The burden of cancer and its economic toll, both on individuals and on the U.S. health care system, are expected to rise in the coming decades, underscoring the urgent need for more research to accelerate the pace of progress against cancer. The progress highlighted in this report was made as a direct result of the cumulative efforts of individuals working across the spectrum of medical research and the support from the federal government. Public sector funding from NIH and NCI directly contributes to patient benefit such as through the development of lifesaving anticancer therapeutics. Continued federal investments in NIH, NCI, FDA, and CDC will help the medical research community maintain the momentum of scientific and technological innovation, accelerate the pace of progress against cancer, and ensure that we achieve the President’s Cancer Moonshot goal of reducing U.S. cancer death rates by 50 percent by the year 2047. Understanding the Path to Cancer Development Decades-long research in basic, translational, clinical, and population sciences, and the breakthroughs stemming from it, have advanced our understanding of cancer development. Insights gleaned from this knowledge have revealed cancer as a collection of diseases that are characterized by unchecked cell multiplication. We now understand that different cancer types share many so-called hallmarks or characteristics. These hallmarks are primarily acquired through alterations in the genetic material of normal cells. The nature and the type of genetic alterations determine when cancer is initiated, how fast it progresses, and where in the body it spreads. Research has shown that there are two types of genetic mutations associated with cancer: inherited and somatic. Inherited mutations are passed on from parents to their progeny and contribute to about 10 percent of all cancer cases. Most cancers are caused by somatic mutations. Somatic mutations are acquired throughout a person’s lifetime and can arise in multiple ways, including from errors made during cell division, smoking, certain viral infections, exposure to UV radiation, and/or exposure to mutagens or other cancer-causing chemicals. Although cancer is a genetic disease at a fundamental level, transformation of normal cells into cancer cells, accumulation of cancer cells to form tumors, and spread of tumors to distant sites are all complex, multistep processes that are further influenced by changes outside the cell. As the disease progresses, cancer cells acquire additional characteristics that give them the ability to manipulate their cellular and molecular environment. The resultant tumor microenvironment can affect how the tumor grows and spreads, and cancer cells can reciprocally influence the tumor microenvironment to promote their survival. A technological revolution in our ability to study cancer at the levels of single cells and molecules has led to important insights, one of which is that each patient’s cancer is unique, thus providing the basis for precision medicine. Also called personalized medicine, precision medicine is broadly defined as treating patients based on molecular characteristics that distinguish them from other individuals with the same disease. As ongoing research continues to unravel the mechanisms of cancer onset and progression, researchers are already leveraging existing knowledge to develop more effective, personalized anticancer therapeutics and improve health outcomes for patients with cancer. Reducing the Risk of Cancer Development Research in basic, translational, and population sciences has broadened our understanding of the factors that increase an individual’s risk of developing cancer. Many of these risk factors are modifiable, such as reducing tobacco use, avoiding an In the United States, patients with cancer have collectively gained nearly 14 million years of life since 1980 as a result of NCIfunded clinical trials. HALLMARKS OF CANCER CELLS Spread to other parts of the body Multiply limitlessly Increase blood vessel formation toward tumor Evade the immune system Increase nutrient and oxygen supply to the tumor Escape cell death Grow uncontrollably Accumulate changes in the genetic material AACR Cancer Progress Report 2023 Executive Summary 4
RkJQdWJsaXNoZXIy NTkzMzk=