Carlos Doti, Vice President, Head of Medical Affairs, US Oncology, AstraZeneca

Despite significant treatment advances in the past few decades, approximately 50% of cancers remain undetected until late in the cancer’s stage, when prognosis is poor and treatment is often less effective in extending survivorship.

Research shows that nearly half of deaths and 42% of healthy years lost among people with cancer could be attributed to preventable risk factors.

 If we pair treatment advances with more effective screening and early detection approaches, we may be able to change these statistics, particularly for cancers that are considered most deadly. Cancer has touched my life in many ways: as a physician and as a caregiver for close family and friends diagnosed with cancer. In each of these experiences, I’ve seen first-hand the impact of timely detection and intervention on one’s prognosis and treatment outcome.

I also recognize that to achieve early detection across cancer types, numerous challenges must be overcome – from better understanding critical care gaps, translating valuable insights into screening technologies, and working with community organizations to better reach underserved populations.


In the US, perceptions, education, and behaviors regarding cancer screening vary widely; understanding these differences is critical to addressing gaps in cancer screening and care. Recently, AstraZeneca conducted a 

 of more than 4,600 US adults, including those who had been diagnosed with cancer or had a family member diagnosed with cancer.

1. Many people are not aware of, and not following, United States Preventive Services Task Force (USPSTF) cancer screening recommendations.

General awareness varies significantly regarding USPSTF cancer screening guidelines, which recommend certain screenings (cervical, breast, colorectal, lung and prostate) based on individual risk and age. The survey showed that among US adults, regardless of the respondents’ eligibility for screening:

75% do not think a lung cancer screening recommendation exists

68% do not think a cervical cancer screening recommendation exists

65% do not think a colorectal cancer screening recommendation exists

57% do not think a prostate cancer screening recommendation exists

51% do not think a breast cancer screening recommendation exists

38% are unsure if any of the provided cancer screening recommendations exist

2. Access to treatment is a top concern for many people.

About a third of the respondents, regardless of demographics, cited various obstacles, including transportation, financial and language barriers, as barriers to getting the care they need. In addition to increasing awareness of screening guidelines, reducing such barriers along the cancer care continuum is critical.

3. Younger generations are more likely to delay cancer treatment to prioritize work and family accommodations.

While recent data shows rising cancer rates (colorectal, breast, uterine, kidney and pancreas) in younger age groups in the US, the same age group is more likely to experience a delayed cancer diagnosis.

AstraZeneca’s survey also found that about half of younger generations (age 18-44) said they’d delay cancer treatment until they felt their life affairs were ready. This was compared to about a third of older generations (older than age 45) who responded similarly.

Translating Insights into Screening Technologies


Today’s unprecedented level of biological understanding and advances in technology highlight that it is time to accelerate early detection research and transform cancer survival. Lung cancer, which continues to be a leading cause of cancer-related deaths in the US, is typically detected when patients have reached the most advanced stage, at which point the five-year survival rate is less than 10%.

 However, in 2022, less than 6% of people in the US eligible for lung cancer screening actually got screened.

 Therefore, early lung cancer detection is especially crucial to improving patient outcomes.

AstraZeneca is working with organizations worldwide to use Artificial Intelligence (AI) technology to advance AI-assisted imaging lung cancer screenings that can detect cancers that may have been overlooked. AI is also helping to reduce disparities among underserved populations by identifying patients who are undiagnosed or who might be diagnosed later down the line and need follow-up care. For instance, through partnerships with Tempus, we are working to diagnose patients with lung cancer earlier, and Qure.ai, to enhance early-stage lung cancer risk identification.


Public health campaigns at the national level work to raise broader awareness of the availability and benefit of early screening; however, these efforts are often less effective in some of the local communities at high risk for developing certain cancers. Therefore, collaboration with community organizations is vital to implementing cancer education and screening programs, especially for those who are underserved in rural areas. AstraZeneca recently signed a 

 with the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center to enhance community-based lung cancer screening and detection. In Maryland, only about 3 percent of people who are at high risk for developing this disease get the recommended annual screening, which is significantly lower than the national average. To help close this gap, the initiative includes strengthening and expanding lung cancer screening programs and tobacco cessation efforts across the state, including in counties that have higher rates of lung cancer than the national average, and establishing a clinic model to drive research in cancer health disparities.

While we continue to bring transformative therapeutic options across cancer types and settings, more must be done to close the gap when it comes to early cancer detection to truly revolutionize cancer care and ultimately eliminate it as a cause of death. It’s a tall order, but I’m more optimistic than ever that we have the blueprint and collective determination to make it a reality.

 Crosby D, et al. Early detection of cancer. Science. 2022;375(6586):eaay9040.


 GBD 2019 Cancer Risk Factors Collaborators. The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022;400(10352):563-591.


Data on File. REF-222152. AstraZeneca Pharmaceuticals LP.


 di Martino E, et al. Incidence trends for twelve cancers in younger adults-a rapid review. Br J Cancer. 2022;126(10):1374-1386.


 American Cancer Society. Lung Cancer Survival Rates. Accessed June 2024. 

https://www.cancer.org/cancer/types/lung-cancer/detection-diagnosis-staging/survival-rates.html

 American Lung Association. New Report: Critically Low Lung Cancer Screening Rates Reveal Opportunity to Save More Lives. Accessed June 2024. 

https://www.lung.org/media/press-releases/state-of-lung-cancer-2022.

Carlos Doti, Vice President, Head of Medical Affairs, US Oncology, AstraZeneca

Closing Screening Gaps is Central to Revolutionizing Cancer Care

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