The Cancer Policy Environment
Barriers to Faster Oncology Innovation, and Strategies for Moving Forward
As a society, we still face many difficult barriers in the fight against cancer. This discussion paper is meant to provide a rough map of the cancer policy terrain and to encourage readers to focus on common challenges regardless of geography, culture, or profession.
The War on Cancer
The National Cancer Act of 1971, a U.S. federal law, signified the beginning of what has come to be known as the "War on Cancer." The long-term goal of this action was to eradicate cancer, while more concrete and short-term goals included increasing resources for research and prioritizing efforts against cancer.
Almost 40 years later, cancer is recognized as a global health crisis, with nearly 12.7 million new cases in 2008, about 44 percent of which occurred in more developed regions. Cancer is a leading cause of death worldwide, responsible for 7.6 million deaths (13 percent of all deaths) in 2008. By 2030, 22 million new cancer cases are expected, representing an increase of 73 percent from 2008, and deaths from cancer worldwide are projected to exceed 13.1 million.
The World Cancer Declaration
In 2008, the Union for International Cancer Control (UICC) drafted the World Cancer Declaration to bring attention to the ongoing and increasing cancer crisis and reduce the global cancer burden by 2020. It describes 11 key targets supported by a worldwide community and calls on decision makers to support key actions required for a cancer- free world. As of 2012, nearly 520,000 cancer advocates have signed the declaration.
Cancer mortality rates have decreased since the 1970s, although not at a pace that satisfies many physicians, researchers, or patients. The War on Cancer turned out to be much more difficult and protracted than expected. Researchers have come to realize that cancer is not one single disease and that patients respond even to advanced treatments in highly individualized ways based on their genetic profiles and disease stages.
Recent advances in genomic technologies have provided researchers with unprecedented abilities to characterize tumors at the DNA level. Unfortunately, results from these studies suggest that there is not only large heterogeneity between tumors in different patients, but also heterogeneity of tumor cells within the same patient. In addition to inherent biological complexities of the disease, a number of other barriers including those related to translational medicine, the drug approval process, and early detection have conspired to thwart progress in defeating cancer.
Cancer Tomorrow: Faster Steps Forward
The war on cancer simply cannot succeed based on policies established before the new insights on cancer. A continuing overhaul of laws, regulations, and programs governing the research, development, regulation, evaluation, and uptake of cancer treatments today is vital.Download Full Paper