NEW YORK--To celebrate its 100th anniversary, the American Cancer
Society has led an effort to anticipate how the world might be
in 2015 and how that might affect the control of cancer.
Helene G. Brown reported that four scenarios were developed. "These
are not predictions but represent the construction of likely plots
based on available information and knowledge of the possibilities,"
she said at the Third World Congress of Psycho-Oncology.
Ms. Brown, director of community applications of research, Jonsson
Comprehensive Cancer Center, UCLA, described each scenario and
its effect on age-adjusted cancer mortality.
- Business as usual. In this scenario, basic health problems
of the 1990s persist. "The population in 2015 continues to
indulge in poor diets and avoid exercise, and many continue to
abuse alcohol, tobacco, and drugs," she said. Age-adjusted
cancer mortality declines by 15% from 1990 levels.
- Hard times. Severe recessions and consistently high
unemployment conspire to increase health risks. "Things fall
apart and there is an expected increase in cancer mortality of
15%," Dr. Brown said.
- Stone soup. In this scenario, "hard times"
are averted, as the independent sector successfully launches effective
health education and information programs, and interactive participation
in health by every citizen helps communities adopt sound health
- Both public and private sectors vigorously attack what they
called bad health habits. Advances in cancer risk identification
and in detection combine with a more spartan lifestyle to reduce
age adjusted cancer mortality by 30% from 1990 levels.
- Great strides. The fruits of the information revolution
and a commitment to sustainable development bring great progress
in this, the happiest of the four scenarios. New technologies
and a maximum 30-hour work week have enhanced economic competitiveness
and kept unemployment low. Optimum cooperation by families and
communities helps push age-adjusted mortality down 70% from 1990
"Everybody wants great strides to happen, but realistically
everybody thinks that stone soup is more likely to occur,"
Ms. Brown concluded. She emphasized that these scenarios are only
learning tools that tell their story about the future in several
ways. "The future is uncertain, but without research and
funding, there is no future."