November 4, 2021
A half century since the National Cancer Act passed, understanding of the disease has deepened but challenges remain
Vincent DeVita Jr., M.D., was the medical branch chief of the National Cancer Institute (NCI) when Richard Nixon launched the “war on cancer” in December 1971. “[T]he same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease,” the president told a national TV audience, calling for an intensive $100 million quest for a cure that would be sparked by new legislation known as the National Cancer Act of 1971.
DeVita, who was 36 at the time, was skeptical. He has since changed his mind. “Money does buy ideas when you put brilliant scientists to work,” says the oncologist and researcher, who became director of the NCI from 1980 to 1988 and later director of the Yale Cancer Center. Today — 50 years and over $100 billion later — he believes that “we are not only winning the war on cancer, but the death of cancer is inevitable.”
Successes and challenges
Decisive victories abound. Since 1971, the cancer death rate is down more than 25 percent. Between 1975 and 2016, the five-year survival rate increased 36 percent. The arsenal of anticancer therapies has expanded more than tenfold. Mammograms, colonoscopies and other screenings are finding common cancers in early stages more often, when survival odds are as high as 99 percent.
Yet cancer remains the number 1 killer of Hispanic and Asian Americans, of women in their 50s and of everyone ages 60 to 80. Your lifetime risk for invasive cancer: a stunning 1 in 2 for men, 1 in 3 for women. And while it can strike at any time in our lives, cancer is now understood to be primarily a disease of aging, one that has proven more complicated than we ever imagined. While the root issue in all cancers is cells that mutate and grow uncontrollably, how this happens, the effects it has and how to treat it vary enormously, based on where in the body these cancerous cells occur.
“When the war on cancer started, somehow people thought we could do it in 10 years,” says oncologist Ezekiel Emanuel, M.D., vice provost for global initiatives at the University of Pennsylvania. “But going to the moon was easier. It takes a long time to understand complicated diseases.”