Why The Drop In U.S. Cancer Death Rate Has Nothing To Do With President Trump

By | January 10, 2020

Yesterday, the American Cancer Society released a report showing that the overall death rate from cancer in the U.S. declined by 29% between 1991-2017. They conclude that this is largely due to progress in treating four major types of cancer – lung, breast, prostate and colorectal.

At roughly 10am this morning, President Trump tweeted about the news suggesting that his administration was at least partly responsible for the progress:

The tweet, sandwiched between another about his proposed Southern border wall and one about the stock market, was perhaps a little unusual in topic but undoubtedly universally good news for all Americans. However, it is highly unlikely that the Trump administration had anything to do with increasing cancer outcomes during this period.

Firstly, the data covered in the paper was collected between 1991 and 2017. Trump was inaugurated on January 20th 2017 and the statistics show a reduction in death rates since 1991, spanning several Presidents, both republicans and democrats. Between 2008 and 2017, featuring approximately a year of George W. Bush’s presidency and the whole of Obama’s two terms, the overall cancer death rates dropped by an average of 1.5% a year.

So, since Trump has only been in office for 1 out of the 26 years that the data in the new publication covers, it seems unlikely that he or his administration have much to do with it. It is true that between 2016 and 2017, there was a drop of 2.2%, but as most new cancer drugs take decades to develop, this is also highly unlikely to have anything to do with the Trump administration.

In fact, Trump tried to cut $ 4.5billion from the National Institute of Health (NIH) budget last year, but was unsuccessful. This followed several years of proposed cuts to science funding, including at the NIH. The NIH is home to the National Cancer Institute (NCI), which would have lost nearly $ 1 billion of funding in the deal. Trump ultimately ended up signing a budget that gave the NIH an increase in funding.

The drop in death rates is likely to be due to not just an improvement in one area of cancer treatment or prevention, but several. For example, people with lung cancer who would have previously lived for only a short term after diagnosis are now benefiting from a variety of new targeted therapies which are keeping them alive for much longer. The number of people who use tobacco in the U.S. has also steadily declined, reducing the incidence of lung cancer and likely several other cancer types too.

Similarly for breast cancer, early detection and a class of new targeted therapies tailored to the specific genetic faults which cause tumors, are far more likely to be responsible. The development of these drugs, through to FDA-approval often takes decades, meaning that Trump was somewhere between businessman and reality TV star when most of these drugs were being developed.

The first therapy to specifically targeted genetic faults in cancer was a drug called Gleevec (Imatinib), approved by the FDA in 2001 for a deadly type of leukemia. In the same year, Trump registered as a democrat, 15 years before he was elected as a republican president.

The reduction in death rates from cancer has not happened overnight. It is the culmination of ongoing work by hundreds of thousands of people from around the world to develop better treatments, early detection methods and better care for those with cancer.

We are sometimes only now feeling the benefits of breakthroughs made in the last millennium as 2018’s Nobel prize won by MD Anderson’s Jim Allison proves. Allison was instrumental in doing the early groundwork on immunotherapy and the treatments developed from this work are now extending the lives of thousands of patients with previously incurable cancers. But, some of Allison’s most important research was done in the mid 1990’s and the first immune checkpoint blocking therapy to come from this work, ipilimumab, was  only approved in 2011.

Science, particularly the development of new cancer therapies, takes considerable time. Perhaps the Trump administration will be able to claim credit for advances in cancer treatment and survival in years to come, but to do so now is disingenuous and misleading.

Forbes – Healthcare