How Can We Win the War on Cancer?
We cannot improve cancer care without improving our health care system in general. Conversely, improving cancer care would markedly improve health care, since one of the most significant aspects of health care that obviously needs to change is our approach to cancer.
In January 2013, the National Research Council and the Institute of Medicine issued U.S. Health in International Perspective: Shorter Lives, Poorer Health—a stunning depiction of how, over the past four decades, the comparative health status of Americans has declined.1 Strikingly, the report applied a term, commonly used to describe the relative deprivation of certain social groups, to the United States as a whole: the “U.S. health disadvantage.”
The American Society of Clinical Oncology pointed out in 2014 that the demand for cancer prevention, screening and treatment services is growing rapidly.2
By 2030, the number of new cancer cases in the United States will increase by 45 percent, and cancer will become the nation’s leading cause of death, largely as a result of the aging of the nation’s population. At the same time, the number of cancer survivors, now almost 13.7 million, will continue to grow. Many of these individuals will require significant, ongoing care.
Access to quality cancer care remains uneven. Millions of people with cancer lack access to quality medical care, and rates of access to care are disproportionately lower for African Americans and Latinos. Today, one quarter of uninsured individuals forego care because of cost, and those without a regular source of care are less likely to receive cancer screening.
The Patient Protection and Affordable Care Act (ACA) is expected to provide millions more Americans with health insurance coverage in the coming years, but millions of Americans are expected to remain uninsured even after the ACA is implemented.
Soaring costs have created an urgent need to improve the value of patient care.
While costs are rising throughout the healthcare system, the trend is especially pronounced in cancer care annual costs that are projected to rise from $104 billion in 2006 to more than $173 billion in 2020. This increase is a result of many factors, including the cost of many new cancer therapies. Access to high-quality cancer care will be sustained and expanded only if we address these rising costs, including the use of unnecessary or ineffective tests and treatments.
Researchers at Columbia University’s Mailman School of Public Health call for a National Commission on the Health of Americans to hold public hearings and determine vigorous steps that must be taken to improve not just the health care of those at the bottom but the health care of Americans as a whole.3
There is strong evidence for action beyond interventions at the individual level. It’s time to reverse a
course of events at least four decades in the making that have put the United States last among comparable nations in health care.
There is reason to hope that the focus of cancer research and treatment will be guided by the visions of the American Society of Clinical Oncology and the Director of the National Cancer Institute, Dr. Harold Varmus, to change the “conversation” from a search for and destroy cancer cells focus to preventing and stopping the underlying processes that produce them.4
Up to 50 percent of cancer deaths are preventable by making positive lifestyle changes. Quitting smoking, losing weight if you’re overweight, exercising and eating nutritious foods clearly lower your cancer risk significantly.
Still, the financial incentives of the cancer culture and industries responsible for polluting our environment are not conducive to preventing and eradicating cancer.
The ideas that “cancer is an evolutionary process destined to ensure the survival of the fittest” and that cancer is inevitable also contribute to a sense of hopelessness.
For these reasons, strong public advocacy, including yours, will be required to focus research and treatment on designing effective treatments, reducing environmental pollution and promoting healthy life styles.