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Higher lung cancer incidence among young women than young men is a global phenomenon

The increase is largely driven by adenocarcinoma of the lung – which occurs more frequently in women than men.

A study published Feb. 5 by four researchers, including two from ACS, finds that the emerging pattern of higher lung cancer incidence among young women than young men is widespread across geographic areas and income-levels.

The authors say this pattern "is not fully explained by sex-differences in smoking prevalence, underscoring the need for etiologic studies." They also warn that "our findings forewarn of a higher lung cancer burden in women than men at older ages in the decades to follow. Further work is therefore needed to intensify anti-tobacco measures and identify factors for the higher incidence of lung cancer among young women."

The study was published online in the International Journal of Cancer

The two ACS researchers contributing to the study are Lindsey Torre, MSPH, and Ahmedin Jemal, DVM, PhD. This new study extends an earlier study led by Dr. Jemal that found that in the U.S. the incidence of lung cancer in young women is higher than that in their male counterparts.

The researchers examined lung cancer incidence rates from 1993 to 2012 in women and men, ages 30 - 64, in 40 countries across five continents. Among men, the age‐specific lung cancer incidence rates generally decreased in all countries, while in women the rates varied across countries with the trends in most countries stable or declining, albeit at a slower pace compared to those in men. As a result, rates in ages 30-49 years became higher in young women than in young men in Canada, Denmark, Germany, New Zealand, the Netherlands, and the United States, reversing the historically lower rates in women than men. This crossover was largely driven by growing adenocarcinoma incidence. 

The researchers posit that "it is possible that females may be at an increased risk of lung cancer compared to males.” They cite a pooled analysis of 13 studies that “found that lifelong female nonsmokers of European, African American, and Asian-descent had higher rates of lung cancer compared to their male counterparts." It's possible, they write, that women have a higher susceptibility to lung cancer because of various gene variants. "Research has suggested that women with lung cancer have impaired DNA repair mechanisms compared to men, which makes them especially susceptible to lung cancer," the researchers wrote. 

Historically, lung cancer rates have been higher among men because they start smoking in large numbers earlier and smoke at higher rates, the researchers explained. However, there has been a convergence in lung cancer incidence between men and women. 

With an estimated 2.1 million cancer cases in 2018, lung cancer is the most common cancer worldwide among men and the second most common cancer among women. By histologic type, it is grouped into four major categories: nonsmall cell carcinoma, adenocarcinomas, squamous cell carcinomas, and large cell carcinomas.  

Cigarette smoking is the main risk factor for all lung cancer subtypes, though the risk of lung cancer associated with smoking is greater for small cell and squamous cell lung cancers than the other types. Other known risk factors for lung cancer include exposure to secondhand smoke, mineral and metal dust, asbestos, and radon.

The best way to avert future lung cancer cases and deaths among current smokers is through smoking cessation. The risk of dying of lung cancer can be reduced substantially by quitting at any age.

  • Nobel prize winner Stanley Cohen, PhD, dies at 97

    The ACS Research Professor acknowledged ACS, with gratitude, in his 1986 Nobel lecture.

    Stanley Cohen, a Nobel Prize winner and Vanderbilt University distinguished professor of biochemistry, emeritus, died Feb. 5 in Nashville at the age of 97.

    Dr. Cohen was awarded the 1986 Nobel Prize in physiology or medicine for the discovery of epidermal growth factor (EGF) and its receptor (EGFR). He shared the award with his Washington University colleague Rita Levi-Montalcini.

    His research on the growth of cells helped build a foundation for other scientists studying cancer, dementia, and other disorders.

    The American Cancer Society provided funding to Dr. Cohen that led to his discovery of EGFR as a tyrosine kinase. Tyrosine kinases are key signaling molecules inside the cell that stimulate the growth of normal and cancerous cells. There are now multiple drugs targeting the EGFR used in treating non-small lung cancer and colorectal cancer. In addition, this research contributed to a better understanding of the link between breast cancer and the expression of the HER-2/neu gene at very high levels. This foundational work ultimately led to the development of Herceptin, the first targeted drug for the treatment of breast cancer to receive FDA approval.

    Mutations in the EGF receptors have been linked with certain forms of lung cancer and brain cancer. Using the building blocks Dr. Cohen put in place, researchers have discovered that EGF receptors can be targeted with specific drugs to inhibit their unchecked growth, holding a possible key to treating cancer and other diseases.

    Dr. Cohen was born Nov. 17, 1922, in Brooklyn. His father was a tailor, his mother a homemaker. Having had polio as a child, Dr. Cohen walked with a limp throughout his life. 

    He graduated in 1943 with a double major in chemistry and zoology from Brooklyn College, which he said he could afford only because the college had free tuition at the time. He received a master’s degree in zoology from Ohio’s Oberlin College in 1945 and a doctorate in biochemistry from the University of Michigan in 1948. He taught at the University Colorado before joining the faculty of Washington University in St. Louis in 1952. He then went on to Vanderbilt University as an assistant professor and continued his research on cellular growth factors.

    Dr. Cohen is survived by his wife, Jan Jordan, three children, and two granddaughters.

    Read more about him here.

  • Dr. Wender: NELSON trial confirms benefit of lung cancer screening

    ​"The ongoing decline in lung cancer mortality is within our collective grasp."

    The New England Journal of Medicine on Jan. 29 published the results of the Dutch-Belgian lung cancer screening trial (NELSON). The large trial of more than 15,000 men confirmed the findings of the National Lung Screening Trial of the mortality benefit of screening at-risk populations using low dose computed tomographic CT screening, finding a 24% reduction in mortality after 10 years of screening.

    Below is a statement from Richard C. Wender, MD, chief cancer control officer for the American Cancer Society:

    “These long-awaited results from the NELSON lung cancer screening trial make a clear conclusion: lung cancer screening in former or current smokers saves lives. The screened population saw a 26% lower risk of dying from lung cancer.

    “This study of low dose CT scan screening ends any ongoing debate about limited evidence supporting the value of lung cancer screening and provides clear direction for the health care community. Lung cancer screening should become a priority for primary care clinicians, health care systems, insurance plans, and employers. It’s time to develop a new quality measure to help drive a steady increase in screening rates and hold all providers accountable to provide evidence-based, high-quality screening, follow-up, and lung cancer treatment.

    “For too many years, too many lives have been lost to lung cancer, the leading cause of cancer related death in the United States. Despite ACS, USPSTF, and other organization’s guidelines recommending screening, and full coverage by private health insurance and Medicare, the percent of eligible people who have been screened is unacceptably low – under 10%. Now that we have another validating study, showing significant mortality reduction with acceptable risk, it’s time for a coordinated all-out push.

    “With a new screening test and advances in treatment, accelerating the ongoing decline in lung cancer mortality is within our collective grasp. This is a major priority for the American Cancer Society and needs to be a major priority for all.”

  • ACS study: new data underscores financial hardship faced by cancer patients

    ​Cancer survivors in the U.S, particularly those 64 years or younger, faced substantial medical financial hardship and sacrifices in spending, savings, or living situation, according to data from a survey published Jan. 15 in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

    “As the number of cancer survivors grows, the costs of cancer treatments rise, and patient cost-sharing increases, there is a growing need for financial intervention at multiple levels to help cancer survivors minimize their risk of financial hardship,” said epidemiologist Xuesong Han, PhD (pictured here), senior principal scientist in Health Services Research at the American Cancer Society, and lead author. “We hope our findings will inform the development of future health policies and interventions in care delivery.”

    In the U.S., the number of cancer survivors increased by 1.4 million people in the past three years, reaching more than 16.9 million as of January 1, 2019. The economic burden of cancer is significant for American cancer survivors: Previous studies have reported that as high as two-thirds of cancer survivors face medical financial hardship. However, few studies have examined the intensity of financial hardship across multiple domains, or sacrifices made as a result of cancer treatment and its longer-term effects. 

    Han and colleagues identified cancer survivors from the 2016 Medical Expenditure Panel Survey (MEPS), a nationally representative survey that collected information on health insurance coverage, health care utilization and expenditures, and health conditions. 

    Participants detailed the effects of their cancer, cancer treatment, and how their cancer experience has affected their finances, health insurance coverage, and employment status. Financial hardships included problems paying medical bills, financial distress, or delaying or forgoing medical care due to cost concerns. Financial sacrifices due to cancer included changes in spending and use of savings as a result of cancer treatment and its lasting effects.

    Because people over the age of 65 years are generally eligible for Medicare insurance coverage, Han and colleagues examined results for adult survivors under and over the age of 65.

    Of the 401 cancer survivors aged 18 to 64 years, 54 percent reported they had faced medical financial hardship as a result of cancer diagnosis and treatment, and 54 percent said they had made financial sacrifices in spending, savings, or their living situation. Nearly a quarter reported trouble paying medical bills, needing to borrow money, or filing for bankruptcy due to cancer diagnosis and treatment. More than 40 percent were worried about finances and almost 30 percent were worried about forgoing or delaying care because of cost concerns.

    Of the 562 cancer survivors aged 65 years or older, medical financial hardship and sacrifices were less prevalent; 42 percent reported ever facing medical financial hardship, and 38 percent said they had made financial sacrifices.  

    Factors that were significantly associated with more intense financial hardship included low income and educational attainment, minority racial/ethnic status, comorbidity, lack of private insurance coverage, extended employment change, and recent cancer treatment. 

    Financial hardship has been linked to higher symptom burden and worse quality of life, and in extreme cases, such as bankruptcy, it is associated with an increased risk of death, Han explained.

    “Overall, health insurance coverage is critically important for cancer patients and survivors,” said Han. “Even those who had private insurance coverage reported financial hardship, suggesting that the types of coverage and extent of patient cost-sharing are important too.” 

    “Provisions of the Affordable Care Act that have expanded insurance coverage options, such as the Medicaid expansion, have been associated with reductions in financial hardship among cancer survivors in other studies,” Han explained. “Employers can play a large role in mitigating hardship through flexible workplace accommodations such as availability of paid and unpaid sick leave, and supportive programs for both survivors and family members.”

  • Congrats to the teams receiving our Hero of Research Award

    An exception was made this year for a non-Relay team

    Our Heroes of Research Award offers qualified Relay For Life teams an opportunity to name an existing post-doctoral fellowship research grant in honor of a loved one or their team. Once identified, this named grant would be active for three years and the team would have the option to talk with the actual researcher.

    This award has been given to 15 Relay For Life teams nationwide since its inception in 2017, including one special exception this year. To win this award, teams must raise $165,000 in a calendar year. 

    In 2019, we had three teams qualify for the Heroes of Research Award — Nucor Steel Louisiana (from Relay For Life of St. James Parish, LA), The Naturals (from the Relay For Life of York, PA), and Ravens in the Hood (from Fighting Cancer to the Coast in Seaside, OR). Among the three teams, they raised more than $285,000 over what they did in 2018.

    Let’s learn more about these three impressive Hero of Research teams! 

    Nucor Steel Louisiana Relay For Life Team

    Nucor Steel Louisiana is a part of the Nucor Corporation based in Charlotte, North Carolina. The team has participated in the St. James Parish Relay event since 2013. It became a Hero of Research in 2018 by raising $217,00. Nucor Steel Louisiana team was awarded a second Hero of Research Award in 2019 by raising $200,000 more than it did in 2018.

    Nucor Steel Louisiana is the only team to receive two Hero of Research Awards, allowing it to name two research grants. The team named its first grant “The Nucor Bailee-Bee DIPG Grant,” and named its second grant “Bailee’s Brigade mTOR Grant” in honor of a teammate’s 12-year-old daughter. 

    The Naturals Relay For Life Team (pictured above)

    The Naturals is a team made up of staff from the United Natural Foods. The Naturals begin fundraising for Relay For Life 10 years ago, and had been consistently raising around $100,000 yearly. In 2018, the team raised a little more than $84,000. Members of the team wondered if they should continue as a team, however in 2019 the team had the best year yet by raising more than $166,000. The Hero of Research Award is a great way to recognize this team for its 2019 fundraising effort. The Naturals now have a renewed excitement.

    This team named its first grant “Gabby Galino and The Naturals of UNFI Hope Research Grant” to honor Gabby Galino, a 13-year-old student at Northern Middle School in York County who is battling cancer. Gabby was diagnosed with stage 4 Hodgkin’s Lymphoma in October. UNFI (the company that supports The Naturals) has rallied around her, helping the family fundraise to pay their medical bills, and supporting the team.

    Ravens in the Hood (pictured in the smaller image)

    Ravens in the Hood is an incredible high school team from Ravenscroft School in North Carolina. This team participates in the Fighting Cancer to the Coast DetermiNation event where athletes run in the Hood To Coast Relay in teams of 8-12 people for 199 mil, from Mount Hood to Seaside, OR. The team has raised approximately $450,000 solely through Fighting Cancer to the Coast, and it also supports Crucial Catch in their hometown of Raleigh, NC, raising more than $80,000 in three years. Because of their dedication to the American Cancer Society mission, an exception for Ravens in the Hood was made so it could become a Hero of Research Award winner, an honor usually reserved for Relay teams. Watch this video to learn more about their experience

    This team named its first grant “Ravenscroft School Cancer Research Fund” to honor the students, faculty, and alumni that are part of the team and who do so much every year to make their team successful. 

    Congratulations to all three teams! If you have any questions, please contact Steve Konsdorf, director, Relay For Life platform initiatives.

  • Cancer research insights from the latest decade, 2010 to 2020

    ​In the last 10 years, the overall cancer death rate has continued to decline. Researchers in the U.S. and across the world have made major advances in learning more complex details about how to prevent, diagnose, treat, and survive cancer. 

    At the forefront of emerging cancer research is the success of immunotherapy, the growing role of precision medicine, the influence that reducing health disparities can have on cancer outcomes, and the development and use of liquid biopsies and machine learning, which is allowing scientists to make sense of "big data." 

    Here's a look at some of the significant advances from the past 10 years that are helping to save lives now – and how ACS research has contributed to each one.

    Treating Cancer Became More Precise

    Precision medicine is helping move cancer treatment from one-size-fits-all to an approach where doctors can choose treatments that are most likely to successfully treat a person's cancer based on the detailed genetic information of that person's specific cancer. With advances leading to faster and less expensive gene sequencing, precision medicine is starting to be used more often to treat patients, most notably in the treatment of lung cancer. Over the last 10 years, many researchers with ACS grants have contributed to that growth. For instance, ACS-funded researchers across the U.S. have developed ways to quickly analyze the large amounts of data that result from gene sequencing, identify mutations in lung cancer genes, and helped find new treatments for lung cancer patients when the precision drug they were using stopped working. ACS also helped fund research on precision medicines for triple negative breast cancer, pancreatic cancer, certain brain cancers, and other types of cancer. 

    Cancers Can Spread With Help From Their Neighbors

    Once cancer spreads (metastasizes) from one place in the body to another, the chances of survival decrease. Until recently, scientists haven't known how much help cancer cells get from other types of cells and substances in their microenvironment. The microenvironment is the immediate area around the tumor. Over the last 10 years, ACS grantees defined features of cancer cells that must be present for metastasis to happen. They also learned more about how cancer cells:

    Identifying each "helper" in the microenvironment could lead to new targets for novel treatments that can help shut down the cancer's growth and ability to spread.

    Two New Types of Immunotherapy Were Developed

    CAR T-cell therapy (also called gene therapy) involves making changes to a patient's T cells (a type of immune cell) in the lab so they can better fight cancer. The ACS helped fund some of the pioneering research involved in the development and improvement of Kymriah (tisagenlecleucel), the first gene therapy approved by the FDA. This drug can be used to treat leukemia and lymphoma in children and adults.

    Immune checkpoint inhibitors are another type of immunotherapy. They stop cancer cells from "hiding" from the immune system. But over time, patients develop resistance to these drugs, and ACS grantees are finding solutions. They've found that:

    More People Started Getting the Message that Obesity Is Linked with Cancer

    Obesity is now the second-leading cause of preventable cancer deaths in the U.S. There's clear evidence that excess weight increases the risk for developing cancer, but research continues in order to better understand the full effect obesity has on cancer. In 2016, the ACS Cancer Prevention Study-II (CPS-II) linked excess weight with 13 types of cancers. Here are some other key findings from ACS research related to obesity:

    Smoking Is Still the Most Preventable Cause of Cancer Deaths

    Though fewer people use tobacco worldwide, smoking remains the leading cause of preventable deaths from cancer. In the past decade, ACS researchers have continued pioneering studies on the complexities of tobacco economics, showing that higher taxes on cigarettes reduce smoking and that increasing such taxes in states where they are still low could save lives. ACS researchers also found that illicit trade and harm to tobacco farmers are mostly myths sustained by the tobacco industry to stop public health efforts. The Surgeon General used ACS data to help show the far-reaching damage from smoking includes associations with breast and prostate cancer, as well as kidney failure, hypertension, infections, and respiratory diseases. In 2013, ACS research showed that women's risk of dying from smoking had caught up to men's.

    Researchers Discover More About the Microbiome's Influence on Cancer

    The microbiome is a complex community of microorganisms like bacteria, fungi, and viruses that live on and in our bodies. When there's a healthy mix of these microorganisms, they do a variety of tasks like help our immune system function, and help our bodies digest food and absorb nutrients. But when the mix becomes out of balance, it may lead to disease, including cancer. Recently, researchers discovered that an unbalanced microbiome may influence metastasis, the spread of cancer to distant parts of the body. For example, in 2017, ACS research found that Fusobacterium travels with colon cancer cells as they metastasize. This close pairing of bacteria and cancer cells gives researchers an exciting opportunity to test whether antibiotics may help patients with Fusobacterium-associated colorectal cancer. ACS research has also contributed greatly to understanding the microbiome's role in immunotherapies, especially for melanoma.

    DNA Mutations Aren't the Only Causes of Cancer

    Epigenetics refers to changes in how genes behave that don't involve changes to the gene itself. Put more simply, you can think of cells as actors, and DNA as the script, which includes the stage directions about key actions. Epigenetics would be like directing. The script (DNA) may be the same, but the director is able to change the movie for better or worse. Both gene changes and epigenetic changes can be involved with cancer. In the last 10 years, ACS-funded researchers have been on the forefront of epigenetics research. Some of their findings include:

    Health Equity Matters

    Health equity is the idea that everyone has a fair and just opportunity to prevent, find, treat, and survive cancer. Tracking health disparities, a difference in health that's closely linked with an economic, social, or environmental disadvantages, is a way to measure progress toward achieving health equity. In the last 10 years, ACS-funded research has studied a range of causes for healthcare disparities and a diverse set of health equity issues. Some of their key findings include:

    New Understanding About Cancer Cells' Metabolism Opens the Door for New Drug Targets

    Like normal cells, cancer cells grow by using metabolic processes to convert "food" (carbohydrates, fats, and proteins) into energy. But cancer cells have abnormal metabolisms that help them multiply and spread quickly. Over the last 10 years, ACS-funded researchers have been actively involved in work that could lead to the development of drugs that could kill cancer cells by interfering with their metabolism. Here are some of the potential new drug targets they've discovered.

    • A protein in a cancer cell that's abnormal. This protein is made by a mutated gene. Normally, it keeps tumors from growing. But when the protein comes from a mutated gene, it does the opposite and helps a tumor grow. A drug that targets this protein could slow a cancer's growth.
    • A type of amino acid. Amino acids are one type of fuel used by cancer cells to grow, and it may be particularly important for pancreatic cancer. A drug that targets this amino acid could cut off a "food" supply to the cancer.
    • The mutated genes in a cancer cell that make an abnormal enzyme. This enzyme is part of the machinery cells use to turn food into energy. Drugs that target this gene in cancer metabolism may help treat some difficult-to-treat cancers, including certain brain or spinal tumors (gliomas) and cancer in the bile duct (cholangiocarcinoma).
    • The gene that's activated in areas where there's too little oxygen. This often happens when cancer cells are growing very rapidly. A drug that targets this gene could prevent cancer from surviving in such areas.

    Researchers Highlighted the Benefits of Receiving Palliative Care Early in Cancer Treatment

    With cancer, there are two modes of care—treatment directed at the disease and treatment, known as palliative care, which is focused on the person with the disease. This type of care helps patients and caregivers manage symptoms from the cancer and side effects from the treatment. Clinical trials have shown that when people with cancer receive both types of treatment at the same time, their symptoms are controlled better, and they have less anxiety and depression, improved family satisfaction and quality of life, improved use of healthcare resources, and longer survival. Palliative care is one of the fastest growing areas of health care in the US, and it's changing as new treatments emerge, especially for cancer patients.

    Over the last decade, ACS-funded researchers led the field in publishing studies on the benefits of early palliative care, finding that patients with metastatic non-small-cell lung cancer who received palliative care early in their treatment had big improvements in their quality of life and mood. A 2017 paper by an ACS-grantee explained why the US needs more palliative care programs, outlining ideas for implementing a national strategy. Furthermore, ACS grantees helped develop an online and face-to-face curriculum to increase education about pediatric palliative care for healthcare providers and to promote resilience as part of stress management for parents of children living with a serious illness.

    The Future

    ACS has taken steps to prepare for the next decade of cancer research including developing a blueprint to improve cancer control in the US, increasing the ability for some of the best cancer experts to work together, collecting blood and tissue samples from volunteers in the ACS Cancer Prevention Studies-3 (CPS-3) that will allow for more research, and starting new partnerships that can help promote more cancer research, such as with St. Baldrick's Foundation for children's cancers and the Melanoma Research Alliance. Just as researchers build on past discoveries while keeping their eyes on the future, our eyes are on our competitor—cancer—and on the prize—a world without cancer. 

    NOTE: This story by Sandy McDowell, Sarah Ludwig Rausch, and Kenna Simmons first appeared on

  • Report links recommended physical activity levels to lower risk of seven cancers

    Aim for 2.5 to 5 hours per week of moderate-intensity activity, or 1.25 to 2.5 hours of vigorous activity

    A pooled analysis of nine prospective studies involving more than 750,000 adults finds that recommended amounts of leisure-time physical activity were linked to a lower risk for seven cancers, with several cancer types having a ‘dose/response’ relationship. The study was led by investigators at the National Cancer Institute, the American Cancer Society, and the Harvard T.H. Chan School of Public Health, and appears in the Journal of Clinical Oncology.

    While it’s long been known that physical activity is associated with a lower risk of several cancers, less clear has been the shape of the relationship and whether recommended amounts of physical activity are associated with lower risk. Updated guidelines for activity now state that people should aim for 2.5 to 5 hours per week of moderate-intensity activity, or 1.25 to 2.5 hours/week of vigorous activity. Moderate-intensity activities are those that get you moving fast enough or strenuously enough to burn off three to six times as much energy per minute as sitting quietly (3 to 6 METs). Vigorous-intensity activities burn more than 6 METs. (MET is the ratio of the rate of energy expended during an activity to the rate of energy expended at rest.)

    For the current analysis, investigators pooled data from nine prospective cohorts with self-reported leisure-time physical activity and follow-up for cancer incidence, looking at the relationship between physical activity with incidence of 15 types of cancer.

    They found engaging in recommended amounts of activity (7.5 to 15 MET hours per week) was associated with a statistically significant lower risk of seven of the 15 cancer types studied, with the reduction increasing with more MET hours. Physical activity was associated with a lower risk of colon cancer in men (8% for 7.5 MET hours/week; 14% for 15 MET hours/week), female breast cancer (6%-10%), endometrial cancer (10%-18%), kidney cancer (11%-17%), myeloma (14%-19%), liver cancer (18%-27%), and non-Hodgkin lymphoma (11%-18% in women).

    The analysis had some limitations: Even with 750,000 participants, patient numbers were limited for some cancers; participants were primarily white; there was a limited number of cohorts with detailed physical activity measures; and the authors relied on self-reported physical activity.

    The authors conclude: “These findings provide direct quantitative support for the levels of activity recommended for cancer prevention and provide actionable evidence for ongoing and future cancer prevention efforts.”

    “Physical activity guidelines have largely been based on their impact on chronic diseases like cardiovascular disease and diabetes,” said Alpa Patel, PhD, senior scientific director of epidemiology research at ACS. “These data provide strong support that these recommended levels are important to cancer prevention, as well.” 

  • Affordable Care Act improved care of colorectal cancer in young adults

    ​The Affordable Care Act (ACA) has led to better treatment for young adults diagnosed with colorectal cancer, according to a study from the American Cancer Society. 

    A provision in the ACA allows young adults up to age 26 to be covered under their parents' private health care insurance. The study, published December 19, 2019 in the Journal of the National Cancer Institute, says the provision helped these young adults get diagnosed earlier and start some treatments sooner.

    The researchers, led by Leticia Nogueira, PhD, MPH, pictured here, used the National Cancer Database to look at data from more than 10,000 young adults diagnosed with colorectal cancer between 2007 and 2013. They compared outcomes for those diagnosed before the ACA took effect in 2010 with those diagnosed after it took effect. They looked at 2 age groups: 19 to 25-year-old patients, who were eligible to be on their parents' insurance, and 27 to 34-year-old patients, who had "aged out" of their parents' health insurance.

    They found eligible patients got better care after the ACA was enacted:

    • The percent diagnosed with early stage cancer increased from 12.8% before the ACA to 27.8% after the ACA went into effect. Early stage cancers are generally easier to treat than later stage cancers.
    • Those who had surgery for stage IIB to IIIC colorectal cancer were 34% more likely after ACA to receive adjuvant, or additional chemotherapy, which is widely considered to be the standard of care.
    • Among those who received adjuvant chemotherapy, the average time from surgery to chemotherapy was 7 days shorter: from 57.4 days before ACA to 50.4 days after ACA.

    At the same time, there was no significant change in care after the ACA took effect for the patients not eligible to be on their parents' insurance.

    The people in the study were too young for routine colorectal cancer screening. The authors write the improvements in care are most likely due to better access to health care that helped them get symptoms checked out earlier.

  • 2019 in Review: New cancer drug approvals

    Chemotherapy is one of the most powerful tools we have to treat cancer, and research continues to find new chemotherapy drugs as well as new uses for existing ones. At the same time, newer types of drugs are being developed that work in different ways to attack cancer cells. These types of treatments include targeted therapy, which aims to more precisely identify and go after cancer cells while doing less damage to normal cells, and immunotherapy, which uses the body's own immune system to help find and destroy cancer.

    Before any new drug can be sold in the United States, it goes through an approval process. The FDA evaluates evidence from testing to decide whether the drug's benefits outweigh any known risks. The FDA also provides doctors and patients with information about how to use the new drug safely.

    In 2019, the FDA approved several new drug treatments for different cancer types that American Cancer Society editors believe will make a significant difference.

    Bladder Cancer

    Balversa (erdafitinib) is the first targeted therapy approved for bladder cancer. The FDA approved this drug in April for adults with advanced bladder cancer with a mutation in the FGFR3 or FGFR2 gene, and that has gotten worse after treatment with chemotherapy. The FDA also approved a test to look for these gene mutations.

    Breast Cancer

    In March, the FDA approved the first immunotherapy treatment for breast cancer. It's a combination of Tecentriq (atezolizumab) and Abraxane (nab-paclitaxel) for people with advanced triple negative breast cancer. There are few other treatments available for this aggressive cancer type.

    In May, the FDA approved the targeted therapy Piqray (alpelisib) for a type of breast cancer caused by a certain inherited genetic mutation. It's the first treatment of its kind for this cancer type.

    Head and Neck Cancer

    The immunotherapy drug Keytruda (pembrolizumab) was approved in June as a first-line, or initial, treatment for people with advanced head and neck cancer. Keytruda is also used to treat people with several other cancer types.

    Lung Cancer

    The FDA approved Tecentriq (atezolizumab) in March as the second immunotherapy drug for people with advanced small cell lung cancer, and the first for use as part of first-line treatment. Tecentriq is also used to treat people with several other cancer types.


    In June, the FDA approved the first antibody-drug conjugate to treat diffuse large B-cell lymphoma, the most common type of non-Hodgkin lymphoma in the US. An antibody-drug conjugate is a targeted drug combined with chemotherapy. The targeted drug finds the cancer cell and then delivers the chemo to destroy it. The new drug, Polivy (polatuzumab vedotin-piiq), is approved to be used along with the chemotherapy drug bendamustine and a rituximab product.

    Multiple Cancer Types

    For just the third time, the FDA approved a drug to treat tumors with a specific genetic change regardless of cancer type. Rozlytrek (entrectinib) was approved in August for adults and adolescents with tumors that test positive for NTRK gene changes, which can help cancerous tumors grow.

    NOTE: This story by Stacy Simon first appeared on

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