Thursday, January 21, 2016

Dr. Philip Cole Discovered the Decline in Cancer 20 Years Ago

Last week the American Cancer Society issued a press release that gained global coverage (here, here, here, here, here, here) by emphasizing a “23% drop in the cancer death rate since its peak in 1991.”  Sadly, the organization failed to credit a world renown cancer epidemiologist for discovering that trend two decades ago. 

The Cancer Society has, in fact, steadfastly refused to credit the original work, even though it was published in the organization’s journal Cancer in 1996.  This blackout also extends to the society’s technical reports (latest version here).

In the 1980s and 1990s, epidemiologists from the National Cancer Institute, the American Cancer Society and other organizations published hundreds of cancer studies, driven by a belief that cancer rates were surging.  The data showed otherwise: the cancer death rate by the late 1980s was, in fact, flat and poised to decline.  Only one epidemiologist appreciated this fact, and had predicted the decline – Dr. Philip Cole of the University of Alabama at Birmingham.

In a 1996 report (abstract here), Dr. Cole attributed the decline in cancer deaths primarily to reductions in smoking that had begun in 1965, and to improvements in diagnosis and treatment.  Dr. Cole predicted that “the decline…is likely to continue for at least 20 years and may accelerate.” (my emphasis)

Why does the Cancer Society embrace key elements of Dr. Cole’s landmark work, but defy the norm of formally citing the source?

The answer may be that the organization is averse to acknowledging that the decline in cancer is linked primarily to the decline in smoking.

Dr. Cole and I published a follow-up study in the Journal of Clinical Oncology in 2001, demonstrating that if lung cancer had never existed, the death rate in the U.S. from all other forms of cancer would have declined continuously, starting in 1950. (abstract here).   

Dr. Cole is a world-renown epidemiologist whose insightful analysis two decades ago has proven prescient.  The American Cancer Society should recognize his scientific contribution.

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