The US has reached a historic milestone in the fight against cancer: what does this mean for Croatia?

The United States has reached a major milestone in cancer care: Seven out of ten people now survive five years or more after a cancer diagnosis. According to the latest annual report from the American Cancer Society, five-year survival has increased to 70 percent, up from around 50 percent in the 1970s. At first glance, it may seem like a tall figure, but in reality, it represents decades of investment in science, treatment, and early detection.

Cancer is increasingly becoming a chronic disease

Five-year survival is a standard benchmark in oncology because after that time, the risk of disease recurrence decreases significantly for many cancers. According to the report, progress has been particularly rapid in the past decade, thanks to the development of immunotherapy and targeted therapy.

Immunotherapy, which “programs” the immune system to recognize and attack cancer cells, has changed the course of treatment for many oncological diseases. Similarly, targeted therapies, which target specific genetic or molecular changes in tumors, allow for more effective treatment with fewer side effects.

This is a key paradigm shift: many forms of cancer that were once rapidly fatal are now increasingly managed as chronic diseases.

4.8 million deaths prevented

The report estimates that 4.8 million cancer deaths were prevented in the United States between 1991 and 2023, largely due to smoking reductions, earlier detection of the disease, and advances in cancer therapies. This clearly demonstrates that the combination of public health measures and scientific advances is producing results. The decline in smoking, which began at the end of the last century, is now being reflected in survival statistics, particularly for lung cancer.

But not all news is good

Despite the progress, the report warns of worrying trends. Colon cancer rates are rising among those under 50, and breast cancer incidence is also showing a slight increase.

Obesity stands out as an important risk factor accompanying these trends. The United States, like many other developed countries, is facing an epidemic of metabolic disorders. Cancer increasingly follows the patterns of modern lifestyles – sedentary lifestyles, excess calories, ultra-processed diets.

It also highlights the large disparities in treatment outcomes among different ethnic groups, as well as concerns about the decline in research funding. This is a reminder that progress in oncology is not just a medical issue, but also a social one.

Where is Croatia in this story?

Croatia does not have a unified national reporting system comparable to the American annual analyses, but according to available data from Eurostat and national registries, the cancer mortality rate in Croatia is still higher than the European Union average.

At the same time, therapeutic options in Croatian clinical centers are significantly more advanced today than they were ten or twenty years ago. Immunotherapy and targeted therapies are also available to our patients to a significant extent, especially in larger hospitals and through clinical trials. The difference is most often not in the therapy itself, but in the speed of diagnosis, availability of screening and organization of the system.

In Croatia, we still record relatively high smoking rates, and the response to preventive programs – especially to colon cancer screening – is not satisfactory. Early diagnosis and systematic screening were one of the key reasons for the American progress.

What can we learn from this?

The US data show that progress is possible, but it comes slowly, over decades of investment. It is not the result of a single “breakthrough therapy”, but rather a combination of prevention, early detection and more precise treatment.

The message is clear: smoking cessation, weight control, physical activity and participation in preventive examinations are as important as the most modern immunotherapy.

At the same time, the development of personalized medicine and immunotherapy shows that oncology is changing rapidly. Cancer is no longer just an acute and rapidly fatal disease – it is increasingly becoming a long-term condition that can be lived with.

Caution with optimism

Despite the encouraging data, more than 626,000 cancer deaths and more than two million new diagnoses are still expected in the United States this year. Cancer remains one of the leading causes of death.

Progress is real, but it is not final. Investments in research, access to therapies, and reduction of social inequalities are crucial for the continuation of this trend.

Perhaps the most important lesson for Croatia is that the greatest progress is achieved systematically and over the long term. Prevention and screening are no less important than the latest drugs. In some cases, they are the most powerful weapons against cancer.

The article was published on the She.hr portal, you can view it at the link.