Cancer: Where We Are and Where We Must Go

1. Cancer: Where We Are and Where We Must Go American Association for Cancer Education European Association for Cancer Education Cancer Patient Education Network Annual Meeting John R. Seffrin, PhD National Chief Executive Officer American Cancer Society

2. Our Goals for 2015: • Decrease cancer mortality by 50 percent • Reduce cancer incidence rates by 25 percent • Measurably improve the quality of life for people with cancer

3. The Early Days • The mystery • The belief • The reality

4. 1946 – Research Program • First successful chemotherapy • Study linking cigarette smoking and lung cancer • Pap test • Prostate-specific antigen (PSA) test • Linkage of asbestos to lung and other cancers • Bone marrow transplants • Development of Tamoxifen and Gleevec • Cancer Prevention Studies l, ll, and lll • Sequencing of the human genome

5. The Progress George N. Papanicolaou, MD

6. All Sites – Mortality RatesBy Year of Death – All Races, Males and Females 2015 Goal – 50 Percent Reduction from Baseline 1991 Baseline 215.1 ( 14.5% from Baseline) 2005 184.0 2015 Projected Rate-145.2 (Current trend to 2015 -  32.5% from Baseline) (The latest joinpoint trend (2002-2005) shows a -1.8 APC in age-adjusted rates) 2015 Goal 107.6 Incidence and mortality rates are per 100,000 and are age-adjusted to the 2000 U.S. standard population. SEER Cancer Statistics Review 1975-2003.

7. All Sites – Mortality Rates By Year of Death – Males and Females – All Races 2015 Goals – 50% Reduction from Baseline Males Females Incidence and mortality rates are per 100,000 and are age-adjusted to the 2000 U.S. standard population. SEER Cancer Statistics Review 1975-2001.

8. Facts of Life … or Death … about Cancer How cancer develops is no longer a mystery … either in how it develops in a person or how it becomes an epidemic in a population. Most human cancer (considerably more than one-half) could be prevented throughout a normal human life span. Most cancer illness, suffering, and death could be avoided throughout a normal human life span. When faced with terminal cancer, state-of-the-art care at end of life results in death with dignity for most cancer patients.

9. Facts of Life … or Death … about Cancer Further reductions in the overall cancer mortality rates will have a significant beneficial effect on the U.S. economy. Cancer can be brought under control as a major public health problem in the United States early in this century if we do the right things. If we fail to intervene with state-of-the art knowledge and proven interventions (both medical and public health), cancer will inevitably become the leading cause of death in the United States by 2018.

10. Facts of Life … or Death … about Cancer • Today, cancer is potentially the most preventable and the most curable of the chronic, life-threatening diseases facing Americans … if we do the right things.

11. What It Will Take We must accelerate discovery by redoubling and balancing our nation’s cancer research portfolio. We must promote and elevate prevention into public policy and standard practice nationwide. We must drive delivery of state-of-the-art cancer care and cancer control at the community level by ensuring access to quality health care for all people.

12. Discovery We must accelerate discovery by redoubling and balancing our cancer research portfolio.

13. Prevention We must promote and elevate prevention into public policy and standard practice nationwide.

14. Prevention • Clean indoor air laws and smoking bans in all public areas and all worksites • Unfettered FDA regulation of all tobacco products and their marketing, especially to children and youth • Reimbursement for smoking cessation therapy • Required time for health education and physical education in all school curricula • Incentives, such as pay for performance, for all proven prevention and early detection tests for cancer • Increases in tobacco excise taxes

15. The Power of Prevention

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22. Roughly 500,000 deaths prevented each year The Potential

23. Delivery We must drive delivery of state-of-the-art cancer care and cancer control at the community level by ensuring access to quality health care for all people.

24. Access to Care: The Campaign 24

25. Access to Care: Why It Matters Cancer patients who have … … skipped treatment, cut pills, or not filled prescriptions due to cost – 40% … used up all or most of their savings – 46% … been unable to pay for basic necessities, including food, heat, and housing – 41% … sought the aid of charity or public assistance – 35% … delayed treatment or opted not to seek treatment at all because of the cost – 27%

26. “ The American Cancer Society’s new advertising campaign urging access to quality health care for all Americans will bring home in gripping terms what happens to people without health insurance. When it comes to dealing with cancer, any delay in detection or treatment, as is common among the uninsured or poorly insured, can be fatal. ” “Cancer’s High Toll on the Uninsured” The New York Times Editorial September 11, 2007

27. Colorectal Cancer Screening*, in Adults, ages 50-64, by Years of Education and Insurance Status Insured Uninsured *Either a fecal occult blood test within the past year or an endoscopy within the past ten years. Source: National Health Interview Survey 2005, National Center for Health Statistics, Centers for Disease Control and Prevention, 2006.

28. Colorectal Stage vs. Insurance

29. Adjusted Colorectal Cancer Survival by Stages and Insurance Status, among Patients Diagnosed in 1999-2000 and Reported to the NCDB

30. Access Campaign – Successes • Encouraged people to take action on the issue • Established four principles for meaningful insurance • Peer-reviewed research on uninsured and cancer outcomes • Collaborated – Are You Covered? • Propelled the cancer issue into the forefront of the national discussion about reform • Earned a “seat at the table”

31. Higher Per Capita Spending in the U.S. does notTranslate into Longer Life Expectancy The Cost of a Long Life Average Life Expectancy (years) Per Capita Spending in USD Life Expectancy – Per Capita Spending 2006 CIA FACTBOOK

32. What Will the Future Hold? • Post-election: another chance at health care reform? • Globalization • Therapeutic advances • Anti-angiogenesis • Vaccines • Targeted therapy

33. What It Will Take We must accelerate discovery by redoubling and balancing our nation’s cancer research portfolio. We must promote and elevate prevention into public policy and standard practice nationwide. We must drive delivery of state-of-the-art cancer care and cancer control at the community level by ensuring access to quality health care for all people.

34. Thank you.