January 2, 2025

First ACS cancer report highlights neoadjuvant therapy expansion, improvements

Editor's Note

A significant increase in the use of neoadjuvant systemic cancer therapies is among the most notable findings from the first annual cancer report from The American College of Surgeons (ACS) National Cancer Database (NCDB). The report also emphasizes the value of early detection, innovative therapies, and robust datasets like the NCDB in advancing cancer care.

According to a December 3 announcement, the ACS cancer report covers 74% of all US diagnoses and focuses on trends in breast, colorectal, and pancreatic cancers. The data show that from 2010 to 2021, the use of neoadjuvant therapy such as chemotherapy and immunotherapy to treat breast, bladder, and pancreatic cancers before surgery continues to grow. Specifically, the use of neoadjuvant therapy for breast cancer rose from 11% in 2010 to 18% in 2021, while bladder and pancreatic cancers saw increases of 102% and 224%, respectively.  

The report reinforces the critical importance of early diagnosis, as patients with stage I or II cancers consistently show significantly higher five-year survival rates compared to those diagnosed at later stages, ACS reports. For instance, early-stage breast cancer patients have a 93% five-year survival rate, while survival drops to 19% for stage IV pancreatic cancer. Encouragingly, diagnoses of early-stage pancreatic cancer have increased, from 10% in 2004 to 28% in 2021, although most cases are still identified late due to limited screening protocols.

The report also revealed gender disparities in survival, with women demonstrating a five-year survival rate of 68% compared to 59% for men. Breast cancer, one of the most common diagnoses, also exhibited favorable trends, with stage I diagnoses increasing by 21% and stage IV diagnoses declining by 28% over the study period. Most breast cancer patients (66%) underwent lumpectomies, with 81% receiving adjunct radiation therapy.

According to the report, colorectal cancer continues to be diagnosed predominantly at later stages, particularly among younger populations. Surgical intervention remains a cornerstone of treatment, with 81% of patients undergoing colectomies.

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