Even today, it continues to occupy our collective imagination as the king of terrors: insidious, capricious, relentless. We tamed heart disease through smoking cessation, better medical management of risk factors such as high cholesterol, and improved interventions for a condition that has clear points of intervention and responds more readily to lifestyle changes.Ĭancer is a different story. We tamed infections with sanitation and vaccines, abetted by antibiotics. And on a broad scale, we have made far less progress preventing cancer than preventing its predecessor scourges.
But advances in treatment alone will never be enough to fully stem the burden of cancer.Īs every public health professional knows, on a population level, the only way to substantially reduce incidence and mortality for any disease is through prevention. He left out the second part of the surgeon’s epithet: “the king of terrors.” Modern targeted treatments and immunotherapy have in some cases led to wondrous cures, and many malignancies are now caught early enough so that their sufferers can live out full lives. Siddhartha Mukherjee titled his magisterial biography of cancer The Emperor of All Maladies, quoting a 19th-century surgeon. The bad news is that cancer continues to bring pain and sorrow wherever it strikes. Cancer’s new ranking also reflects public health’s impressive gains against infectious disease, which held the top spot until the last century, and against heart disease, the current number one. Cancer is primarily a disease of aging, and the dubiously good news is that we are living long enough to experience its ravages.
The shift marks a dramatic epidemiological transition: the first time in history that cancer will reign as humankind’s number-one killer. Later in this century, it is likely to be the top cause of death worldwide. In the next few years, cancer will become the leading cause of death in the United States. The only solution is a full-scale defense, so that nobody suffers the disease in the first place. We cannot treat our way out of the rising cancer caseload.
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