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July 26, 2000

The Politics of Cancer

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;284(4):442. doi:10.1001/jama.284.4.436

To the Editor: While conceding that Politics of Cancer Revisited 1998 offers much valuable information, Dr Meyer's1 review is replete with serious misunderstandings.

First, Meyer incorrectly charges that my book "declares political war between a basic preventive approach and a general patient care approach to the cancer problem." The book's fundamental thesis is that the cancer establishment—the National Cancer Institute (NCI) and the American Cancer Society (ACS)—is fixated on damage control in the form of diagnosis and treatment and on basic genetic research, with little interest in prevention.2 The NCI currently allocates less than 3% of its budget to primary prevention, while the ACS allocates less than 0.2%. More critically, the cancer establishment has never provided Congress, regulatory agencies, and the public with scientific information on a wide range of avoidable and involuntary exposures to industrial and other carcinogens that have been incriminated in the increasing incidence of nonsmoking-related cancers since the 1950s. These concerns have been endorsed by a group of 65 leading public health experts, including past directors of federal agencies, who recommended drastic reforms of NCI policies, including parity of funding for outreach and prevention with all other programs combined.3