American Cancer Society
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A new report assesses how the nation fared against the ambitious
challenge goal set by the American Cancer Society to reduce the cancer death
rates by 50% over 25 years ending in 2015.
The report finds areas where progress was substantial, and
others where it was not.
The report, appearing in the American Cancer Society journal,CA:
A Cancer Journal for Clinicians, says the best improvements were seen in
cancers for which prevention, early detection, and treatment tools are
available, including cancers of the lung, colon, breast, and prostate.
How much more progress will be made going forward will depend on
how well policy makers and the American public work together to continue
progress in those areas, and in making the best available care accessible to
all.
In 1996, the Board of Directors of the American Cancer Society
challenged the United States to reduce what looked to be peak cancer mortality
in 1990 by 50% by the year 2015.
The current analysis, led by Tim Byers, MD, of the University of
Colorado, examined trends in cancer mortality across the 25-year challenge
period from 1990 to 2015*. The report found:
- In 2015, the overall cancer death rate was 26% lower than in 1990 (32% lower among men and 22% lower among women).
- Among men, mortality rates dropped for lung cancer by 45%, for colorectal cancer by 47%, and for prostate cancer by 53%.
- Among women, mortality rates dropped for lung cancer by 8%, for colorectal cancer by 44%, and for breast cancer by 39%.
- Declines in the death rates of all other cancer sites were substantially smaller (13% among men and 17% among women).
The major factors that accounted for the drops were progress in
tobacco control and improvements in early detection and treatment.
"As we embark on new national cancer goals, this recent
past experience should teach us that curing the cancer problem will require 2
sets of actions: making new discoveries in cancer therapeutics and more
completely applying those discoveries in cancer prevention we have already
made," write the authors.
The report says not fully reaching the goal should be seen as an
opportunity.
"That the ACS challenge goal to reduce US cancer mortality by 50% over the 25-year period from 1990 to 2015 was only one-half achieved should be seen as a glass half full. This progress should eliminate any historical remnants of cancer fatalism, and it should now stimulate our national imagination about what might be possible to achieve into the future."
The report says the effort also has a valuable lesson in
goal-setting: "The best goals are those that stretch the limits of what
might actually be achieved by renewed efforts. There is a sweet spot in goal
setting between projecting what will likely happen regardless of renewed
efforts (setting the bar too low) and creating unrealistic challenges that tend
to paralyze us (setting the bar too high)."
The report concludes:
"All sectors of civil society will need to join in efforts to further reduce cancer mortality in the United States, including those focused on the many social determinants of cancer, including income, availability of care, and many other social and environmental factors impacting cancer-reducing policies and programs. How much more progress we will make will depend on the extent to which policy makers and the American public can join together to create systems and incentives to understand cancer better, to reduce several of the known risk factors for cancer, to better diagnose cancer earlier, and to assure that state-of-the-art treatment is available for all."
* 2015 rates were estimated as a linear extrapolation of the
trends from 2010 to 2014