Wednesday, June 18, 2014

The Ongoing Challenge to Secure Resources for Cancer Prevention

The ongoing challenge of garnering appropriate resources and recognition for cancer prevention was highlighted yet again by a recently released paper in the Journal of Cancer Policy titled Cancer economics, policy and politics: What informs the debate? Perspectives from the EU, Canada and US.

The overall goal of this paper was to assess the factors that are informing and influencing the political debate on cancer economics in the United States, Canada, and Europe.  That the analysis focuses on cancer diagnosis and treatment isn't surprising.  What is surprising, however, is that a paper on the economics of the burden of cancer and cancer care almost completely ignores prevention.

If there is one thing that has become clear over the past decade it is that cancer is a problem we will not be able to treat our way out of.  With the aging population, prevalence of the disease is increasing so much, and the disease itself is simply so diverse, that therapies are very unlikely to have a major impact on cancer burden population-wide in the foreseeable future.

We know enough today, however, to prevent at least half of all cancer cases.  Yet, the word "prevention" appears exactly once in this paper, and the concept of prevention appears only in passing in a handful of places throughout.

Of course, this single paper isn't responsible for cancer prevention not receiving its due attention.  It is, however, an example of many cancer-related policy papers that don't fully acknowledge the potential of prevention in reducing population-wide cancer burden.

As CNiC's Graham Colditz stated in his recent paper: Carpe Diem: Time to Seize the Opportunity for Cancer Prevention:
"What is currently lacking is the political will to allocate resources, prioritize incentives and rewards, and implement regulations that reinforce behaviors that will prevent cancer. Given that we know today that 50% or more of cancer is preventable, gathering political support for prevention should be our highest priority. One likely reason for its current limited support is simply the nature of prevention. Its success is marked by silent victories. Those who do not get cancer do not have compelling stories of survival that often accompany cancer treatment. And the understated approach of prevention—putting into practice the knowledge we already have—does not garner the same political and research excitement associated with newer technologies and the hunt for undiscovered and unproven cancer risk factors. 
Of course, research across the full spectrum of cancer is essential and needs to continue. Cancer prevention, however, must be funded in proportion to its potential effect. If we do not act, with the aging United States population, the number of new cancer cases diagnosed annually will double within 35 years."
To make true headway against the burden of cancer - especially in the face of economic realities - it's time for such a vision for prevention to become reality. 

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