Recent news stories touted a 22% drop in cancer death rates that has “spared the lives” of over 1.5 million people over the past two decades. The American Cancer Society (ACS) was attributed as explaining this drop as caused by U.S. smoking habits, extra attention to cancer prevention, improvements in various cancer treatments, and advances in early detection methods.
Maybe I’m being too picky, but this reads like they’re counting screening twice: extra attention to cancer prevention and advances in early detection. The other two points I have no qualms with.
As apparently pure coincidence, the International Journal of Epidemiology published a study by John Ioannidas and colleagues that reviewed all high-quality trials of cancer screening. Their conclusion was “Among currently available screening tests for diseases where death is a common outcome, reductions in disease-specific mortality are uncommon and reductions in all-cause mortality are very rare or non-existent.”
By burying the point about better treatments in the middle of the prevention statements, the ACS has possibly misled the public about the relative weights of the causes for improvement. The reality is the new cancer treatments are effective at extending the median life expectancy – at a cost of $100,000+ per course of treatment to gain a few months of life. Pushing more prevention is politically safe. Transparently spreading the news that the new generation of biologic cancer treatments are somewhat effective, but very costly, is not safe.
The ACS has made some improvements over the last 5 years by not blindly supporting every theoretical possibility for cancer detection/prevention. It still has a long way to go in leading this country to a more adult conversation about the costs and outcomes of cancer treatments.