Women and Cancer: Celebrating Advances, Planning for Progress
Just 2 weeks ago we learned that two trials testing trastuzumab (Herceptin) against early-stage, HER2-positive breast cancer were being stopped early because the combination of trastuzumab and standard chemotherapy reduced cancer recurrence risk by more than half compared with chemotherapy alone.
The findings represent the latest step in a sustained journey of progress in preventing, diagnosing, and treating cancer in women (see "Notes") - certain to be a topic at the health education and other events scheduled as part of National Women's Health Week.
There is still much work to be done to blunt cancer's impact on women. Nearly 663,000 women will be diagnosed with cancer this year, and 275,000 will die. That said, the late 1990s saw cancer incidence rates in women begin to dip after 9 years of stable rates, while mortality rates have sunk for 8 of the top 15 cancers in women.
Breast cancer is an excellent example of progress, based on our increasing knowledge of molecular oncology, including the results seen with aromatase inhibitors to treat estrogen receptor-positive breast cancer and the lessons learned about the role of exercise and diet in prevention.
But breast cancer is by no means a solo success story. For cervical cancer, in addition to the advances made with HPV vaccines, NCI also is funding research to test whether a new DNA test can effectively triage equivocal Pap test interpretations. And then there are the critical efforts of NCI's CRCHD to address disparities in cervical cancer mortality among minority groups and underserved populations.
As noted in NCI's 2004 annual Report to the Nation, for the first time since statistics have been collected, lung cancer incidence rates among women are declining. To maintain this progress, an NCI-led group of experts last year released Women, Tobacco, and Cancer: An Agenda for the 21st Century. The report provides a blueprint for reducing and eliminating the harmful effects of smoking in women which extend far beyond lung cancer to cancers of the cervix, bladder, kidney, and other sites.
NCI is funding efforts to develop proteomic-based screening tests to detect ovarian cancer at early stages when it is more treatable. Research to develop a high-throughput assay may help to identify women at high risk for endometrial cancer recurrence who might benefit from adjuvant therapy in addition to surgery.
Meanwhile, many of NCI's Specialized Programs of Research Excellence (SPOREs) are developing biomarkers and new treatments for breast, ovarian, cervical, and uterine cancer. Through the NCI Mouse Models of Human Cancer Consortium, we are making progress in developing mouse models that more closely mimic human cancers that uniquely affect women.
I'd like to extend my sincere gratitude to the NCI Office of Women's Health for providing guidance to NCI's research programs related to women's health activities and helping advance research on women's cancers. From committed advocates to basic researchers, we have worked as a community to achieve important progress in this area, and I'm confident that the next decade will bring more of the same.
Dr. Andrew C. von Eschenbach