Director's Update: September 2, 2003
This year's just-published "Report to the Nation on the Status of Cancer" offers encouraging evidence that the accelerating pace of cancer research over the past several decades is paying dividends - but the report also indicates that we can and must do more.
It's good news that death rates from the four leading cancers - lung, breast, prostate, and colorectal - continue to decline, and good news that this decline has occurred in most states across the nation. Less encouragingly, the report shows that death and incidence rates for all cancers combined stopped declining and leveled off in the mid to late 1990s.
And for the four leading cancers, rates for some segments of our population are not falling as fast as others. For instance, while the breast cancer death rate has been declining among both blacks and whites, the decline has been steeper for whites. Similarly, the decrease in colorectal cancer death rates was not as great for black men and black women as for white men and white women.
This year's "Report to the Nation on the Status of Cancer" makes our purpose clear: We must work to accelerate the downward trends in mortality for the leading cancers and extend them to other cancers and all population groups. The authors of the report conclude that "further reduction in the burden of cancer is possible but will require the continuation of strong federal, state, local and private partnerships to increase dissemination of evidence-based cancer control programs to all segments of the population."
There are, in fact, many opportunities in addition to enhanced cancer control programs that we must harvest. Rapid advances in biomedical research over 30 years dramatically enhanced our understanding of cancer, leading to improved clinical practice and the gains that we have seen in the 1990s. Now, in the first decade of the new century, we are poised to build on these gains through coordinated, collaborative discovery, development, and delivery of even more effective interventions.
NCI is in a unique position to help accelerate progress in intervention development. Initiatives under development at NCI are intended to do exactly this, and to build on ongoing parts of the NCI portfolio. By way of illustration, in the area of discovery, we intend to increase our commitment to studies that illuminate the workings of the tumor microenvironment and how cancer initiation and progression are mediated and modified by that environment. An example in the area of development is our focus on exploiting the potential of nanotechnology - tiny tools that can be built molecule by molecule - to engineer implantable biomolecular sensors for continuous monitoring of disease progress. And in the area of delivery, we will use the Cancer Biomedical Informatics Grid (caBIG) to create a biomedical informatics network that will interconnect data and organizations to redefine how cancer research is conducted and cancer care is provided.
Accelerating progress toward the elimination of suffering and death due to cancer is our top priority. It is my sincere hope that we will see renewed evidence of such progress in the next release of the "Report to the Nation on the Status of Cancer."
Andrew C. von Eschenbach, M.D.
Director, National Cancer Institute
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