Progress against GI cancer during the American Society of Clinical Oncology's first 50 years

Abstract

GI cancers are among the most common tumors and represent the leading cause of cancer-related death worldwide.3 Most of the (Table Presented) progress against these cancers over the last 50 years has resulted from either earlier detection of premalignant lesions or to improved treatment linked to a better understanding of the molecular drivers of malignancy. However, much remains unknown about the fundamental biology of gastric, pancreatic, and biliary tract cancers, and although many of the molecular pathways of colon and rectal cancer have now been elucidated, few effective targeted agents have yet been introduced into clinical practice for these diseases. Although the relatively easy access of the GI tract to endoscopic surveillance and imaging should enable widespread screening of high-risk populations for premalignant and early-stage lesions, much remains to be done to widely disseminate screening programs in many communities. A recent colon cancer screening pilot program in the state of Delaware demonstrated that highly committed efforts can increase screening rates, reduce incidence rates, eliminate racial disparities in outcomes, and reduce cost.148 Vaccination against viral causes of GI cancer such as hepatitis B and C and HPV as well as the eradication of H pylori, if widely applied in high-risk regions, have the potential to eliminate or substantially decrease the incidence of these diseases where they are endemic but will require concerted public health efforts in many countries to achieve these goals. As is the case with most cancers, it is the interplay of basic science research, robust clinical trials, and dissemination of known effective treatments to all communities that will enable continued progress against GI cancers during ASCO's next 50 years. © 2014 by American Society of Clinical Oncology.