Improving Health

Cancer

Lung Cancer

NIH-funded research on the prevention and treatment of lung cancer, including development of screening interventions and clinical guidelines, has contributed to a decline in U.S. lung cancer deaths by 54% since 1990 in men and by 30% since 2002 in women.

Image credit: National Cancer Institute, NIH

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  • NIH-supported advances in CT scans enable earlier lung cancer detection, and this influenced the U.S. Preventive Services Task Force’s recommendation that middle-aged and older adults with a history of heavy smoking be screened with spiral CT. 
  • NIH supported the development of new treatments for lung cancer, including targeted therapies and immunotherapies.
  • Reductions in smoking reached an all-time low of 13.7% of U.S. adults in 2018, also contributing to declines in lung cancer deaths.
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BRCA Mutations

NIH research led to the identification and characterization of BRCA gene mutations in breast, ovarian, prostate, and pancreatic cancers. Families with a history of these cancers can now use genetic test results to make informed decisions about screening, prevention activities, and treatments.

Image credit: Ernesto del Aguila III, NHGRI

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  • A patient’s lifetime risk of developing breast and/or ovarian cancer is greatly increased if they inherit a harmful mutation in genes BRCA1 or BRCA2. 
  • Understanding this link has saved patient lives through changes to cancer screening, prevention, and treatment:
    • Guidelines for screening for patients with BRCA mutations are different than for average-risk patients.
    • Risk lowering drugs and prophylactic mastectomy are prevention options.
    • A class of drugs known as PARP inhibitors are recommended treatments for patients with BRCA mutations.
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Breast Cancer

NIH-supported research has helped identify major breast cancer subtypes based on tumors’ molecular features, which enables treatments to be tailored to the cancers’ specific molecular profiles. This has contributed to the 41% drop in breast cancer death rates for patients between 1990 and 2019.

Image credit: Bruce Wetzel and Harry Schaefer, National Cancer Institute, NIH

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  • Nearly 300,000 people are diagnosed with breast cancer each year, and about 44,000 people die from the disease annually. 
  • In the U.S., one in eight women will develop breast cancer in her lifetime. 
  • Targeted treatments exist for HER-2-positive breast cancer, breast cancers with BRCA gene mutations, and some triple-negative breast cancers.
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Cervical Cancer

Between 1975 and 2018, the incidence rate of cervical cancer in the U.S. dropped 55%, and the death rate dropped 60%. This is in part due to NIH-supported research that led to screening and prevention approaches, including the development of HPV testing and vaccines.

Image credit: National Cancer Institute, NIH

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  • Routine Pap tests allow doctors to find and treat precancerous lesions caused by human papillomavirus (HPV) infection, preventing cervical cancer from developing.
  • HPV vaccines have been shown to reduce infections from the types of HPV that cause cancer and prevent cervical precancers and cancers.
  • Because of the availability of HPV vaccines, screening, and treatments, in 2020 WHO announced that 194 countries have committed to ending cervical cancer—the first global commitment to eliminate a cancer.
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Colorectal Cancer

NIH-funded research on colorectal cancer has improved the prevention, early detection, and treatment of this cancer, contributing to a 55% drop in death rates from 1970 to 2018.

Image credit: NCI Center for Cancer Research

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  • NIH-supported research on the biology of colorectal cancer and ways to detect its precursors has led to a number of screening tests, contributing to its early detection and prevention. 
  • NIH-funded research has contributed to surgical and systemic therapies for patients with colorectal cancer.        
  • The colorectal cancer death rate has dropped by 55%, from 29.2 per 100,000 in 1970 to 13.1 per 100,000 in 2018, due to prevention and earlier detection through screening and improvements in treatment.
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Melanoma

The death rate due to melanoma—the most serious type of skin cancer—has dropped almost 18% from 2013 to 2016, due in part to NIH-supported research that has led to the development of new therapies.

Image credit: Sriram Subramaniam, NCI

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  • Melanoma is a rare form of skin cancer, though rates have been increasing over the last 30 years. It is more likely to invade nearby tissues and spread to other parts of the body than other types of skin cancer, and it causes the most skin cancer deaths.
  • Until 2011, there were no effective treatments for advanced (metastatic) melanoma. Building on NIH-supported research on disease mechanisms, targeted therapies for common molecular changes in melanoma and immunotherapies have dramatically changed these outcomes.
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Chemotherapy

Since the 1950s, researchers at NIH have played a large role in developing chemotherapy for cancer and testing various combinations of chemotherapy drugs. This led to effective treatments for many forms of cancer and a dramatic increase in childhood cancer survival rates from 5% before 1950 to 85% today.

Image credit: National Cancer Institute, NIH

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  • Of note, in 1958, chemotherapy drugs were used at the NIH Clinical Center to treat solid tumor cancers, such as lung, breast, or prostate cancers (rather than leukemia or lymphoma). At the time this was a unique way to treat cancer, and the study showed that chemotherapy could be effective.            
  • Chemotherapy is now a standard treatment for solid tumor cancers, and each year about 650,000 cancer patients receive chemotherapy in outpatient oncology clinics in the U.S.
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Cisplatin Chemotherapy

NIH-supported research led to the development of Cisplatin, a type of chemotherapy commonly used to treat testicular, ovarian, cervical, lung, and bladder cancers. Millions of people have benefited from cisplatin treatment and, when used with other chemotherapy drugs, its cure rate for testicular cancer is more than 90%.

Image credit: Karl Harrison 3DChem.com

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  • While studying the effects of electrical fields on bacteria, an NIH-funded researcher discovered that platinum chemicals inhibited bacterial growth. Of these platinum-containing compounds, cisplatin was found to stop or slow the growth of certain cancer cells. 
  • Cisplatin was first approved in the U.S. for clinical use to treat cancer in 1978. Today, research is actively ongoing to discover better ways to use cisplatin in the fight against cancer.
  • Cisplatin and similar platinum-based drugs are prescribed for an estimated 10-20% of all cancer patients.
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Precision Therapy

Thanks to NIH-supported development of the precision cancer treatment, imatinib (Gleevec®), patients with chronic myelogenous leukemia (CML) now have a nearly normal life expectancy.

Image credit: Rhoda Baer/NCI

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  • One of the first precision cancer treatments to receive FDA approval in 2001, Gleevec® specifically blocks an abnormal protein that causes CML and is not found in healthy cells. It is now the standard therapy for CML patients.
  • Due in part to targeted treatments like Gleevec®, the 5-year survival rate for CML has more than tripled from 22% in the mid-1970s to 67% for those diagnosed between 2008 and 2014.
  • CML patients are now expected to live 30 years post-diagnosis, essentially a normal lifespan.
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Immunotherapy

Decades of NIH-funded research on the immune system and cancer has led to the development of immunotherapies for over 15 different cancer types and counting. Research shows that 52% of patients with metastatic melanoma who received immunotherapy are still alive after five years, up from just 5% before immunotherapy was developed.

Image credit: Rita Elena Serda, Duncan Comprehensive Cancer Center at Baylor College of Medicine, National Cancer Institute, NIH

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  • Immunotherapy is a treatment that uses the patient’s own immune system to fight cancer by enhancing or restoring the immune system’s ability to fight the disease.
  • Immune checkpoint inhibitors, a specific type of immunotherapy, facilitate the immune system’s ability to kill cancer cells more effectively by removing naturally occurring barriers, or “immune checkpoints.” 
  • In another kind of immunotherapy, called CAR T cells, a patient’s own immune cells are engineered to target and destroy cancerous cells. These have been most effective for blood cancers so far.
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Neuroblastoma

More than 30 years of research by NIH-supported scientists led to the development of Unituxin™ (dinutuximab or monoclonal antibody ch14.18), a treatment that is now a first-line therapy for aggressive neuroblastoma. Neuroblastoma is a rare cancer that most often occurs in young children, and this treatment has increased the 5-year survival rate by 20%.

Image credit: Dr. Maria Tsokos, National Cancer Institute

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  • Approved by FDA in 2015, Unituxin™ resulted from 30 years of NIH-funded research on antibody-based immunotherapy—from discovery through phase 3 clinical trials.
  • Before Unituxin™, fewer than 40% of children with aggressive neuroblastoma lived 5 years after diagnosis. Used in combination with a treatment that helps turn on the patient’s immune system, this is the first effective immunotherapy for neuroblastoma shown to reduce the risk of recurrence and improve survival.
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Childhood Leukemia

Prior to the 1950s, childhood acute lymphocytic leukemia (ALL) was a fatal disease, and little was known about its biology. Long-term NIH investments in cancer research have transformed outcomes for children with ALL—as a result of treatments available today, more than 90% of children with ALL are cured.

Image credit: Bill Branson/NCI

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  • ALL treatment regimens, which involve combination chemotherapy, radiation, stem cell transplant, and immunotherapy, have improved thanks to NIH-funded research. 
  • NIH's clinical trials networks have contributed to a culture in which around 60% of children with cancer participate in clinical trials, compared to around 5% of adult patients with cancer. These networks and this level of participation has enabled many of these advances for children with cancer.
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Declining Death Rates

Long-term NIH investments in cancer research have contributed to a decline in overall age-adjusted death rates for all cancers in the U.S. The overall age-adjusted cancer death rate dropped 31% from 1991 to 2018.

Image credit: Bill Branson/NCI

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  • This decline in deaths due to cancer is a result of advances in prevention (particularly reductions in smoking), early detection, and new treatments for cancer.
  • It is estimated that the drop in cancer death rates translates into almost 3.2 million deaths averted from 1991-2018.
  • While disparities still exist, mortality disparities between Black and White individuals have been reduced by more than half since 1990.
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References

Lung Cancer

  1. Cancer Stat Facts: Lung and Bronchus Cancer: https://seer.cancer.gov/statfacts/html/lungb.html
  2. National Lung Screening Trial: https://www.cancer.gov/types/lung/research/nlst
  3. Howlader N, et al. N Engl J Med. 2020;383(7):640-649. PMID: 32786189.
  4. Article: Cigarette Smoking Among U.S. Adults Hits All-Time Low: https://www.cdc.gov/media/releases/2019/p1114-smoking-low.html#:~:text=Cigarette%20smoking%20among%20U.S.%20adults%20has%20reached%20an%20all%2Dtime,the%20health%20consequences%20of%20smoking.
  5. Moyer VA, et al. Ann Intern Med. 2014;160(5):330-8. PMID: 24378917.
  6. Klabunde CN, et al. Am J Prev Med. 2022;62(2):e77-e86. PMID: 34657771.

BRCA Mutations

  1. BRCA Gene Mutations: Cancer Risk and Genetic Testing: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet
  2. Enhancing Breast and Ovarian Cancer Care: The Discovery of BRCA1 and BRCA2: https://www.cancer.gov/research/progress/discovery/brca
  3. BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing;
  4. Hadar T, et al. JAMA Oncol. 2020;6(9):1460-1463. PMID: 32644100.

Breast Cancer

  1. Report: Breast Cancer Death Rates Down 40% Since 1989: https://www.cancer.org/latest-news/report-breast-cancer-death-rates-down-40-percent-since-1989.html
  2. Breast Cancer Facts: https://www.nationalbreastcancer.org/breast-cancer-facts?gclid=Cj0KCQjwg7KJBhDyARIsAHrAXaFs7_vbKd1BHP_CVds81wVE7TYryvCosb7huenkNn4tV7agpP8zdlkaApNSEALw_wcB
  3. Breast Cancer Treatment: https://www.cancer.gov/types/breast/patient/breast-treatment-pdq

Cervical Cancer

  1. Cancer Stat Facts: Cervical Cancer: https://seer.cancer.gov/statfacts/html/cervix.html
  2. Cervical Cancer Screening: https://www.cancer.gov/types/cervical/screening
  3. Cervical Cancer Prevention: https://www.cancer.gov/types/cervical/hp/cervical-prevention-pdq
  4. Article: An Estimated 92% of Cancers Caused by HPV Could be Prevented by Vaccine: https://www.cdc.gov/media/releases/2019/p0822-cancer-prevented-vaccine.html
  5. What Is Cervical Cancer?: https://www.cancer.gov/types/cervical
  6. Article: NCI’s Douglas R. Lowy and John T. Schiller to receive 2017 Lasker Award: https://www.nih.gov/news-events/news-releases/ncis-douglas-r-lowy-john-t-schiller-receive-2017-lasker-award

Colorectal Cancer

  1. Cancer Facts & Figures 2021: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2021.html
  2. Article: Advances in Colorectal Cancer: https://www.webmd.com/colorectal-cancer/features/advances-in-colorectal-cancer
  3. Screening Tests to Detect Colorectal Cancer and Polyps: https://www.cancer.gov/types/colorectal/screening-fact-sheet

Melanoma

  1. Skin Cancer (Including Melanoma): https://www.cancer.gov/types/skin
  2. Melanoma Treatment: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq
  3. Melanoma of the Skin: Recent Trends in U.S. Age-Adjusted Mortality Rates, 2000-2020: https://seer.cancer.gov/explorer/application.html?site=53&data_type=2&graph_type=2&compareBy=sex&chk_sex_1=1&chk_sex_3=3&chk_sex_2=2&race=1&age_range=1&advopt_precision=1&advopt_show_ci=on&advopt_display=2
  4. Deaths from Metastatic Melanoma Drop Substantially in the United States: https://www.cancer.gov/news-events/cancer-currents-blog/2020/metastatic-melanoma-deaths-drop

Chemotherapy

  1. Zubrod CG, et al. Cancer Chemother. Rep 1966; 50: 349–540. 
  2. DeVita VT Jr, et al. Cancer Res. 2008;68(21):8643-53. PMID: 18974103.
  3. Information for Health Care Providers: https://www.cdc.gov/cancer/preventinfections/providers.htm#:~:

Cisplatin Chemotherapy

  1. Curiosity Creates Cures: The Value and Impact of Basic Research: https://www.nigms.nih.gov/education/fact-sheets/Pages/curiosity-creates-cures.aspx
  2. The "Accidental" Cure—Platinum-based Treatment for Cancer: The Discovery of Cisplatin: https://www.cancer.gov/research/progress/discovery/cisplatin

Precision Therapy

  1. Gambacorti-Passerini C, et al. Am J Hematol. 2015;90(2):156-61. PMID: 25370814.
  2. Druker BJ, et al. N Engl J Med. 2006;355(23):2408-17. PMID: 17151364.
  3. Druker B. Keio J Med. 2010;59(1):1-3. PMID: 20375651.

Immunotherapy

  1. Larkin J, et al. N Engl J Med. 2019;381(16):1535-1546. PMID: 31562797.
  2. Immune Checkpoint Inhibitors: https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/checkpoint-inhibitors
  3. Melanoma Treatment: https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq
  4. CAR T Cells: Engineering Patients’ Immune Cells to Treat Their Cancers: https://www.cancer.gov/about-cancer/treatment/research/car-t-cells

Neuroblastoma

  1. Harnessing the Power of Our Immune Systems to Treat Neuroblastoma: Discovery of Ch14.18 Immunotherapy: https://www.cancer.gov/research/progress/discovery/neuroblastoma
  2. Investments in Basic Research for Pediatric Cancers: https://visualsonline.cancer.gov/details.cfm?imageid=11963

Childhood Leukemia

  1. Childhood Cancer Research Highlights: https://www.cancer.org/research/acs-research-highlights/childhood-cancer-research-highlights.html
  2. Children’s Oncology Group: What is a Clinical trial?: https://www.childrensoncologygroup.org/clinicaltrials-136
  3. Smith MA, et al. Cancer. 2014;120(16):2497-506. PMID: 24853691.
  4. National Academy of Sciences. Curing Childhood Leukemia. 1997. http://www.nasonline.org/publications/beyond-discovery/curing-childhood-leukemia.pdf

Declining Death Rates

  1. Siegel RL, et al. CA Cancer J Clin. 2021;71(1):7-33. PMID: 33433946.

This page last reviewed on March 1, 2023