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Losing the "War Against Cancer": Need for Public Policy Reforms

February 4, 1992

Cancer now strikes one in three and kills one in four Americans, with over 500,000 deaths last year. Over the last decade, some 5 million Americans died of cancer and there is growing evidence that a substantial proportion of these deaths was avoidable.

We express grave concerns over the failure of the "war against cancer" since its inauguration by President Nixon and Congress on December 23, 1971. This failure is evidenced by the escalating incidence of cancer to epidemic proportions over recent decades. Paralleling and further compounding this failure is the absence of any significant improvement in the treatment and care of the majority of all cancers. Notable exceptions are the successes with some relatively rare cancers, particularly those in children.

A recent report by the American Hospital Association predicts that cancer will become the leading cause of death by the year 2000 and the "dominant specialty" of American medicine. The costs in terms of suffering and death and the inflationary impact of cancer, now estimated at $110 billion annually (nearly 2% of the GNP), is massive. These costs are major factors in the current health care crisis, with Per-case Medicare payments exceeding those of any other disease.

We express further concerns that the generously funded cancer establishment, the National Cancer Institute (NCI), the American Cancer Society (ACS) and some twenty comprehensive cancer centers, have misled and confused the public and Congress by repeated claims that we are winning the war against cancer. In fact, the cancer establishment has continually minimized the evidence for increasing cancer rates which it has largely attributed to smoking and dietary fat, while discounting or ignoring the causal role of avoidable exposures to industrial carcinogens in the air, food, water, and the workplace.

Furthermore, the cancer establishment and major pharmaceutical companies have repeatedly made extravagant and unfounded claims for dramatic advances in the treatment and "cure" of cancer. Such claims are generally based on an initial reduction in tumor size ("tumor response") rather than on prolongation of survival, let alone on the quality of life which is often devastated by highly toxic treatments.

We propose the following reforms, not as a specific blueprint, but as general guidelines for redefining the mission and priorities of the NCI...

(For the complete report and signature, see The Politics of Cancer Revisited, S. S. Epstein, p.341-348.)

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