First NCDB Annual Report Reveals More Neoadjuvant Systemic Therapy before Surgery

The ACS National Cancer Database (NCDB) recently released its first annual report, published in the Journal of the American College of Surgeons (JACS). The NCDB captures hospital-based data on nearly 74% of newly diagnosed cancers in the US, and this report focused on data from 2021 and trends in cancer 2004–2021.

“This report is our approach to making NCDB data more broadly available to others who may benefit from understanding this large source of cancer data and what it’s telling us about the current state of cancer diagnoses and treatments in the United States,” said first author Elizabeth B. Habermann, MPH, PhD, chair of the ACS Cancer Data Modeling Committee and a professor of health services research at Mayo Clinic in Rochester, Minnesota.

Key among the reports’ main findings was that before surgery is pursued, more cancer patients are being treated with neoadjuvant systemic therapy, such as hormone therapy and immunotherapy, in addition to chemotherapy. Pancreatic cancer and urinary bladder cancer had stark increases in systemic therapy between 2010 and 2021, at 224% and 102%, respectively. A notable rise in systemic therapy, particularly hormone therapy, was noted in that timeframe for breast cancer, rising to 18% in 2021 versus 11% in 2010.

Other noteworthy findings confirm the benefits of cancer screening, as well as show that women with cancer have a better 5-year survival overall than men (68% versus 59%, respectively).

The report also takes a deep dive into three specific cancers, showing that early stage breast cancer is on the rise, colon cancer is commonly diagnosed at later stages, and that pancreatic cancer is often found too late to be treated effectively.All surgeons, oncologists, and members of cancer care teams are encouraged to read the report. Access to JACS is a free benefit of ACS membership.