The war on cancer: demonstrating the impact of aging upon cancer mortality

Despite two decades of concerted federal government effort and the expenditure of billions of dollars, the war on cancer, as judged by mortality, is not going well. However, the mortality yardstick by which progress against cancer is often measured should be reassessed based upon current concepts of carcinogenesis. The multistage model of carcinogenesis, assumed to reflect inherent genetic instability and the accumulation of multiple genetic abnormalities, has gained general acceptance. Accordingly, cancer cells typically display multiple characteristic abnormalities in presumed oncogenes and tumor suppressor genes. Age-specific cancer mortality rates in the United States from 1962 to 1988 were analyzed using the Strehler-Mildvan modification of the Gompertz relationship between aging and mortality. This method of analysis suggests that aging of the population, which allows for the manifestation of inherent genetic instability, rather than increasing environmental carcinogens, accounts for the continued rise in cancer mortality.