Today, nearly 14.5 million Americans have experienced a cancer diagnosis in their lifetime. Though we have seen progress in fighting the disease, cancer is still the second most common cause of death in the nation, exceeded only by heart disease. While there has been an important focus on finding better treatments and a cure, many risk factors contributing to cancer incidence and death are preventable. That is why BPC recently co-hosted an important conversation with the American Cancer Society Cancer Action Network spotlighting the country’s opportunities to fight cancer with prevention. The panel, moderated by former Agriculture Secretary and BPC Senior Fellow Dan Glickman, featured Acting Assistant Secretary for Health Dr. Karen DeSalvo and two of her predecessors, Dr. Howard Koh and Dr. Joxel Garcia. The event opened with a keynote presentation by Dr. Richard Wender that focused on prevention as an essential component to widespread reductions in cancer incidence and mortality.
Dr. Wender is the chief cancer control officer of the American Cancer Society, where he provides oversight and guidance to the organization’s domestic and global cancer control programs, with a focus on access, navigation, and health equity. During his presentation, the audience learned that age-adjusted mortality from cancer has decreased 26 percent since 1990 and a shocking 83 percent of that decrease is attributable to improvements in prevention and screening. Not surprisingly, the primary driver of preventable cancer death is tobacco use. But as obesity rates rise and tobacco use drops, the United States could see obesity overtake tobacco as the number one cause of preventable cancer deaths. Dr. Wender also offered poignant insights into cancer disparities that are widening, as advances such as mammograms become commonplace in certain populations, but remain inaccessible to others.
The panel discussion with the assistant secretaries recognized the tremendous opportunity presented by the fact that 50 percent of cancer deaths are preventable. There was consensus among the panel that key risk factors, such as obesity and tobacco use, can be combated using a public health approach where multiple sectors engage collaboratively in targeted prevention efforts. Dr. Garcia, currently the executive director of the Cancer Control and Prevention Platform at the University of Texas MD Anderson Cancer Center, highlighted the importance of considering upstream factors and social determinants of health: “If we continue finding cures of cancer, we’re actually missing the boat …. We have to go early and actually target specific populations … because they have higher risk.” Dr. DeSalvo, who previously served as the national coordinator for health information and technology, presented big data and analytics as tools to help drive prevention resources where they are needed most.
It came as no surprise that Glickman posed a question about how nutrition and obesity play into the fight against cancer. The panelists agreed that a knowledge gap exists about the impact that diet has on overall health, both among health professionals and the general population. But they highlighted several leading efforts to close that gap, such as innovative medical school programs and the most recent Dietary Guidelines. Dr. Koh, who is now a professor of Public Health Leadership at the Harvard School of Public Health and the Harvard Kennedy School, noted that although most people don’t make the connection that cancer can be prevented through lifestyle choices, there is overwhelming evidence to support the idea that “obesity prevention is cancer prevention.”
One key takeaway from the panel was the clear sense that now is the right moment to be embedding prevention in the larger fight against cancer. The Cancer Moonshot effort led by Vice President Joe Biden has brought renewed national attention to that fight, and BPC was pleased to see several prevention efforts, including human papillomavirus vaccine promotion, included in the Moonshot’s recent report. We have seen over the last decade the power of prevention to reduce cancer mortality. A substantial, sustained commitment to prevention will be necessary to maximize success in the fight to end cancer.