Within the next decade, cancer is likely to replace heart disease as the leading cause of U.S. deaths, according to forecasts by the NCI and the Centers for Disease Control and Prevention. It is already the biggest killer of those under 75. Among those ages 45 to 64, cancer is responsible for more deaths than the next three causes (heart disease, accidents, and stroke) put together. It is also the leading disease killer of children, thirtysomethings--and everyone in between.
Researchers point out that people live a lot longer than they used to, and since cancer becomes more prevalent with age, it's unfair to look just at the raw numbers when assessing progress. So when they calculate the mortality rate, they adjust it to compare cancer fatalities by age group over time. But even using this analysis (in which the proportion of elderly is dialed back to what it was during the Nixon administration), the percentage of Americans dying from cancer is about the same as in 1970 ... and in 1950. The figures are all the more jarring when compared with those for heart disease and stroke--other ailments that strike mostly older Americans. Age-adjusted death rates for those diseases have been slashed by an extraordinary 59% and 69%, respectively, during the same half-century.
Today the cancer effort is utterly fragmented--so much so that it's nearly impossible to track down where the money to pay for all this research is coming from. But let's try anyway.
We begin with the NCI budget. Set by Congress, this year's outlay for fighting cancer is $4.74 billion. Critics have complained that is a mere 3.3% over last year's budget, but Uncle Sam gives prodigiously in other ways too--a fact few seem to realize. The NIH, technically the NCI's parent, will provide an additional $909 million this year for cancer research through the National Institute of Environmental Health Sciences and other little-noticed grant mechanisms. The Department of Veterans Affairs will likely spend just over the $457 million it spent in 2003 for research and prevention programs. The CDC will chip in around $314 million for outreach and education. Even the Pentagon pays for cancer research--offering $249 million this year for nearly 500 peer-reviewed grants to study breast, prostate, and ovarian cancer.
Now throw state treasuries into the mix--governors signed 89 cancer-related appropriations from 1997 to 2003--plus the fundraising muscle of cancer charities, cancer centers, and research hospitals, which together will raise some $2 billion this year from generous donors, based on recent tax forms. And finally, that huge spender Big Pharma. The Tufts Center for the Study of Drug Development estimates that drug companies will devote about $7.4 billion, or roughly a quarter of their annual R&D spending, to products for cancer and metabolic and endocrine diseases.
When you add it all up, Americans have spent, through taxes, donations, and private R&D, close to $200 billion, in inflation-adjusted dollars, since 1971
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According to PubMed, the NCI's online database, the cancer research community has published 1.56 million papers--that's right: 1.56 million!--largely on this circuitry and its related genes in hundreds of journals over the years. Many of the findings are shared at the 100-plus international congresses, symposiums, and conventions held each year.
