumor as well as expanded the use of a different molecularly targeted therapeutic as a treatment to reduce the risk of relapse in children with high-risk neuroblastoma.

Cancer survivors include anyone with a history of a cancer diagnosis. As of January 2022, the most recent year for which such data are available, there were more than 18 million people in the United States living with a history of such a diagnosis (22). This section highlights the physical, psychosocial, and financial challenges faced by cancer survivors, while also highlighting unique challenges faced by children, AYA, and older adults. Also discussed are ways by which survivors of cancer can improve health-related quality of life, such as by participating in physical activity, maintaining a healthy diet and weight, as well as reducing or eliminating alcohol and tobacco use. To deliver care effectively and to improve the survivorship experience, a multifaceted approach that addresses all aspects of survivorship and that is delivered by patient navigators and clinical care coordinators is necessary to have positive outcomes for this vulnerable population.

The future of cancer science and medicine is promising, with remarkable innovations in the areas of radiotherapy, including radiotheranostics, which offers new possibilities for detecting and treating cancers (23). Furthermore, advances in noninvasive cancer imaging are revolutionizing visualization of tumor metabolism and assessment and monitoring of treatment response inside the body, allowing physicians to make more informed decisions about cancer treatment (24). Finally, cancer engineering, which combines principles from engineering, biology, and medicine, is emerging as a powerful interdisciplinary approach for understanding the complexities of cancer development to improve health outcomes.

The Report concludes by highlighting the importance of investments by the federal government in several programs, including those led by the CDC, FDA, NIH, and NCI. This federal support is needed to ensure that the benefits of medical research are shared by all populations and to effectively train the next generation of researchers and clinicians. The AACR calls on Congress to increase NIH funding for these medical and research programs, which are vital in the fight against cancer. These include $51.3 billion in fiscal year (FY) 2024 for the NIH; $3.6 billion in dedicated funding for Cancer Moonshot activities through 2026, $472.4 million in FY 2025 for the CDC Division of Cancer Prevention; and allocating $55 million in funding for the Oncology Center of Excellence at FDA.

By following these recommendations, Congress will help accelerate the rate of discovery and create vital pathways for young scientists to contribute to future advances in cancer research. This investment will improve our nation’s health, including the lives of the millions of people who have been affected by cancer.

No disclosures were reported.