Cancer Death Rate
Image by F. Muhammad from Pixabay

WASHINGTON — President Biden unveiled a plan on Wednesday to reduce the death rate from cancer by at least 50 percent over the next 25 years — an ambitious new goal, he said, to “supercharge” the cancer “moonshot” program he initiated and presided over five years ago as vice president.

Mr. Biden, joined by his wife, Jill Biden, and Vice President Kamala Harris, also announced a campaign to urge Americans to undergo screenings that were missed during the coronavirus pandemic. And he said he would create a new “cancer cabinet” to center the fight against cancer inside the White House.

“Let there be no doubt,” the president declared during a White House ceremony attended by roughly 100 people, including patients, doctors, caregivers, researchers and members of Congress. “Now that I am president, this is a presidential White House priority — period.”

But despite the grand ambitions of the moonshot, cancer experts expressed doubt that it would be possible to so profoundly reduce the age-adjusted death rate, which accounts for expectations that older people are more likely to grow ill and die.

More screenings are not the answer — the only cancers for which screening has indisputably lowered the death rate are colon and cervical. Death rates for other cancers, like breast, have fallen, but a large part of the drop, if not all of it, is because of improved treatment, said Donald A. Berry, a biostatistician at the University of Texas M.D. Anderson Cancer Center who has spent decades studying these issues.

“Everybody loves early detection, but it comes with harms,” he said — principally, the harm of finding and treating tumors that do not need to be treated because they are innocuous. “The harms we know, but the benefits of screening are very uncertain,” he said.

If the age-adjusted cancer death rate were to plunge by 50 percent, it would have to be because cancers were being cured. Some treatments, like a drug that treats chronic myelogenous leukemia, have slashed death rates for that disease, but such marked effects in cancer are few and far between.

The president has a deep personal interest in cancer research; in 2015, his son Beau died of glioblastoma, an aggressive brain cancer. The next year, President Barack Obama called on Mr. Biden in his State of the Union address to lead the moonshot program, with a goal of making “a decade’s worth of advances in cancer prevention, diagnosis and treatment” in five years.

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At the time, Congress authorized $1.8 billion over seven years; roughly $400 million of that money has yet to be allocated. The National Cancer Institute, which oversees the initiative, says it has already spent $1 billion on more than 240 research projects.

Senior administration officials, speaking on condition of anonymity, said Tuesday evening that the White House would not be announcing any new funding commitments, but insisted that there would be “robust funding going forward.” Mr. Biden called on Congress to appropriate money to create a health research initiative modeled on the Pentagon’s Defense Advanced Research Projects Agency, known as DARPA.

The White House billed the event as a fresh push by the president to “reignite” the moonshot program and “end cancer as we know it.” Specifically, Mr. Biden set a goal of cutting the age-adjusted death rate by more than half over the next 25 years. But there were few specifics about how that goal would be achieved.

“These are audacious goals, and I have no doubt there will be mechanisms to achieve them,” said Ellen V. Sigal, the founder of Friends of Cancer Research, which works to support cancer research and deliver new therapies to patients, who was briefed on the plan.

Mr. Biden has already named Danielle Carnival, who worked on the moonshot program during the Obama administration, to help oversee the new version of the effort. Now, the president said, the “cancer cabinet” will coordinate the work of multiple government agencies.

The White House says more than 9.5 million cancer screenings were missed in the United States as a result of the pandemic. Mr. Biden is calling on the cancer institute, a branch of the National Institutes of Health, to coordinate with cancer treatment centers to offer screenings around the country, and to develop a program to fast-track the development of tests that can detect multiple types of cancer at once.

The new blood tests that are said to detect all cancers are still unproven and there are currently no plans to do the sort of very large studies that could determine if they actually prevent deaths and are not harming people with unnecessary treatment. But companies interested in them were thrilled with Mr. Biden’s announcement.

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