Assessing the magnitude of the problem

The cost of cancer in the United States, in terms of human suffering and financial resources, is enormous. Since 1990, over 6 million Americans have died of cancer, more than the combined casualties from the Civil war, WWII, and the Vietnam and Korea conflicts combined. Over their lifetime, about 1 out of 2 American men and 1 out of 3 American women will develop cancer 1. The National Institutes of Health estimate overall costs for cancer in the United Sates in the year 2002 at approximately $171.6 billion, including $60.9 billion for direct medical costs, $15.5 billion for indirect costs of morbidity (lost productivity due to illness), and $95. billion for indirect mortality costs (lost productivity due to premature death). In 1997, the last year for which data are available, 5 billion dollars were allocated to laboratory cancer research in the United States3. Yet, despite extraordinary advances in our understanding the biology, genetics, and growth regulation of cancer, little progress has been made towards its prevention and treatment. Indeed, in 2004 over 1.3 million Americans will develop cancer and more than 560.000 will die of it 4 (Table I). Because cancer deaths shorten the average life-span by 15.1 years per person, an estimated total of 8.3 million years of life were lost from cancer deaths in 1998. This exceeds the years of life lost from heart disease deaths (7.8 million years), and from all other causes of death combined (6.5 million years). Finally, because the vast majority of cancers afflict individuals 55 years of age or older it was estimated, based on population projections from the US Bureau of the Census, that 1 in 56 Americans in this age group contracted cancer during 2001 and 1 in 130 died of the disease.