NCI to Take a New Look at Cancer Surveillance

BETHESDA, Md—A major re-evaluation of the nation’s cancer surveillance system is in the offing. National Cancer Institute director Richard D. Klausner, MD, told the President’s Cancer Panel that he has asked for such a review by NCI staff, working with other relevant agencies such as the National Center for Health Statistics.

“We must treat numbers with extreme care and extreme caution to make sure that they serve as much as possible to answer real questions about the burden of cancer,” Dr. Klausner said. “Cancer numbers are changing. To make sure that we can fully interpret them, I believe we need a deeper and richer system of surveillance that looks at a wider array of parameters, including the nature of diagnostic and detection approaches, as well as treatment follow-up.”

The need goes beyond reliable numbers to information that can provide valuable hypotheses to address issues of mortality, incidence, survival, complications, and responses, Dr. Klausner said.

An important issue is how the burden of cancer is distributed among various subpopulations within the country and the role of genetics and race in assessing this. As a greater understanding of cancer genetics emerges, he said, “we realize that ethnicity and race are poor, if not totally inadequate, surrogates for biologic differences, and certainly for genetic differences.”

Over the next year, those involved in the re-evaluation will be “looking very hard at our surveillance system to find out how we should modify it, expand it, and change it to make sure that these extremely powerful things called cancer statistics are rich and reliable.”