Cancer death rates have hit a 30-year low. Here’s how we got there | Opinion

Cancer kills fewer Americans today than at any point in the past three decades. Since 1991, the overall cancer death rate in the U.S. has fallen 34%, a decline driven by expanded prevention and screening along with a new generation of treatments including targeted therapies and immunotherapies.

These advances trace directly back to clinical trials — the research that turns scientific questions into standard care.

As a surgical oncologist who has treated patients for more than 30 years, I’ve watched this progress unfold. The treatments we use today for lung cancer, melanoma, leukemia and a growing number of other cancers would have been unimaginable when I started my career. Patients who once had few options are now in remission. Some are cured, which is an outcome I genuinely did not expect to see in my lifetime.

Clinical trials depend on federal funding through the National Institutes of Health and the National Cancer Institute, and the budget decisions lawmakers make this year will determine the trajectory of that progress.

At the University of Kentucky Markey Cancer Center, Kentucky’s only NCI-designated Comprehensive Cancer Center, we currently have around 100 active clinical trials. As one of just 58 Comprehensive Cancer Centers in the country, Markey gives patients access to the most advanced treatments and earliest-phase trials without leaving the state. Last year, patients from 110 of Kentucky’s 120 counties enrolled in one of them. For many of those patients, a clinical trial was the best option available — offering hope when their cancers stopped responding to other treatments.

One of those trials targets small cell lung cancer, an aggressive form of the disease that typically responds to initial treatment but comes back quickly and leaves patients with few options. Markey oncologist Zhonglin Hao, M.D., Ph.D., is leading the first U.S. trial of ZG006, an immunotherapy that works by directing the body’s own immune cells to attack cancer cells. Markey was the first site in the country to treat a patient, a direct result of our NCI designation. Trials like this one take years to build and cannot be quickly restarted once interrupted.

The national decline in cancer deaths also reflects the power of screening. Cancer found early is far more treatable, and catching it sooner saves lives. Kentucky, which has historically had among the highest cancer rates in the nation, has made screening a priority and the results are measurable. Since Markey first achieved NCI designation in 2013, Kentucky’s lung cancer screening rate has risen from well below the national average to consistently ranking near the top. Colorectal cancer screenings have doubled statewide over the past two decades and colorectal cancer diagnoses and deaths have each fallen more than 30% as a result. For Kentuckians, that means 650 fewer diagnoses and 275 fewer deaths from the disease every year.

Screening advances don’t happen in isolation, either. Federal funding supports clinical trials that determine who should be screened, how often and with what tools. The lung and colorectal cancer screening guidelines that are saving lives today came directly from that kind of research. The next generation of screening recommendations will, too.

Kentucky patients have a direct stake in all of this. Markey and its 20 affiliate hospitals across the state serve approximately 38% of the roughly 29,000 people diagnosed with cancer in Kentucky each year, and half come from Eastern Kentucky — one of the regions in the country with the highest cancer burden. The funding decisions Congress makes this year will be felt in these communities.

The 34% decline in cancer deaths represents real people who are alive today because of investments made years ago. The next generation of progress depends on the investments Congress makes now.

Dr. B. Mark Evers is the UK Markey Cancer Center director.