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Established in 2008, the Deadliest Cancers Coalition is a collaboration of national non-profit organizations focused on addressing policy issues related to the nation’s most deadly, or recalcitrant, cancers. The Recalcitrant Cancer Research Act of 2012 defines these cancers as those with a five-year relative survival rate below 50 percent. The overall five-year relative survival rate for all cancers was approximately 50 percent back in 1971, when the “War on Cancer” was declared, and it has now risen to 68 percent. While there are various types of cancers that fall under the “recalcitrant” definition, it is worth noting that nearly half of the 589,430 cancer deaths expected in 2015 will be caused by eight of the deadliest sitespecific cancers: pancreas, lung, liver, esophagus, stomach, brain, ovary and myeloma.1 2015 EST. CANCER DEATHS MOST COMMON CANCERS: 2015 CASES, DEATHS AND FIVE-YEAR RELATIVE SURVIVAL RATES1 589,430 8 DEADLIEST SITE-SPECIFIC CANCERS COMBINED 290,200 (49.2%) 2015 Est. Cases 2015 Est. Deaths Five-Year Relative Survival Rate 48,960 40,560 7% 221,200 158,040 17% Liver & intrahepatic bile duct 35,660 24,550 17% Esophagus 16,980 15,590 18% Stomach 24,590 10,720 28% Brain and CNS 22,850 15,320 35% Ovary 21,290 14,180 45% Myeloma 26,850 11,240 47% Leukemia 54,270 24,450 60% 132,700 49,700 65% Non-Hodgkin Lymphoma 71,850 19,790 71% Kidney 61,560 14,080 72% Urinary Bladder 74,000 16,000 77% Uterine Corpus 54,870 10,170 82% 234,190 40,730 89% 73,870 9,940 91% 220,800 27,540 99% Pancreas Lung Colon and Rectum ALL OTHER CANCERS COMBINED 299,230 (50.8%) Breast Melanoma of the Skin Prostate The impact that these cancers are having on Americans is staggering and is intensified by the fact that there are significant gaps in our ability to help those diagnosed with these diseases. Lung cancer accounts for more deaths than any other cancer in both men and women.1 Ovarian cancer is the fifth leading cause of cancer-related death among women and is the deadliest of the gynecologic cancers.1 Although the incidence rates of stomach cancer have declined overall, studies indicate that the incidence of some forms of stomach cancer are significantly increasing for whites aged 25-59.2,3 Brain and central nervous system (CNS) cancer is the second most common pediatric site-specific cancer type in children and adolescents diagnosed at ages 0-19 and is the leading cause of cancer-related death in that same age group.4 deadliestcancers.org While overall cancer incidence trends are declining, the rates at which three of the recalcitrant cancers (pancreatic, liver and myeloma) have been diagnosed increased significantly between 1992 and 2010.5 In more recent years, the incidence of esophageal cancer in women has risen as well.6 And unfortunately, the long-term trends for death rates have also increased for both pancreatic and liver cancers.5 A 2014 study published in Cancer Research projected that pancreatic cancer will surpass breast and colorectal cancer to become the second leading cause of cancer-related death around 2020. Liver cancer will replace prostate cancer as the fifth leading cause of cancer-related death by 2020. The authors also projected that by 2030, the top five cancer killers in the United States will be lung, pancreatic, liver, colorectal and breast – a significant shift from the current ranking of lung, colorectal, breast, pancreatic and prostate.7 The projected rise of pancreatic and liver cancers in the rankings of leading cancer killers underscores the need for greater federal research investment to prevent these projections from coming true. PROJECTED CANCER-RELATED DEATHS7 160,000 Lung 140,000 80,000 Pancreas 60,000 Liver Colon and Rectum 40,000 Breast Prostate 20,000 0 2010 2020 2030 The Recalcitrant Cancer Research Act calls on the National Cancer Institute (NCI) to develop “scientific frameworks,” or strategic plans, to advance research on the deadliest cancers, first for pancreatic and lung cancers, with other recalcitrant cancers added at its discretion. As required by the Act, the NCI has released a scientific framework report outlining priority areas of research focus for pancreatic cancer, as well as a similar report for small-cell lung cancer. These reports demonstrate the vast potential for progress in diseases that are currently feared as some of the nation’s leading killers. The Deadliest Cancers Coalition strongly supports the use of this scientific framework model in developing reports for other deadly cancers. Unfortunately, the promise of research into the deadliest cancers is being severely undercut by the steady erosion of funding for the NCI. The Deadliest Cancers Coalition calls on Congress to consider the special challenges associated with the deadliest cancers and provide the NCI with the meaningful increase necessary to advance innovative research and build a better understanding of individualized disease – a critical first step toward the development of precision medicine strategies that may provide personalized treatment options for patients, which could be an essential tool in fighting the deadliest cancers. 1. Cancer Facts & Figures 2015. (Atlanta GA, USA, 2015). 2. Anderson, W. F. et al. Age-specific trends in incidence of noncardia gastric cancer in US adults. Jama 303, 1723-1728, doi:10.1001/jama.2010.496 (2010). 3. Camargo, M. C. et al. Divergent trends for gastric cancer incidence by anatomical subsite in US adults. Gut 60, 1644-1649, doi:10.1136/gut.2010.236737 (2011). 4. Cancer Facts & Figures 2014. (Atlanta GA, USA, 2014). 5. Edwards, B. K. et al. Annual report to the nation on the status of cancer, 1975-2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer 120, 1290-1314, doi:10.1002/cncr.28509 (2014). 6. Siegel, R. L., Miller, K. D. & Jemal, A. Cancer statistics, 2015. CA: a cancer journal for clinicians 65, 5-29, doi:10.3322/caac.21254 (2015). 7. Rahib, L. et al. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Research 74, 2913-2921, doi:10.1158/00085472.can-14-0155 (2014). 3/15