EVALUATION OF THE NATIONAL CANCER PROGRAM AND PROPOSED REFORMS

A statement by 68 prominent national experts in cancer prevention, carcinogenesis, epidemiology, and public health, released at a February 4, 1992, press conference in Washington, D.C., charged that the National Cancer Institute (NCI) has misled and confused the public by repeated claims of winning...

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Veröffentlicht in:International journal of health services 1993-01, Vol.23 (1), p.15-44
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description A statement by 68 prominent national experts in cancer prevention, carcinogenesis, epidemiology, and public health, released at a February 4, 1992, press conference in Washington, D.C., charged that the National Cancer Institute (NCI) has misled and confused the public by repeated claims of winning the war against cancer. In fact, age-standardized incidence rates have escalated to epidemic proportions over recent decades, while the ability to treat and cure most cancers has not materially improved. Furthermore, the NCI has minimized evidence for increasing cancer rates, which are largely attributed to smoking, trivializing the importance of occupational carcinogens as non-smoking attributable causes of lung and other cancers, and to diet per se, in spite of tenuous and inconsistent evidence and ignoring the important role of carcinogenic dietary contaminants. Reflecting this near exclusionary blame-the-victim theory of cancer causation, with lockstep support from the American Cancer Society and industry, the NCI discounts the role of avoidable involuntary exposures to industrial carcinogens in air, water, food, the home, and the workplace. The NCI has also failed to provide any scientific guidance to Congress and regulatory agencies on fundament principles of carcinogenesis and epidemiology, and on the critical needs to reduce avoidable exposures to environmental and occupational carcinogens. Analysis of the $2 billion NCI budget, in spite of fiscal and semantic manipulation, reveals minimal allocations for research on primary cancer prevention, and for occupational cancer, which receives only $19 million annually, 1 percent of NCI's total budget. Problems of professional mindsets in the NCI leadership, fixation on diagnosis, treatment, and basic research, much of questionable relevance, and the neglect of cancer prevention, are exemplified by the composition of the National Cancer Advisory Board. Contrary to the explicit mandate of the National Cancer Act, the Board is devoid of members authoritative in occupational and environmental carcinogenesis. These problems are further compounded by institutionalized conflicts of interest reflected in the composition of past executive President's Cancer Panels, and of the current Board of Overseers of the Sloan-Kettering Memorial Cancer Center, the NCI's prototype comprehensive cancer center, with their closely interlocking financial interests with the cancer drug and other industries. Drastic reforms of NCI polici
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In fact, age-standardized incidence rates have escalated to epidemic proportions over recent decades, while the ability to treat and cure most cancers has not materially improved. Furthermore, the NCI has minimized evidence for increasing cancer rates, which are largely attributed to smoking, trivializing the importance of occupational carcinogens as non-smoking attributable causes of lung and other cancers, and to diet per se, in spite of tenuous and inconsistent evidence and ignoring the important role of carcinogenic dietary contaminants. Reflecting this near exclusionary blame-the-victim theory of cancer causation, with lockstep support from the American Cancer Society and industry, the NCI discounts the role of avoidable involuntary exposures to industrial carcinogens in air, water, food, the home, and the workplace. The NCI has also failed to provide any scientific guidance to Congress and regulatory agencies on fundament principles of carcinogenesis and epidemiology, and on the critical needs to reduce avoidable exposures to environmental and occupational carcinogens. Analysis of the $2 billion NCI budget, in spite of fiscal and semantic manipulation, reveals minimal allocations for research on primary cancer prevention, and for occupational cancer, which receives only $19 million annually, 1 percent of NCI's total budget. Problems of professional mindsets in the NCI leadership, fixation on diagnosis, treatment, and basic research, much of questionable relevance, and the neglect of cancer prevention, are exemplified by the composition of the National Cancer Advisory Board. Contrary to the explicit mandate of the National Cancer Act, the Board is devoid of members authoritative in occupational and environmental carcinogenesis. These problems are further compounded by institutionalized conflicts of interest reflected in the composition of past executive President's Cancer Panels, and of the current Board of Overseers of the Sloan-Kettering Memorial Cancer Center, the NCI's prototype comprehensive cancer center, with their closely interlocking financial interests with the cancer drug and other industries. Drastic reforms of NCI policies and priorities are long overdue. 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Hygiene ; Public health. Hygiene-occupational medicine ; PUBLIC INFORMATION ; PUBLIC RELATIONS ; RADIOLOGY AND NUCLEAR MEDICINE ; Reform ; RESEARCH PROGRAMS ; Research Support as Topic - standards ; Risk Factors ; Section on Health Policy ; Survival Rate ; U.S.A ; United States - epidemiology ; USA ; USA 552000 -- Public Health ; WASHINGTON</subject><ispartof>International journal of health services, 1993-01, Vol.23 (1), p.15-44</ispartof><rights>Copyright © 1992, Baywood Publishing Co., Inc.</rights><rights>1993 SAGE Publications</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-2ff79aa2015cf4320f0e8f1fa06ab39ba0107cdf96c7599d9eaab9344d34b57c3</citedby><cites>FETCH-LOGICAL-c512t-2ff79aa2015cf4320f0e8f1fa06ab39ba0107cdf96c7599d9eaab9344d34b57c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/45131110$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/45131110$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,780,784,803,885,4024,27923,27924,27925,31000,33775,58017,58250</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=6437270$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8425784$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/6704965$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Epstein, Samuel S.</creatorcontrib><title>EVALUATION OF THE NATIONAL CANCER PROGRAM AND PROPOSED REFORMS</title><title>International journal of health services</title><addtitle>Int J Health Serv</addtitle><description>A statement by 68 prominent national experts in cancer prevention, carcinogenesis, epidemiology, and public health, released at a February 4, 1992, press conference in Washington, D.C., charged that the National Cancer Institute (NCI) has misled and confused the public by repeated claims of winning the war against cancer. In fact, age-standardized incidence rates have escalated to epidemic proportions over recent decades, while the ability to treat and cure most cancers has not materially improved. Furthermore, the NCI has minimized evidence for increasing cancer rates, which are largely attributed to smoking, trivializing the importance of occupational carcinogens as non-smoking attributable causes of lung and other cancers, and to diet per se, in spite of tenuous and inconsistent evidence and ignoring the important role of carcinogenic dietary contaminants. Reflecting this near exclusionary blame-the-victim theory of cancer causation, with lockstep support from the American Cancer Society and industry, the NCI discounts the role of avoidable involuntary exposures to industrial carcinogens in air, water, food, the home, and the workplace. The NCI has also failed to provide any scientific guidance to Congress and regulatory agencies on fundament principles of carcinogenesis and epidemiology, and on the critical needs to reduce avoidable exposures to environmental and occupational carcinogens. Analysis of the $2 billion NCI budget, in spite of fiscal and semantic manipulation, reveals minimal allocations for research on primary cancer prevention, and for occupational cancer, which receives only $19 million annually, 1 percent of NCI's total budget. Problems of professional mindsets in the NCI leadership, fixation on diagnosis, treatment, and basic research, much of questionable relevance, and the neglect of cancer prevention, are exemplified by the composition of the National Cancer Advisory Board. Contrary to the explicit mandate of the National Cancer Act, the Board is devoid of members authoritative in occupational and environmental carcinogenesis. These problems are further compounded by institutionalized conflicts of interest reflected in the composition of past executive President's Cancer Panels, and of the current Board of Overseers of the Sloan-Kettering Memorial Cancer Center, the NCI's prototype comprehensive cancer center, with their closely interlocking financial interests with the cancer drug and other industries. Drastic reforms of NCI policies and priorities are long overdue. Implementation of such reforms is, however, unlikely in the absence of further support from industrial medicine professionals, besides action by Congress and concerned citizen groups.</description><subject>550600 -- Medicine</subject><subject>Air Pollutants - adverse effects</subject><subject>Attitude of Health Personnel</subject><subject>Biological and medical sciences</subject><subject>Budgets</subject><subject>Cancer</subject><subject>CARCINOGENESIS</subject><subject>CARCINOGENS</subject><subject>Conflict of Interest</subject><subject>Continental Population Groups</subject><subject>DEVELOPED COUNTRIES</subject><subject>DIET</subject><subject>DISEASE INCIDENCE</subject><subject>DISEASES</subject><subject>ENVIRONMENTAL EXPOSURE</subject><subject>EPIDEMIOLOGY</subject><subject>EVALUATION</subject><subject>FEDERAL EXPENDITURES</subject><subject>Female</subject><subject>GENERAL AND MISCELLANEOUS//MATHEMATICS, COMPUTING, AND INFORMATION SCIENCE</subject><subject>GOVERNMENT POLICIES</subject><subject>HAZARDS</subject><subject>HEALTH HAZARDS</subject><subject>Health policy</subject><subject>Health Priorities</subject><subject>Humans</subject><subject>Incidence</subject><subject>INDUSTRY</subject><subject>INFORMATION</subject><subject>Institutes</subject><subject>Interinstitutional Relations</subject><subject>Leadership</subject><subject>Male</subject><subject>Medical Research</subject><subject>Medical sciences</subject><subject>Methodological Problems</subject><subject>Miscellaneous</subject><subject>Morbidity</subject><subject>National Health Programs - organization &amp; administration</subject><subject>National Health Programs - standards</subject><subject>National Institutes of Health (U.S.) - organization &amp; administration</subject><subject>National Institutes of Health (U.S.) - standards</subject><subject>National programmes</subject><subject>NEOPLASMS</subject><subject>Neoplasms - epidemiology</subject><subject>Neoplasms - etiology</subject><subject>Neoplasms - prevention &amp; control</subject><subject>Neoplasms - therapy</subject><subject>NORTH AMERICA</subject><subject>OCCUPATIONAL EXPOSURE</subject><subject>Organizational Objectives</subject><subject>PATHOGENESIS</subject><subject>Prevention</subject><subject>Primary Prevention - methods</subject><subject>Primary Prevention - standards</subject><subject>PUBLIC HEALTH</subject><subject>Public health. 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In fact, age-standardized incidence rates have escalated to epidemic proportions over recent decades, while the ability to treat and cure most cancers has not materially improved. Furthermore, the NCI has minimized evidence for increasing cancer rates, which are largely attributed to smoking, trivializing the importance of occupational carcinogens as non-smoking attributable causes of lung and other cancers, and to diet per se, in spite of tenuous and inconsistent evidence and ignoring the important role of carcinogenic dietary contaminants. Reflecting this near exclusionary blame-the-victim theory of cancer causation, with lockstep support from the American Cancer Society and industry, the NCI discounts the role of avoidable involuntary exposures to industrial carcinogens in air, water, food, the home, and the workplace. 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subjects 550600 -- Medicine
Air Pollutants - adverse effects
Attitude of Health Personnel
Biological and medical sciences
Budgets
Cancer
CARCINOGENESIS
CARCINOGENS
Conflict of Interest
Continental Population Groups
DEVELOPED COUNTRIES
DIET
DISEASE INCIDENCE
DISEASES
ENVIRONMENTAL EXPOSURE
EPIDEMIOLOGY
EVALUATION
FEDERAL EXPENDITURES
Female
GENERAL AND MISCELLANEOUS//MATHEMATICS, COMPUTING, AND INFORMATION SCIENCE
GOVERNMENT POLICIES
HAZARDS
HEALTH HAZARDS
Health policy
Health Priorities
Humans
Incidence
INDUSTRY
INFORMATION
Institutes
Interinstitutional Relations
Leadership
Male
Medical Research
Medical sciences
Methodological Problems
Miscellaneous
Morbidity
National Health Programs - organization & administration
National Health Programs - standards
National Institutes of Health (U.S.) - organization & administration
National Institutes of Health (U.S.) - standards
National programmes
NEOPLASMS
Neoplasms - epidemiology
Neoplasms - etiology
Neoplasms - prevention & control
Neoplasms - therapy
NORTH AMERICA
OCCUPATIONAL EXPOSURE
Organizational Objectives
PATHOGENESIS
Prevention
Primary Prevention - methods
Primary Prevention - standards
PUBLIC HEALTH
Public health. Hygiene
Public health. Hygiene-occupational medicine
PUBLIC INFORMATION
PUBLIC RELATIONS
RADIOLOGY AND NUCLEAR MEDICINE
Reform
RESEARCH PROGRAMS
Research Support as Topic - standards
Risk Factors
Section on Health Policy
Survival Rate
U.S.A
United States - epidemiology
USA
USA 552000 -- Public Health
WASHINGTON
title EVALUATION OF THE NATIONAL CANCER PROGRAM AND PROPOSED REFORMS
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