The United States Program on Cancer, 1975-2003: A Dismal Failure

It seems to us that we are living in a cancer epidemicincreases was that at the end of the period, 2003,
in the United States. Both of us have lost parents tomany more people were dying from cancer than died
cancer, and we have been losing more and morein 1975.
relatives and friends to cancer. Based on our ownOver the period of analysis (1975-2003), a total of 33
sad experience, we were driven to carry outmillion Americans were afflicted by cancer. Even this
research on the impacts of cancer in the U.S. overis an underestimate, due to delayed reporting of
the period 1975 to 2003. This study assesses the U.S.cancer cases, and the actual number would be
cancer program, as guided by the National Cancerconsiderably higher. During the same period, a total of
Institute, by examining three basic measures of that15 million Americans lost their lives to cancer. The
program: 1) the cancer incidence rate; 2) the cancerratio between these two numbers provides an
mortality rate; and 3) the probability of gettingapproximation of those who die in relation to those
cancer for an American male or female in theirafflicted by cancer - at 45 percent. Almost half of
lifetime. The basic data series were obtained fromthose who get cancer will eventually die from it.
NCI's SEER (Surveillance, Epidemiology, and EndProbability of Getting Cancer
Results) program. The result of our research was aWith regard to one's chances of getting cancer, as
paper (52 pages), and this is a synopsis of thatof 2002, American males faced a staggering
paper. The paper in its entirety is available on theprobability that is close to 50 percent of contracting
web:cancer in their lifetime, while American females were
The findings of our research on the impacts offacing a 42 percent probability of getting cancer in
cancer on Americans are grim and shocking. Sincetheir lifetime. Moreover, these probabilities have been
1975, the effects of cancer on people has beengetting worse over time. By contrast, the probability
continuously and steadily worsening - with thein 1975-1977 for an American man or woman of
following dismal outcomes of the three measures:contracting cancer was 34 percent. This was already
Cancer Incidencea high number - which became even higher over time.
The reported age-adjusted cancer incidence rate ofFurthermore, the probabilities - particularly in the
Americans getting cancer in 2003 was 460 people1990s and 2000s - are underestimates since cancer
per 100,000. This was in stark contrast to 400 peopleprobabilities are calculated from cancer incidence rates
per 100,000 in 1975. This reveals a significantand these rates are underestimates as a result of
worsening of cancer incidence in the U.S. over time.reporting delays.
In actual numbers, this means that 1.3 millionCancer in the News
Americans got cancer in 2003 as compared toDespite data shortcomings that result in significant
864,540 in 1975. This bleak situation is even worseunderestimates of cancer statistics, the existing
because of the delays in the reporting of cancercancer data show a dismal situation with respect to
cases (Clegg et.al., 2002). As a result of these delays,cancer prevention and cancer treatment. The grim
the reported cancer incidence in 2003 is anstatistics are typically not depicted in the news media.
underestimate of the correct incidence, which weOver the years, the media has focused on news
have calculated to be 494 per 100,000 people gettingportraying small numbers of deaths, from diseases
cancer; and the total number of Americans gettinglike the bird flu, and have ignored the horrendous fact
cancer now increases to 1.4 million people.that millions of Americans with cancer have died, and
Over the period of analysis, 1975-2003, the reportedcontinue to die, from cancer. In addition, they have
cancer incidence rate increased at an average annualfocused on short periods of time that give misleading
rate of 0.5 percent. This positive growth rate meansresults.
that the number of people diagnosed with cancerConclusions and Recommendations
every year was increasing faster than the populationIf the cancer program worked, positive benefits to
of the country. Moreover, this rate will be higher withAmericans would have been shown by a decrease in
the adjusted incidence numbers for the delayedthe cancer incidence rate and the mortality rate,
reporting of cancer cases (particularly for 1993 tofrom their levels in 1975. In addition, the probability of
2003). In addition, the total number of Americansgetting cancer in one's lifetime would have decreased.
affected by cancer increased every year (1975-2003)That did not happen; on the contrary, the numbers
by 1.6 percent (also an underestimate).increased across all measures. Even a rudimentary
Cancer Mortalityevaluation of the costs of the NCI compared to the
During each of the 25 years since 1975 - until 2001 -benefits obtained by the American people would
more Americans died from cancer, per 100,000, thanconclude that it has been a horribly inefficient use of
in 1975. Also, many more Americans died from cancernational funds.
in 2003 - 553,244 - than in 1975 - 430,002.A single main recommendation arises from the big
Furthermore, we surmise that the number of cancerand continuing failure of the NCI cancer program: The
mortality rates reported by SEER/NCI areNational Cancer Institute to be drastically restructured
underestimates due to the likely misses of cancerand its programs to be significantly changed, in order
death cases when they are marked in theto develop and make effective programs of
IMMEDIATE CAUSE section of the death certificateprevention and programs of treatment of cancer.
rather than the UNDERLYING CAUSE section; thisThe American people have been paying too high a
shortcoming can be a substantial one.price - with their lives - for an extremely misguided
It is a very disturbing fact that the number ofand ineffective cancer program.
Americans who have been losing their lives to cancer,References
in the 1990s and the 2000s - on a daily basis -Clegg, L.X., et.al., "Impact of Reporting Delay and
reached the count of a World Trade Center towerReporting Error on Cancer Incidence Rates and
at 1,500 people. This number translates into 63Trends." Journal of the National Cancer Institute. Vol.
Americans dying from cancer every hour of the day94, No. 20, Oct. 16, 2002, pp. 1537-1545.
- which means 1 American dies from cancer everyNational Cancer Institute (NCI). Surveillance,
minute. These are indeed grim statistics, attributableEpidemiology and End Results (SEER), 1975-2002.
to the failure of the cancer program.United States Bureau of the Census. Statistical
The total number of people in the U.S. who lost theirAbstract of the United States, 2006; section on
lives to cancer also increased annually at a rate of 0.9Population.
percent (1975-2003). The dismal result of these