The American Cancer Society published its first in a series of articles in CA: A Cancer Journal for Clinicians that collectively will outline our vision for cancer control for the U.S. through 2035. It assesses progress thus far in cancer control by reviewing trends in cancer mortality and disparities in cancer outcomes, and concludes: "We can do better."
These articles comprise our "Blueprint for Cancer Control," and are meant to form the basis of a national cancer control plan and our organization's vision for how cancer prevention, screening, diagnosis, and treatment can be transformed to define the most efficient path to lower the cancer burden in our nation.
"It is our hope that this blueprint will be a call to action for cancer patients, family members of cancer patients, professional organizations, government agencies, the medical profession, academia, and industry to work together to implement what is known about cancer control," write the authors, led by our Chief Medical Officer Otis Brawley, MD.
Published on July 10 was an introduction, Toward the Control of Cancer, and article one, An Assessment of Progress in Cancer Control. Subsequent chapters will focus on cancer risk factors, screening, treatment, survivorship, and research.
There has been a good amount of media coverage. Of particular interest, is Dr. Brawley's interview with NPR.
Despite a 25-year decline in mortality rate, cancer remains the second-leading cause of death in the U.S. and is expected to become the leading cause of death in the next decade. To refocus nationwide efforts, the ACS has assessed the successes and challenges in cancer control and oncology, identifying key issues that must be addressed and what interventions must be implemented to most efficiently control cancer.
One area of critical disparity is in socioeconomic status. Using educational attainment as a surrogate of socioeconomic status, ACS epidemiologists in this report estimate that 1 in 4 current cancer deaths would not occur if all Americans had the cancer death rate of college educated Americans. Applying the death rate for the most educated group (bachelor's degree or above) to the entire population would lead to 59% fewer lung cancer deaths, 32% fewer colorectal cancer deaths, 19% fewer pancreas cancer deaths, and 50% fewer liver cancer deaths. In total, more than 150,000 of the estimated 610,000 cancer deaths in the U.S. in 2018 would not occur if all Americans had the same levels of cancer risk exposure and received the same amount and quality of care as college graduates.
"This calculation speaks volumes," write the authors. "The statistics demonstrate our obligation to deliver the fruits of already completed research to all Americans. They tell us what can be accomplished in cancer control without the development of new technology, new screening tests or new treatments."
In the introduction, the authors note: "These goals cannot be achieved, however, without recognizing that the roots of health care disparities are deep, reflecting fundamental determinants of health, such as poverty, conscious and unconscious racism, barriers to the availability of healthy foods, a "built community" that limits opportunities for physical activity, and lack of systems that ensure access to high-quality health care. Any national cancer control plan must include meaningful efforts to address these determinants of health."
The Blueprint also will inform ACS priorities going forward, and reinforces ACS's leadership in cancer control.