Labs notes

Cancer

Cancer: what has actually moved survival

Progress against cancer has been uneven. This note sets out which advances have measurably saved lives, from vaccines and screening to new treatments, and where survival has barely moved.

By attnomSources read on 20 sources4 min read

The overall picture

In 2022 the world saw about 20 million new cancer cases and 9.7 million cancer deaths.[1] In the United States, the cancer death rate fell by 34 percent from 1991 to 2023, which the American Cancer Society says avoided about 4.8 million deaths. It credits three things: less smoking, earlier detection and better treatment. Five-year survival for all cancers together reached 70 percent for people diagnosed from 2015 to 2021, up from 63 percent in the mid-1990s.[2]

Stopping cancer before it starts

HPV vaccine against cervical cancer

Cervical cancer is caused by long-lasting infection with a virus called HPV.[3] In England, women offered the vaccine at age 12 to 13 had 87 percent fewer cervical cancers than women born before the programme.[4] A 2026 study found no cervical cancer deaths from 2020 to 2024 among women in England aged 20 to 24, almost 9 in 10 of whom had been vaccinated at 12 or 13, where about 23 would have been expected from earlier years. Both studies observe populations rather than run a trial, but the effect is large.[5]

Hepatitis B vaccine against liver cancer

After Taiwan began a national programme of hepatitis B vaccination for babies in 1984, liver cancer in children aged 6 to 14 fell from 0.70 to 0.36 cases per 100,000 children within about ten years.[6]

Finding it early

Screening tests

In a large US trial of heavy smokers, yearly low-dose CT scans cut lung cancer deaths by 20 percent compared with chest X-rays. Most positive scans were false alarms, which is one cost of screening.[7] In a UK trial of people aged 55 to 64, an offer of a single check of the lower bowel cut bowel cancer deaths by 30 percent over 17 years.[8] In a European trial, an invitation to colonoscopy lowered bowel cancer cases by 18 percent over ten years, but the fall in deaths was too small to be certain. Only 42 percent of those invited took the test.[9]

Blood tests for many cancers at once

A blood test that looks for traces of many cancers is an appealing idea. In an NHS trial of about 142,000 people aged 50 to 77, published in 2026, adding such a test did not reduce the number of cancers found at stage III or IV, its main goal. Stage IV cancers were slightly fewer, but not clearly beyond chance. The trial was paid for by the test’s maker, and whether it saves lives is not yet known.[10]

Treatments that changed the outlook

Immunotherapy

Checkpoint drugs release the brakes on the immune system so it can attack cancer. In advanced melanoma, a skin cancer, people given two such drugs together lived a median of 71.9 months, against 19.9 months on the older drug alone, in a trial followed for at least ten years.[11]

CAR-T cell therapy

Here a patient’s own immune cells are changed in a lab to find their cancer, then put back. The US approved the first such therapy in 2017 for young people with a leukaemia that had returned or resisted treatment.[12] In its main trial, 81 percent of patients were in remission within three months, and about half were still free of relapse a year later.[13] Two adults with a different leukaemia, treated in 2010, were still in remission more than ten years later, though two cases cannot show how often this happens.[14]

Targeted drugs

Some drugs block the exact fault that drives a cancer. With imatinib, a daily pill for chronic myeloid leukaemia, 83 percent of patients in a major trial were alive after ten years.[15] For breast cancers with a protein called HER2, one year of trastuzumab after surgery and chemotherapy lowered the risk of death by about a quarter over 11 years.[16]

Where progress is thin

Some cancers have barely moved. In the United States, five-year survival for pancreatic cancer is 13 percent, up from 4 percent in the mid-1990s, partly because more slow-growing tumours are now found by chance. Lung cancer still causes more deaths than bowel and pancreatic cancer combined.[2] For glioblastoma, a brain cancer in adults, the standard drug added to radiotherapy raised five-year survival only from 1.9 to 9.8 percent.[17]

Where a person lives matters as much as which cancer they have. For the same childhood leukaemia, five-year survival ranged from 49.8 percent in Ecuador to 95.2 percent in Finland, and breast cancer survival was 90 percent in the US but 66 percent in India.[18] WHO aims for at least 60 percent survival for children with cancer worldwide by 2030.[19]

What is still unknown

  • Whether multi-cancer blood tests reduce deaths. The NHS trial is still following its participants.[10]
  • Whether HPV vaccination cuts cervical cancer deaths in older women, not only the youngest groups studied so far.[5]
  • How much of the US fall in deaths each cause explains. The American Cancer Society names three causes but we found no split between them.[2]
  • How large the survival gap between countries is today for adults. The best global comparison for adults covers diagnoses up to 2014; for children, a 2026 update runs to 2019 and still shows a wide gap.[18][20]

This note summarises published research. It is not medical advice. For any question about your own health, or someone in your care, see a doctor.

Sources

Numbered in the order the note first cites them. Each was opened and read on 15 November 2026.

  1. [1]Global cancer burden growing, amidst mounting need for servicesInternational Agency for Research on Cancer (WHO), 1 February 2024.Read 15 November 2026. Cited once. www.iarc.who.int
  2. [2]Cancer statistics, 2026CA: A Cancer Journal for Clinicians (American Cancer Society), 13 January 2026.Read 15 November 2026. Cited 3 times. pmc.ncbi.nlm.nih.gov
  3. [3]Cervical cancer (fact sheet)World Health Organization, 10 November 2026.Read 15 November 2026. Cited once. www.who.int
  4. [4]The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational studyThe Lancet, 3 November 2021.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  5. [5]Cervical cancer mortality trends following HPV vaccination in England, 2001-24: an analysis of population-based mortality dataThe Lancet, 17 June 2026.Read 15 November 2026. Cited 2 times. pubmed.ncbi.nlm.nih.gov
  6. [6]Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in childrenNew England Journal of Medicine, 26 June 1997.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  7. [7]Reduced lung-cancer mortality with low-dose computed tomographic screeningNew England Journal of Medicine, 29 June 2011.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  8. [8]Long term effects of once-only flexible sigmoidoscopy screening after 17 years of follow-up: the UK Flexible Sigmoidoscopy Screening randomised controlled trialThe Lancet, 22 February 2017.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  9. [9]Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related DeathNew England Journal of Medicine, 9 October 2022.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  10. [10]Effect of Screening with Multicancer Early-Detection Test on Late-Stage Cancer DiagnosisNew England Journal of Medicine, 22 September 2026.Read 15 November 2026. Cited 2 times. pubmed.ncbi.nlm.nih.gov
  11. [11]Final, 10-Year Outcomes with Nivolumab plus Ipilimumab in Advanced MelanomaNew England Journal of Medicine, 15 September 2024.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  12. [12]KYMRIAH (tisagenlecleucel)US Food and Drug Administration, 30 August 2017.Read 15 November 2026. Cited once. www.fda.gov
  13. [13]Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic LeukemiaNew England Journal of Medicine, 1 February 2018.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  14. [14]Decade-long leukaemia remissions with persistence of CD4+ CAR T cellsNature, 2 February 2022.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  15. [15]Long-Term Outcomes of Imatinib Treatment for Chronic Myeloid LeukemiaNew England Journal of Medicine, 9 March 2017.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  16. [16]11 years' follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trialThe Lancet, 17 February 2017.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  17. [17]Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trialThe Lancet Oncology, 9 March 2009.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov
  18. [18]Global surveillance of trends in cancer survival 2000-14 (CONCORD-3)The Lancet, 31 January 2018.Read 15 November 2026. Cited 2 times. pubmed.ncbi.nlm.nih.gov
  19. [19]Childhood cancer (fact sheet)World Health Organization, 10 March 2026.Read 15 November 2026. Cited once. www.who.int
  20. [20]Progress towards the WHO Global Initiative for Childhood Cancer target of 60% 5-year survival for all childhood cancers combined, 1990-2019 (CONCORD-4)The Lancet, 26 March 2026.Read 15 November 2026. Cited once. pubmed.ncbi.nlm.nih.gov