research on mrna vaccines and therapeutics for cancer – this will be achieved through the uk's global leadership and supporting industry to develop new cancer treatments by combining expertise in cancer immunotherapy treatment and the vaccine capabilities developed throughout the pandemic improving prevention of cancer through tackling the big known risk factors such as smoking boosting the cancer workforce tackling disparities and inequalities, including in cancer diagnosis times and ensuring recovery from the pandemic is delivered in a fair way – for instance, the "help us help you" cancer awareness campaign will be directed towards people from more deprived groups and ethnic minorities progress though there has been significant progress in the understanding of cancer biology, risk factors, treatments, and prognosis of some types of cancer (such as childhood leukemia) since the inception of the national cancer act of 1971, progress in reducing the overall cancer mortality rate has been disappointing. many types of cancer remain largely incurable (such as pancreatic cancer) and the overall death rate from cancer has not decreased appreciably since the 1970s. the death rate for cancer in the u.s., adjusted for population size and age, dropped only 5 percent from 1950 to 2005. as of 2012, who reported 8.2 million annual deaths from cancer heart disease (including both ischaemic and hypertensive) accounted for 8.5 million annual deaths. stroke accounted for 6.7 million annual deaths. there is evidence for progress in reducing cancer mortality. age-specific analysis of cancer mortality rates has had progress in reducing cancer mortality in the united states since 1955. an august 2009 study found that age-specific cancer mortality rates have been steadily declining since the early 1950s for individuals born since 1925, with the youngest age groups experiencing the steepest decline in mortality rate at 25.9 percent per decade, and the oldest age groups experiencing a 6.8 percent per decade decline. dr. eric kort, the lead author of this study, claims that public reports often focus on cancer incidence rates and underappreciate the progress that has been achieved in reduced cancer mortality rates. the effectiveness and expansion of available therapies has seen significant improvements since the 1970s. for example, lumpectomy replaced more invasive mastectomy surgery for the treatment of breast cancer. treatment of childhood leukemia and chronic myeloid leukemia (cml) have undergone major advances since the war on cancer began. the drug gleevec now cures most cml patients, compared to previous therapy with interferon, which extended life for approximately 1 year in only 20-30 percent of patients. dr. steven rosenberg, chief of surgery at the nci has said that as of the year 2000, 50% of all diagnosed cases of cancer are curable through a combination of surgery, radiation, and chemotherapy. cancer surveillance experts have reported a 15.8 percent decrease in the age-standardized death rate from all cancers combined between 1991 and 2006 along with an approximately 1 percent annual decrease in the rate of new diagnoses between 1999 and 2006. a large portion of this decreased mortality for men was attributable to smoking cessation efforts in the united states. a 2010 report from the american cancer society found that death rates for all cancers combined decreased 1.3% per year from 2001 to 2006 in males and 0.5% per year from 1998 to 2006 in females, largely due to decreases in the 3 major cancer sites in men (lung, prostate, and colorectum) and 2 major cancer sites in women (breast and colorectum). cancer death rates between 1990 and 2006 for all races combined decreased by 21.0% among men and by 12.3% among women. this reduction in the overall cancer death rates translates to the avoidance of approximately 767,000 deaths from cancer over the 16-year period. despite these reductions, the report noted, cancer still accounts for more deaths than heart disease in persons younger than 85 years. an improvement in the number of cancer survivors living in the u.s. was indicated in a 2011 report by the cdc and the nci, which noted that the number of cancer survivors in 2007 (11.7 million) increased by 19% from 2001 (9.8 million survivors). the number of cancer survivors in 1971 was 3 million. breast, prostate, and colorectal cancers were the most common types of cancer among survivors, accounting for 51% of diagnoses. as of january 1, 2007, an estimated 64.8% of cancer survivors had lived ≥5 years after their diagnosis of cancer, and 59.5% of survivors were aged ≥65 years. a continued decline in cancer rates in the u.s. among both women and men, across most major racial groups, and in the most common cancer sites (lung, colon and rectum), was indicated in a 2013 report by the national cancer institute. however, the same report indicated an increase from 2000 to 2009 in cancers of the liver, pancreas and uterus. challenges a multitude of factors have been cited as impeding progress in finding a cure for cancer and key areas have been identified and suggested as important to accelerate progress in cancer research. since there are many different forms of cancer with distinct causes, each form requires different treatment approaches. however, this research could still lead to therapies and cures for many forms of cancer. some of the factors that have posed challenges for the development of preventive measures and anti-cancer drugs and therapies include the following: inherent biological complexity of the disease: number of changes within a cell leading to the cancerous state disease heterogeneity due to different tissues of origin contribution of numerous genetic and environmental risk factors complexity of cellular interactions and cell signaling within the tumor microenvironment suitability of model organisms for understanding human disease. roadblocks to translational medicine challenges of early detection and diagnosis the drug approval process availability of and access to patients with suitable tumor tissue for research challenges in implementing preventive measures, such as the development and use of preventive drugs and therapies choropleth mapping of the changes over time, of the national incidence rate, by cancer type, relative to the population at risk, is a technical challenge. the public is so jaded by cancer research media attention at the moment... and let's face it, rather embarrassingly, most claimed "breakthroughs" are not proving to significantly advance cancer therapies... it is a real conundrum for researchers today, because "early publicity" is needed for funding, capital raising and professional kudos, but not too helpful for the public who then think that an immediate cure might be just around the corner.— professor brendon coventry, 9 july 2013 modern cancer research genome-based cancer research projects the rise of a new class of molecular technologies developed during the human genome project opens up new ways to study cancer and holds the promise for the discovery of new aspects of cancer biology that could eventually lead to novel, more effective diagnostics and therapies for cancer patients. these new technologies are capable of screening many biomolecules and genetic variations such as snps and copy number variations in a single experiment and are employed within functional genomics and personalized medicine studies. speaking on the occasion of the announcement of $1 billion in new funding for genome-based cancer research, dr. francis collins, director of the nih claimed, "we are about to see a quantum leap in our understanding of cancer." harold varmus, after his appointment to be the director of the nci, said we are in a "golden era for cancer research", poised to profit from advances in our understanding of the cancer genome. high-throughput dna sequencing has been used to study the whole genome sequence of two different cancer tissues: a small-cell lung cancer metastasis and a malignant melanoma cell line. the sequence information provides a comprehensive catalog of approximately 90% of the somatic mutations in the cancerous tissue, providing a more detailed molecular and genetic understanding of cancer biology than was previously possible, and offering hope for the development of new therapeutic strategies gleaned from these insights. the cancer genome atlas the cancer genome atlas (tcga), a collaborative effort between the national cancer institute and the national human genome research institute, is an example of a basic research project that is employing some of these new molecular approaches. one tcga publication notes the following: here we report the interim integrative analysis of dna copy number, gene expression and dna methylation aberrations in 206 glioblastomas...together, these findings establish the feasibility and power of tcga, demonstrating that it can rapidly expand knowledge of the molecular basis of cancer. in a cancer research funding announcement made by president obama in september 2009, tcga project is slated to receive $175 million in funding to collect comprehensive gene sequence data on 20,000 tissue samples from people with more than 20 different types of cancer, in order to help researchers understand the genetic changes underlying cancer. new, targeted therapeutic approaches are expected to arise from the insights resulting from such studies. cancer genome project the cancer genome project at the wellcome trust sanger institute aims to identify sequence variants/mutations critical in the development of human cancers. the cancer genome project combines knowledge of the human genome sequence with high throughput mutation detection techniques. cancer research supportive infrastructure advances in information technology supporting cancer research, such as the nci's cabig project, promise to improve data sharing among cancer researchers and accelerate "the discovery of new approaches for the detection, diagnosis, treatment, and prevention of cancer, ultimately improving patient outcomes." modern cancer treatment cancer clinical trials researchers are considering ways to improve the efficiency, cost-effectiveness, and overall success rate of cancer clinical trials. increased participation in rigorously designed clinical trials would increase the pace of research. currently, about 3% of people with cancer participate in clinical trials; more than half of them are patients for whom no other options are left, patients who are participating in "exploratory" trials designed to burnish the researchers' résumés or promote a drug rather than to produce meaningful information, or in trials that will not enroll enough patients to produce a statistically significant result. targeted tumor treatment a major challenge in cancer treatment is to find better ways to specifically target tumors with drugs and chemotherapeutic agents in order to provide a more effective, localized dose and to minimize exposure of healthy tissue in other parts of the body to the potentially adverse effects of the treatments. the accessibility of different tissues and organs to anti-tumor drugs contributes to this challenge. for example, the blood–brain barrier blocks many drugs that may otherwise be effective against brain tumors. in november 2009, a new, experimental therapeutic approach for treating glioblastoma was published in which the anti-tumor drug avastin was delivered to the tumor site within the brain through the use of microcatheters, along with mannitol to temporarily open the blood–brain barrier permitting delivery of the chemotherapy into the brain. public education and support an important aspect to the war on cancer is improving public access to educational and supportive resources, to provide individuals with the latest information about cancer prevention and treatment, as well as access to support communities. resources have been created by governmental and other organizations to provide support for cancer patients, their families and caregivers, to help them share information and find advice to guide decision making.