The goal set by the National Cancer Institute to reduce cancer deaths by 50% by the year 2000 will fail unless known preventive measures are more widely practiced, cancer control experts told a meeting of the National Cancer Advisory Board in Los Angeles on Tuesday.
Although some headway in prevention is being made, the greatest boost could come by stepping up no-smoking programs, including less fat and more fiber in diets, reducing occupational exposure to cancer-causing chemicals and making mammogram screening tests for breast cancer available to more women, said Dr. Lester Breslow, dean emeritus of the UCLA School of Public Health.
Such measures, if adequately implemented, could result in 72,000 fewer deaths per year due to smoking by the year 2000; 38,000 fewer deaths per year due to fatty diets and insufficient fiber, and 14,000 fewer deaths annually due to increased screening for breast and cervical cancers, according to National Cancer Institute Director Vincent DeVita.
Importance of Prevention
Breslow, pointing out that billions of dollars are spent for cancer treatment and research, said a more effective strategy would be a better balance of the two with prevention.
"Prevention," he said, "is by far the most underemphasized, yet potentially the most effective, aspect of cancer control. . . ."
At present, said Helene Brown, an advisory board member, only 15% of women between ages 50 and 69 currently are being screened for breast cancer. The reasons, Brown said, are that most doctors fail to recommend it and, among patients who use public health facilities, there is a lack of sufficient mammography screening programs. In Los Angeles, preventive programs were described by Dr. Caswell Evans, deputy director of the Department of Health Services, as "fragmented."
At the University of California, San Francisco, radiologists have developed a low-cost mammograph program that offers women a mammogram for $27.50, or about half the most economical charge in most places. Dr. Edward A. Sickles said the high cost of mammography is the main reason more doctors do not recommend it.
The ethnic diversity in California presents special problems for prevention here, several experts said. According to Dr. Thomas Davis of the Northern California Cancer Center, there must be large and immediate improvements in screening and early cancer detection among blacks and Latinos if the institute's goal is to be achieved. Blacks, he said, have the highest overall cancer rate and cancer mortality rate, followed by Latinos.
Davis suggested that the institute encourage more members of minority groups to become biomedical researchers.