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America Losing Winnable War Against Cancer

Experts Urge Clinton to Chart New Course

Press Conference, June 24, 1993. National Press Club, Washington, D.C.

Washington: The Cancer Prevention Coalition, a national organization of doctors, cancer researchers and public health officials, today released a letter to President Clinton warning that the nation is losing a winnable war against cancer and urging a new federal strategy that emphasizes preventing exposure to cancer-causing substances.

Led by Drs. Samuel Epstein, University of Illinois cancer prevention expert, John Spratt, oncologist and surgeon affiliated with the University of Louisville Medical School, and Peter Orris, Medical Director at Chicago's Mount Sinai Hospital's Occupational Medical Program, 50 leading cancer experts called on the White House "to make prevention the guiding strategy for a successful war on this dread disease."

"Despite significant gains in the treatment of certain cancers, America is still losing the war," declared Dr. Epstein. Citing the government's own statistics, Epstein pointed to the 43% increase between 1950 and 1988 in cancer incidence rates and the failure to improve cancer survival rates as evidence that "not enough is being done to protect citizens from exposure to cancer-causing substances."

"Over the past 20 years," argued Dr. Epstein, "spending has increased nearly 10-fold, yet cancer incidence rates have climbed by more than 16 percent." Furthermore, added Epstein, "5-year survival rates have remained flat at about 50% for men and women and at about 38% for African-Americans."

The Cancer Prevention Coalition called on the President to:

  • Place equal budgetary emphasis on cancer cause and prevention alongside research, diagnosis and treatment
  • Phase-out the manufacture and use of industrial carcinogens and institute a crash program to develop safer alternatives
  • Expand the testing of chemicals and chemical compounds for carcinogenicity

"Pesticide residues, chemicals in the workplace, benzene in gasoline, air and water pollution, and toxic waste dumps pose cancer threats to exposed populations. Since there is no such thing as a 'safe' exposure level, and since many forms of cancer are now clearly associated with exposure to these substances, it is unconscionable that the federal government allocates so few resources to identifying and testing cancer-causing chemicals and preventing public exposure," said Dr. Peter Orris.

"Clearly," said Orris, "our government is not doing enough to protect workers and the public from exposure to chemicals in the workplace and environment that cause or trigger cancer. Much has been done to inform the public about the deathly hazards of smoking. Similar efforts are needed to educate the public about the proliferation of cancer-causing chemicals in our workplaces, in the food we eat, the water we drink and the air breathe," said Orris.

The National Cancer Institute has failed its mission," argued Dr. John S. Spratt. "The NCI has given first priority to chemotherapy, a treatment of marginal benefit. The NCI needs a new direction. It must focus on preventing the onset of cancer in the first place, given that by the year 2000, cancer will be America's single most expensive disease."

June 24, 1993

President Clinton
The White House
Washington, D.C.

Dear President Clinton:

America is losing a winnable war against a dreaded disease, cancer. We can prevent unnecessary suffering and deaths only by radically reforming federal cancer policy to emphasize prevention rather than just diagnosis, treatment and basic research. The undersigned cancer and public health professionals urge you to undertake a thorough reform of cancer policies throughout your Administration, and make prevention the guiding strategy for the war against cancer.

Over the last decade, some five million Americans died of cancer. Cancer now strikes one in three and kills one in four Americans, with over 500,000 deaths last year. Cancer incidence rates in the white U.S. population (adjusted for increasing longevity) have increased by 43% from 1950-1988. During this time breast cancer has increased by 60%, childhoodd cancer by 21%, and other cancers by over 100%. 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".

There is substantial evidence that many of these cancers are due to avoidable exposures to industrial carcinogens in air, water, food, and the workplace. Meanwhile, our ability to treat and cure most cancers has remained virtually unchanged. From 1973-1988, 5-year survival rates have remained about 50% for the overall population and only 38% for Afro-Americans. The cancer mortality rate for black males is over four times higher than for white males.

The annual costs of cancer, an estimated $110 billion (nearly 2% of the GNP), are major inflationary factors in the current health care crisis with Per-case Medicare payments exceeding those for any other disease. These costs seriously threaten your Administration's efforts to provide health care to all Americans.

Even as cancer incidence escalates the National Cancer Institute (NCI) continues to mislead the public and Congress with claims that we are "winning" the war against cancer. The NCI which still attributes most cancer to smoking and dietary fat, discounts or ignores the causal role of avoidable exposures to occupational and environmental carcinogens and devotes minimal priorities and resources in its $1.9 billion budget to these concerns.

Your Administration offers great hopes for changing the nation's misdirected cancer policies and reversing the cancer epidemic. We attach a statement of reforms as general guidelines for redefining the mission and priorities of the NCI. We urgently request a meeting with your staff to discuss how we can work together to win the war against cancer.

Samuel S. Epstein, M.D.

Professor of Occupational and Environmental Medicine
The Chairman Cancer Prevention Coalition


Dan Abrahamson, M.D., Ph.D., Professor Public Affairs, University of Minnesota

Nicholas A. Ashford, Ph.D., J.D., Associate Professor Technology & Policy, Massachusetts Institute of Technology, Cambridge

Louis S. Beliczky, M.S., MPH, Director Industrial Hygiene Safety, United Rubber Workers, AFL-CIO

Rosalie Bertell, Ph.D., President International Institute of Public Health Concern, Toronto, Canada

Eula Bingham, Ph.D., University of Cincinnati Medical Center (former Assistant Secretary of Labor, OSHA)

Irwin D. Bross, Ph.D., President Metatechnology, Buffalo. (former Director Biostatistics Roswell Park Memorial Institute)

Barry Castleman, Ph.D., Environmental Consultant, Baltimore

David Christiani, M.D., Associate Professor Occupational Medicine. Harvard School Public Health

Richard Clapp, Ph.D., Director John Snow. Institute Boston

Paul Connett, Ph.D., Professor Chemistry. St. Lawrence University , New York

Brian Dolan, M.D., Internist. Santa Monica, California

Michael Ellenbecker, Ph.D., Professor Work Environment. University Massachusetts Lowell

George Friedman-Jimenez, M.D. Medical Director. Occupational & Environmental Health Clinic, Bellevue Hospital, NY

Richard Garcia, Ph.D., Entomologist. University of California, Berkeley

Jack Geiger, M.D., Professor Community Medicine CUNY Medical School, New York

Jay Gould, Ph.D., Director Radiation & Public Health Project, New York

Stephen Hessl, M.D., Chairman Division Medicine. Cook County Hospital, Chicago, Professor Occupational and Environmental Medicine, University Illinois

Thomas Higginbotham, D.O., Internist, Colorado Springs

Ruth Hubbard, Ph.D., Emerita Professor Biology, Harvard University

Howard Kippen, M.D., MPH, Professor Environmental & Occupational Health, Robert Wood

Johnson Medical School, Piscataway, New Jersey

Marc Lappe, Ph.D., Professor Health Policy & Ethnics, University Illinois College of Medicine, Chicago

Marvin Legator, Ph.D., Professor Preventive Medicine and Community Health, University Texas, Galveston

Brian Leibovitz, Ph.D., Editor-in-Chief. Journal Optimal Nutrition. Davis, California

Charles Levenstein, Ph.D., Professor Work Environment, University Massachusetts, Lowell

Edward A. Lichter, M.D., Professor Internal Medicine. University Illinois College of Medicine

William Lijinsky, Ph.D., (former Director Chemical Carcinogenesis, Frederick Cancer Research Center, Maryland)

Thomas Mancuso, M.D., Emeritus Professor Occupational Medicine, University Pittsburgh

Franklin E. Mirer, Ph.D., Director Health & Safety Department United Auto Workers, Detroit

David Monroe, Ph.D., Toxicologist. Oak Harbor, Washington

Vicente Navarro, M.D., Ph.D., Professor Health Policy, Johns Hopkins University

John W. Olney, M.D., Professor Medicine. Washington University School Medicine, St. Louis

Peter Orris, M.D., Senior Physician, Division Occupational Medicine, Cook County Hospital

Brandon P. Reines, D.V.M., President Center Health Science Policy, Washington, D.C.

Knut Ringen, Dr.Ph., Director Center to Protect Workers Rights. Washington, D.C. (Former Director Labor's Health & Safety Fund North America, Washington, D.C.)

Kenneth Rosenman, M.D., Professor Medicine, Michigan State University, Lansing

D.S. Sarma, Ph.D., Department of Pathology, University of Toronto, Canada

Ruth Shearer, Ph.D., Toxicologist. Issaquah, Washington

Janette D. Sherman, M.D., Internist. Alexandria, Virginia

Victor Sidel, M.D. Distinguished University Professor Social Medicine. Albert Einstein College Medicine, New York

Joseph H. Skom, M.D., Professor Clinical Medical Northwestern University Medical School, Chicago

John Spratt, M.D., American Cancer Society. Professor Oncology & Professor Surgery, Brown

Cancer Center. University Louisville Medical School, Kentucky

E.J. Sternglass, Ph.D., Emeritus Professor Radiological Physics. University, Pittsburgh Medical School

Carlo Tamburro, M.D., Professor Medicine & Chief Division Occupational Medicine.

Brown Cancer Center, University Louisville Medical School, Kentucky

George Wald, Nobel Laureate, Harvard University

George Washington University, Washington, D.C.

Thomas Woodcock, M.D. Professor Medicine & George Wald, Nobel Laureate, Harvard University

Laura Welch, M.D., Associate Professor Medicine, Director Division Occupational & Environmental Medicine Head Division Haematology & Oncology, Brown Cancer Center University Louisville Medical School, Kentucky

Charles Wurster, Ph.D., Associate Professor Environmental Toxicology. Marine Sciences Research Center, SUNY. Stony Brook, New York

Arthur Zahalsky, Ph.D., Professor Immunology, Department biological Sciences, Southern Illinois University, Edwardsville, Illinois

Grace Ziem, Ph.D., Consultant Occupational and Environmental Health, Baltimore

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