Covid -19 has caused 400,000 deaths in America disproportionately upon communities of color, poverty, immigrants, and older age. It has exposed the inequities within our health care system. However, the patients at greatest risk of death from Covid are those with cancer. Covid-19 has ravaged patients with cancer. While 1.8 percent of Americans with Covid-19 have died, those in long term care facilities have had a 12 percent mortality, and 26 percent of cancer patients who contracted the disease have died from the virus. Certainly cancer patients should be a priority in getting vaccinations.
This is personal: As a three-time cancer survivor and a doctor who has cared for patients with cancer for nearly 50 years, I have had and seen the suffering cancer can visit upon patients and their families. Now that there are vaccines, this vulnerable population should be just below health care workers and first responders.
It has impacted cancer patients not only in causing morbidity and mortality, but also in the reduction of scientific advancement of early diagnosis, treatment, and cure. The extraordinary and appropriate focus and achievement of medical science to discover a vaccine against Covid-19 graphically demonstrates the genius of researchers, but also diverted potential discovery beneficial to cancer patients. Now is the time to refocus with increase funding in clinical and basic science research in cancer, the leading killer of Americans, second only to heart disease.
Further, because of the pandemic, standard cancer screening such as breast cancer screenings dropped by 89.2% and colorectal cancer screenings dropped by 84.5% just in only 5 months, resulting in a decrease of 65.2% incidence of new cancer diagnoses. More than 22 million screening tests the first half of 2020 in the United States have been delayed due to COVID-19. The Director of the National Cancer Institute estimates that an additional 10,000 Americans will die in the next 10 years because Covid-19 prevented early diagnosis and undertreated breast and colorectal cancers, but this model did not include other cancers, the effects of metastatic advancement due to delays, or a disruption in care lasting for more than 6 months.
Another casualty of Covid is the politicization of science. Whether it is altering data at the Centers for Disease Control (CDC), promoting false treatments, refuting the need for a mask, leaving the World Health Organization and the consortium of finding a vaccine, or conspiracy theories about the origin of or the vaccines for Covid-19, science has taken a hit. Yet according to a Pew survey, there has been little change in Americans trust in science in the past 40 years, so public support of redoubling our efforts is possible.
The death rate from cancer in the US declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop ever recorded, according to annual statistics reporting from the American Cancer Society. But underfunding and diversion of focus may change that trajectory.
The achievement of the world’s research scientists in 2020 demonstrates that when governments and pharmaceutical companies commit unlimited money and effort into solving a medical problem, cures are possible. Although the funding from the Federal government has not abated, the American Cancer Society predicts a $200 million reduction in philanthropy, Great Britain’s shortfall is $150 million and Canada’s is $100 million, plus the European Union support has been reduced by 30 percent, approximately $365 million, with predictions of a $9.5 billion shortfall in the next 6 years. This will result in hundreds of researchers, particularly the young, not being funded. The loss funds will take years to makeup, and the potential loss of young investigators’ discoveries may be catastrophic. This has direct effect on Americans: in the past 120 years, 212 scientists have won the Nobel Prize in Medicine, 110 from Europe and 102 from the US. We have a vested interest in European discoveries.
In the next stimulus package or budget, a line item of additional billions should be for cancer research both in the US and Europe to make up the loss of funding and to encourage the kind of Herculean effort in Operation Warp Speed, but for cancer research. What better way of sending a message to the world that there is a new American direction than to help researchers throughout the world?
The pandemic is calamitous, but in 2020, 606,520 people will die of cancer in the United States, nearly twice as many as have died of Covid, and this is annual. We can wear a mask, socially distance, and wash our hands to reduce the chance of Covid-19, but only research will bring us closer to early diagnostic testing, curative treatments, and prevention of cancer.
Richard Boxer, MD FACS, is Clinical Professor at the David Geffen School of Medicine at UCLA, Former Member of the National Cancer Advisory Board and National Board of Advisors, National Institute of Diabetes, Digestive and Kidney Diseases, NIH.