Table of Contents A Message from AACR..................................................1 Executive Summary......................................................3 A Snapshot of a Year in Progress.............................10 Cancer in 2023..............................................................12 Research: Driving Progress Against Cancer.......12 Cancer: An Ongoing Public Health Challenge.....14 Inequities in the Burden of Cancer in the United States...............................................................15 Variable Progress Against Different Types of Cancer and Stages of Diagnosis..................................20 The Growing Population Burden of Cancer...................20 The Global Burden of Cancer.............................................21 Funding Cancer Research: A Vital Investment...22 Understanding the Path to Cancer Development..................................................24 Cancer Development: Generating Knowledge....24 Basic Research: Vital for Making Progress Against Cancer....................................................27 Cancer Development: Interpreting Knowledge...29 Changes That Contribute to Cancer Initiation..............29 Genetic Alterations...............................................................29 RNA Variations........................................................................31 Protein Modifications...........................................................32 Epigenetic Changes.............................................................32 Systems That Enable Cancer Progression......................32 The Blood System.................................................................32 The Lymphatic System........................................................33 The Immune System.............................................................34 Processes That Promote Cancer Growth and Metastasis.......................................................................34 Tumor Heterogeneity...........................................................34 Epithelial-to-mesenchymal Transition...........................35 Tumor Microenvironment...................................................35 Cancer Development: Integrating Knowledge.....35 Reducing the Risk of Cancer Development...........38 Eliminate Tobacco Use............................................38 Maintain a Healthy Weight, Eat a Healthy Diet, and Stay Active.................................41 Reduce Risk of Diabetes.........................................44 Limit Alcohol Consumption...................................46 Protect Skin from UV Exposure.............................47 Prevent and Eliminate Infection from Cancer-causing Pathogens.....................................48 Limit Exposure to Environmental Risk Factors...51 Be Cognizant of Hormonal Factors......................52 Pregnancy and Breastfeeding...........................................52 Hormone Replacement Therapy.......................................53 Screening for Early Detection..................................54 Importance of Cancer Screening........................54 Guidelines for Cancer Screening.........................58 Eligibility for Cancer Screening..........................59 Those at an Average Risk of Being Diagnosed with Cancer.......................................................60 Those at a Higher-Than-Average Risk of Being Diagnosed with Cancer............................................61 Suboptimal Uptake of Cancer Screening............61 Progress Toward Increasing Adherence to Cancer Screening Guidelines........................................64 New Frontiers in Cancer Screening....................65 Realizing the Potential of Artificial Intelligence for Early Detection of Cancers..........................................65 Moving Toward Minimally Invasive Cancer Screening....65 Advancing the Frontiers of Cancer Science and Medicine................................................................68 Clinical Research ..................................................68 Progress Across the Clinical Cancer Care Continuum.........................................71 Advances in Cancer Treatment with Surgery................74 Improving Quality of Life After a Cancer Surgery.....74 Visualizing Lung Cancers More Precisely During Surgery ......................................................................78 Improvements in Radiation-based Approaches to Cancer Care.......................................................................79 Imaging Prostate Cancer More Clearly.........................82 Advances in Treatment with Cytotoxic Chemotherapy....................................................82 Advances in Treatment with Molecularly Targeted Therapy..................................................................83 Expanding Treatment Options for Patients with Lung Cancer..................................................................83 Targeting Cancers Based on a Common Genetic Feature, Not Tissue of Origin...........................85 Delivering a Cytotoxic Drug Precisely to Ovarian Cancer Cells......................................................86 Improving Outcomes for Patients with Metastatic Breast Cancer.........................................86 Personalizing Treatment for Patients with a Rare Solid Tumor ....................................................87 Combining Molecularly Targeted Therapeutics to Block Tumor Growth.......................................................90 AACR Cancer Progress Report 2023 ii
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