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Toward the control of cancer – issues opportunities screening and treatment

“Cancer is a devastating disease. It is estimated that 1.7 million Americans will be diagnosed with cancer in 2018 and approximately 610,000 will die of it. Cancer does not discriminate. It affects humans of all ages, races, and ethnicities. Although virtually everyone is at risk for developing and dying from cancer, the burden of this disease is not equal. Substantial disparities have been present for years. Bridging these disparities defines a central challenge for our nation’s cancer control efforts. Despite a 25‐year decline in the cancer mortality rate, cancer is the second leading cause of death in the United States and will surpass cardiovascular disease to become the leading cause of death in the next decade. Review of the progress to date indicates that, although much good has been done, much more good can be done. Since 1991, there has been a 26% decline in the cancer death rate age adjusted to the year 2000 standard population. There are more than 15.5 million cancer survivors in the United States. Given the challenge that still exists, it is appropriate to assess where the fields of cancer control and oncology have come from and where they are going, what issues must be dealt with, and what interventions must be implemented if we are to most efficiently control cancer. Over the past 5 decades, there has been an extraordinary investment in cancer research that has led to a greater understanding of the disease. Indeed, cancer is being redefined. We are literally moving from the mid‐19th century definition based on histopathology to a 21st century definition of cancer that also includes genomic information. Past investments in basic research are yielding better diagnostic and screening technologies and leading to new approaches to treatment. Molecular biology provides the foundation for new treatments in precision medicine. Decades of immunology research are showing us ways to effectively harness the patient’s immune system and encourage it to attack their cancer. At the same time, a better understanding of carcinogenesis is allowing for improved cancer prevention. doi: 10.3322/caac.21461. Available online at

In the next several issues of CA: A Cancer Journal for Clinicians, the American Cancer Society will publish a series of articles assessing trends in cancer mortality [Free Access] and issues and opportunities in cancer prevention, screening, and treatment. These articles summarize where we have come from, the current state of cancer in the United States, and how more consistent and equitable application of currently available interventions can further reduce the cancer incidence and death rates. When there are sufficient data to make a projection, estimates of the potential effect of cancer control interventions are included. Of course, we must continue to support scientific research and innovation, as the future promises even greater benefit…”

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