Epistemic status: This isn’t medical advice. To the extent that it’s advice it’s health policy advice. I’m no domain expert. If you are faced with the prospect of cancer, consult with multiple experts.

Introduction

Richard Nixon declared the war against cancer in 1971. Beau Biden, the son of Joe Biden, died in 2015 due to brain cancer. Having their child die before them is one of the worst experiences a parent can have. Joe Biden, then the vice-president, decided to start the Vice President's Cancer Moonshot. On the campaign trail on his run for presidency he declared in 2019: “I promise you if I'm elected president, you're going to see the single most important thing that changes America: We're gonna cure cancer.” Joe Biden essentially declared the second war against cancer.

With both Nixon and Biden wanting to fight wars on cancer the issue is essentially bipartisan. Biden has personal reasons for fighting the war that distinguish him from other recent presidents but they are not party-political. I applaud the ideal of fighting wars against cancer instead of burning resources to fight expensive wars against human people.

While I applaud the principle, the first war against cancer failed. In this article I want to lay out the problems with the policies that came with the last war on cancer and make a case of how we can approach health policy in a better way.

The difference between the cancer survival rate and the cancer death rate

One mainstream view of the war on cancer is that it was partly a success. Vincent DeVita writes in The 'War on Cancer' and its impact:

Relative survival rates for all cancers have increased 70%, since the passage of the Act [National Cancer Act of 1971]

To a layperson that claim might seem impressive but as Sarah Constantin writes in Is cancer progress stagnating:

But the War on Cancer seems to have disappointing results. Cancer deaths have only fallen by 5% since 1950, at a rate of 200 deaths a year per 100,000 individuals. (By contrast, heart disease deaths are a third of what they were in 1950, thanks to innovations like statins, stents, and bypass surgery.)

There are three possible explanations of why those two numbers diverge.

The longer lifespans thesis

While it's true that we increased lifespan and a higher lifespan increases the likelihood of getting cancer you would expect the same with heart disease. Given that we ...

Transposons