Is it really the case that we’ve made no substantial progress on cancer? The current age-adjusted mortality rate is the same as in 1930, and the recent decline only tracks the fall in smoking.https://blogs.scientificamerican.com/cross-check/the-cancer-industry-hype-vs-reality/ …
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Replying to @danwwang
A very senior US cancer funding official recently told me that his view is that we’ve made very little progress in treatment since 1971. (And, to your point, that most mortality curves are confounded by non-treatment factors.)
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I thought this was interesting since local incentives presumably push him to be *optimistic* about rate of progress.
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What about Gleevec et al? I'm sympathetic to the concerns over early diagnosis distorting the stats but there seem to have been some real innovations, moreso in cancer than other fields.
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Yeah, he wasn’t denying that particular breakthroughs have happened. Just arguing that *overall* improvement (lifestyle- and detection-adjusted) has been slight.
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Does he think we could be improve this with a different funding model? Or is this just the power law at work over a grand scale? Eg instead of betting on specific ideas or teams funding infrastructure (like let’s make micropipetting as cheap and automated as possible)
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In short, yes. NIH is screwed up (he agreed with all the usual critiques) but also more constrained by patient advocacy groups than might be obvious.
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Can you say more about the nonobvious constraints? Curious about this.
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Simply that if they reduce funding for any area or approach, they’re immediately on receiving end of anger from very (justifiably) motivated lobby groups. Those groups will happily go to Congress if needed. Congress sets the budget...
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Gotcha. Wasn’t aware that it was the advocacy groups per se that maintained pressure on specific approaches. Just assumed it was bureaucratic structures, etc. I imagine there are few advocates on the Hill for general advances in experimental infrastructure...
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Right. To be clear, I don’t think it’s *just* the advocacy groups. Study sections, to your point, are also a very pro-status quo force. (If you wanted to deliberately create institutional intertia, you’d design something like that.)
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