by wayne persky |
RSS Feed Remember that old campaign slogan? Many of us are surely old enough to remember when it was widely publicized, and some of us are old enough to remember when the U.S. government launched an ambitious campaign based on that slogan in the mid-20th century
The campaign aimed to galvanize public support and funding for cancer research, leading to significant advancements in understanding and treating the disease. Yet, despite remarkable progress in treating certain types of cancer, a recent report from the American Cancer Society (ACS) indicates that the global fight against cancer is far from over, with cancer cases expected to rise significantly in the coming decades.
The campaign aimed to galvanize public support and funding for cancer research, leading to significant advancements in understanding and treating the disease. Yet, despite remarkable progress in treating certain types of cancer, a recent report from the American Cancer Society (ACS) indicates that the global fight against cancer is far from over, with cancer cases expected to rise significantly in the coming decades.
The campaign marked a pivotal moment in the history of cancer research.
It inspired increased investment in cancer research, leading to breakthroughs in early detection, treatment, and prevention. Key milestones over the past few decades include the development of targeted therapies, immunotherapies, and significant improvements in screening methods for various cancers.
Early detection methods, such as mammograms for breast cancer and colonoscopies for colorectal cancer, have dramatically improved survival rates. Moreover, public health initiatives to reduce smoking have led to declines in lung cancer rates in many countries. Vaccinations, such as the HPV vaccine, have shown promise in preventing cancers linked to viral infections.
Early detection methods, such as mammograms for breast cancer and colonoscopies for colorectal cancer, have dramatically improved survival rates. Moreover, public health initiatives to reduce smoking have led to declines in lung cancer rates in many countries. Vaccinations, such as the HPV vaccine, have shown promise in preventing cancers linked to viral infections.
That campaign was launched in 1971.
The National Cancer Act was signed by President Richard Nixon on December 23, 1971. The campaign was also referred to as the War on Cancer. The legislation was designed to strengthen the National Cancer Institute and significantly increase funding for cancer research with the goal of making substantial progress in the fight against cancer.
The Cancer Moonshot Initiative
45 years later, during President Barack Obama's January 12, 2016 State of the Union address, then Vice President Joe Biden announced the Cancer Moonshot Initiative. The initiative was initially funded through the 21st Century Cures Act, with the goal of accelerating cancer research in order to make significant progress in cancer prevention, diagnosis, and treatment within a decade. That decade is almost over.
Over the last half-century, the investment in cancer research has been huge.
The National Cancer Institute (NCI) has had significant annual budgets. For instance, in fiscal year 2022 alone, the NCI budget was approximately $6.8 billion. Over the past 50 years, the cumulative funding from the NCI alone is estimated to be over $100 billion.
Besides the NCI, other sources of federal funding include the Department of Defense, National Institutes of Health (NIH), and other government agencies which also contribute significantly to cancer research.
Private Sector and Non-Profit Organizations such as the American Cancer Society, various foundations, and pharmaceutical companies also invest heavily in cancer research. The American Cancer Society alone has invested over $5 billion since its inception.
When combining federal funding, private sector investments, and contributions from non-profits, it's estimated that the U.S. has invested well over $200 billion in cancer research over the past half-century.
Besides the NCI, other sources of federal funding include the Department of Defense, National Institutes of Health (NIH), and other government agencies which also contribute significantly to cancer research.
Private Sector and Non-Profit Organizations such as the American Cancer Society, various foundations, and pharmaceutical companies also invest heavily in cancer research. The American Cancer Society alone has invested over $5 billion since its inception.
When combining federal funding, private sector investments, and contributions from non-profits, it's estimated that the U.S. has invested well over $200 billion in cancer research over the past half-century.
So are we at least close to stamping out cancer?
Despite all the political hullabaloo and hundreds of billions of dollars spent on cancer research, The global burden of cancer is continuing to grow, and there is currently no cure for any type of cancer. Researchers predict more than 35 million new cancer cases by 2050, marking a 77% increase from 2022 (Thompson, 2024, April 4).1
Despite relatively modest advancements (in comparison with the huge investments), the American Cancer Society's "Global Cancer Statistics 2024" report paints a concerning picture of the future (American Cancer Society, 2024, April 4).2 In 2022 alone, approximately 20 million new cancer cases were diagnosed worldwide, and 9.7 million people died from cancer. As mentioned above, by 2050, the number of annual cancer cases is projected to reach 35 million.
Despite relatively modest advancements (in comparison with the huge investments), the American Cancer Society's "Global Cancer Statistics 2024" report paints a concerning picture of the future (American Cancer Society, 2024, April 4).2 In 2022 alone, approximately 20 million new cancer cases were diagnosed worldwide, and 9.7 million people died from cancer. As mentioned above, by 2050, the number of annual cancer cases is projected to reach 35 million.
This anticipated increase is claimed to be primarily due to the aging global population.
"This rise in projected cancer cases by 2050 is solely due to the aging and growth of the population, assuming current incidence rates remain unchanged," explained Hyuna Sung, a senior principal scientist for cancer surveillance at the ACS. Obviously, this implies that they aren't expecting any additional improvements in the prevention of cancer by 2050. The report also blames unhealthy lifestyle choices, such as poor diet, physical inactivity, heavy alcohol consumption, and smoking, as reasons why cancer cases are expected to continue to increase.
Basically unchanged from half a century ago,
lung cancer remains the most commonly diagnosed cancer globally and the leading cause of cancer deaths. It accounts for one in every eight cancer diagnoses and one in five cancer deaths. In men, prostate and colon cancers follow lung cancer in prevalence, while breast cancer is the most common cancer in women, followed by lung, colon, and cervical cancers.
The report underscores the critical importance of prevention.
"With more than half of cancer deaths worldwide being potentially preventable, prevention offers the most cost-effective and sustainable strategy for cancer control," said Dr. Ahmedin Jemal, senior vice president of surveillance and health equity science at the ACS. But after spending over $200 billion over the past half-century, we would much rather hear about substantial progress, rather than to hear a recommendation that we should try to avoid getting cancer because that's a lot cheaper and more effective than trying to treat cancer after it develops. We already knew that.
By emphasizing prevention, that serves to highlight the fact that gains in the treatment of cancer have been relatively modest. And any treatments that have been developed typically require increasingly expensive drugs that only the wealthy can afford. And while many of these drugs seem to be able to prolong life by months or even years, in some cases, the eventual outcome is still typically mortality.
The report notes that eliminating tobacco use alone could prevent one in four cancer deaths, or approximately 2.6 million deaths annually. But that advice appears to be similar to flogging a dead horse, in view of the drastic reductions in tobacco use over the past three or four decades because of government-sponsored anti-tobacco campaigns.
By emphasizing prevention, that serves to highlight the fact that gains in the treatment of cancer have been relatively modest. And any treatments that have been developed typically require increasingly expensive drugs that only the wealthy can afford. And while many of these drugs seem to be able to prolong life by months or even years, in some cases, the eventual outcome is still typically mortality.
The report notes that eliminating tobacco use alone could prevent one in four cancer deaths, or approximately 2.6 million deaths annually. But that advice appears to be similar to flogging a dead horse, in view of the drastic reductions in tobacco use over the past three or four decades because of government-sponsored anti-tobacco campaigns.
Vaccination programs also play a vital role in cancer prevention.
For instance, only 15% of eligible girls worldwide have received the HPV vaccine, even though nearly all cervical cancers are caused by HPV. Why hasn't this program been more effective, after so much money has been invested in it? Improving vaccination rates could drastically reduce the incidence of cervical cancer, which remains a leading cause of cancer death in women in many low-income countries.
And although this wasn't mentioned in the ACS report, despite the fact that males can't develop cervical cancer, boys should also be vaccinated. As pointed out in an online weblog on a Nationwide Children's Hospital website, 40% of cases of HPV related cancer are in males (DaJusta. and Fuchs, 2023, January 06).3 Obviously they should also be vaccinated in order to prevent the spread of these diseases.
And although this wasn't mentioned in the ACS report, despite the fact that males can't develop cervical cancer, boys should also be vaccinated. As pointed out in an online weblog on a Nationwide Children's Hospital website, 40% of cases of HPV related cancer are in males (DaJusta. and Fuchs, 2023, January 06).3 Obviously they should also be vaccinated in order to prevent the spread of these diseases.
Many people cannot afford timely cancer diagnoses and treatment.
The report highlights significant disparities in cancer outcomes between high-income and low-income countries. Inadequate early detection and treatment services contribute to higher cancer death rates in low-income countries despite having lower overall cancer incidence rates. For example, Ethiopia's breast cancer mortality rate is twice that of the United States, despite a 60% lower incidence rate.
Low income is not a crime.
"Understanding the global cancer burden is critical to ensuring everyone has an opportunity to prevent, detect, treat, and survive cancer," said Karen Knudsen, CEO of the ACS. But placing the blame for ineffective cancer management practices on financial disparities among countries of the world is a relatively poor excuse for the overall poor performance of cancer management. Instead of blaming poor cancer management on low income, perhaps the way the entire program is administered needs to be redesigned and drug pricing needs to be policed so that the detection and management of cancer is not unaffordable for so many people.
Why are cancer treatment drugs so expensive?
In 2023, research data were published regarding a cross-sectional study of 224 cancer drug approvals in the U.S. across 119 individual drugs that were approved between the dates of January 1, 2015 and December 31, 2020 (Miljković, Tuia, Olivier, Haslam, and Prasad, 2023).4 The study determined that the median annual cost of a treatment with any of those drugs was $196,000, and there was no significant difference in the cost of drugs, regardless of whether they were the first in class, next in class, or subsequent approvals of an already approved drug.
A degree in medicine is certainly not required by anyone to realize that once a drug treatment is developed, the cost of developing similar drugs that mimic the behavior of the original drug is virtually always much less expensive. The original research article, published in JAMA Network Open, concluded that:
The results of this study suggest that drug pricing cannot be explained by innovations alone; further study is warranted.
A degree in medicine is certainly not required by anyone to realize that once a drug treatment is developed, the cost of developing similar drugs that mimic the behavior of the original drug is virtually always much less expensive. The original research article, published in JAMA Network Open, concluded that:
The results of this study suggest that drug pricing cannot be explained by innovations alone; further study is warranted.
Cancer remains the biggest health concern for most people.
The University of Cambridge analyzed a poll conducted by Public First of 2000 United Kingdom (UK) adults (University of Cambridge, 2024, July 14).5 Their analysis of the poll results showed that:
- Two-thirds of respondents expressed significant worry about being diagnosed with cancer, more than for any other health condition. The primary concern (70%) is that cancer would be diagnosed too late for effective treatment. Over half of the respondents (52%) worried about the effect of a cancer diagnosis on their loved ones.
- 55% of respondents prioritized advancements in early cancer detection and treatment over other transformative developments like eradicating diseases or eliminating poverty.
- Aside from late detection, 41% were concerned about accessing the right treatment, and 36% worried about treatment side effects. 61% said they would be less afraid of a cancer diagnosis if they knew the cancer was treatable. Over half (51%) mentioned that improved early detection capabilities would alleviate their fears.
- 43% believe university research will significantly reduce cancer deaths, though 64% think reducing NHS waiting times would have the biggest impact.
- The public largely supports the use of AI in cancer research and treatment, with 55% endorsing its use in speeding up research, 47% for aiding diagnosis, and 41% for assisting in treatment decisions. Researchers are developing AI tools to predict patient responses to treatments, expedite diagnosis, personalize therapy, and reduce costs.
- The fear of a cancer diagnosis is second only to the death of a close relative, ranking higher than fears of nuclear war, terrorism, and crime. Younger individuals (18-34 years) are more likely to be very worried about cancer compared to older adults (over 65 years).
According to the National Health Service (NHS) of the UK,
“1 in 2 people will develop some form of cancer during their lifetime NHS” (NHS, 2022, October 13).6
In conclusion
The U.S. campaign "We'll Stamp Out Cancer in Our Lifetimes," initiated with the National Cancer Act signed by President Richard Nixon in 1971, aimed to significantly advance cancer research and treatment. Over the past five decades, substantial progress has been made in a few areas, including breakthroughs in early detection, treatment innovations, and public health initiatives.
Despite these advancements, and the investment of hundreds of billions of dollars in research, the global cancer burden remains substantial, with the American Cancer Society predicting a significant increase in cancer cases by 2050. Cancer research obviously continues to be a huge money pit, and despite all the appeals and excuses, we obviously are no closer to stamping out cancer within our lifetimes than we were half a century ago.
Despite these advancements, and the investment of hundreds of billions of dollars in research, the global cancer burden remains substantial, with the American Cancer Society predicting a significant increase in cancer cases by 2050. Cancer research obviously continues to be a huge money pit, and despite all the appeals and excuses, we obviously are no closer to stamping out cancer within our lifetimes than we were half a century ago.
References
1. Thompson, D. (2024, April 4). Cancer cases will keep rising worldwide: Report. Medical Xpress, Retrieved from https://medicalxpress.com/news/2024-04-cancer-cases-worldwide.html?utm_source=nwletter&utm_medium=email&utm_campaign=daily-nwletter
2. American Cancer Society. (2024, April 4). American Cancer Society Releases Latest Global Cancer Statistics; Cancer Cases Expected to Rise to 35 Million Worldwide by 2050. American Cancer Society, Retrieved from https://pressroom.cancer.org/GlobalCancerStatistics2024
3. DaJusta, D. and Fuchs, M. (2023, January 06). HPV Vaccine for Boys: Cancer Protection for the Future. Nationwide Children’s Hospital, [Web log]. Retrieved from https://www.nationwidechildrens.org/family-resources-education/700childrens/2023/01/hpv-vaccine-for-boys
4. Miljković, M. D., Tuia, J., Olivier, T., Haslam, A., and Prasad, V. (2023). Cancer Drug Price and Novelty in Mechanism of Action. JAMA Network Open, 6(12), e2347006. Retrieved from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2812734#:~:text=Results%20There%20were%20224%20cancer,%24170%20000-%24277%20000).
5. University of Cambridge. (2024, July 14). Cancer is the biggest health concern among the public, poll reveals. Medical Xpress, Retrieved from https://medicalxpress.com/news/2024-07-cancer-biggest-health-poll-reveals.html?utm_source=nwletter&utm_medium=email&utm_campaign=daily-nwletter
6. NHS. (2022, October 13). Overview - Cancer. NHS, Retrieved from https://www.nhs.uk/conditions/cancer/
