Personalized medicine is continuing to take hold, according to the first-ever annual report from the National Cancer Database (NCDB) of the American College of Surgeons (ACS) Cancer Programs. Among the key findings was that more cancers are being treated with targeted medical therapies before surgery. The report also describes in-depth data on breast, colorectal, and pancreatic cancer, each of which are on the rise among young people.
The NCDB is a clinical oncology database jointly operated by the ACS and the American Cancer Society. It captures hospital-based data on approximately 74% of all cancers diagnosed in the U.S. and is one of the most comprehensive cancer research databases. The findings were published this week in the Journal of the American College of Surgeons (JACS).
“This report is our approach to making NCDB data more broadly available to others who may benefit from understanding this large source of cancer data and what it’s telling us about the current state of cancer diagnoses and treatments in the United States,” said first author Elizabeth B. Habermann, PhD, chair of the ACS Cancer Data Modeling Committee and a professor of health services research at the Mayo Clinic in Rochester, Minnesota.
The report summarizes new observations and recent trends in cancer diagnoses, and includes many details not usually included in other cancer reports, the authors said. Some additional metrics tracked in NCDB data include length of stay, hospital readmission rates, and hospital type (such as a community or academic institution). These metrics help hospitals assess quality of care and inform treatment options for the growing number of cancer patients nationwide, the authors added.
Of the 1,328,131 cancers diagnosed in 2021 at 1,281 reporting Commission on Cancer hospitals, one-fifth continue to be female breast cancer cases. In 2021, the NCDB’s five most common adult cancers were: breast, prostate, lung, colon, and melanoma.
The NCDB report found that colon cancer is one of the most common solid organ cancers diagnosed in both men and women, who were diagnosed at a median age of 68. Most commonly, patients were diagnosed with stage II or stage III colon cancer. About 81% of patients diagnosed with colon cancer underwent a colectomy, a surgery that involves removing all or part of the colon.
Early-stage breast cancer is on the rise: From 2004–2021, about 21% more women were diagnosed with early-stage (stage I) breast cancer, while rates of advanced-stage diagnoses (stage IV) declined overall by about 28%. Most patients who had breast surgery underwent lumpectomy (66%), and the majority of these women (81%) were also treated with radiation therapy. The use of hormone therapy treatment more than doubled from 3.3% in 2018 to 7.7% in 2020.
One of the key observations about pancreatic cancer is that there currently are no uniform guidelines on screening, and symptoms do not often appear until the cancer has spread, making it more difficult to treat. Also, more patients with pancreatic cancer are being treated with chemotherapy and other therapies before having surgery, with the use of neoadjuvant systemic therapy increasing by more than 200% from 2010 to 2021.
The authors noted that, “Future Annual Reports of the American College of Surgeons Cancer Programs will include new data as they are released as well as in-depth descriptions of other selected cancer sites.”
