America first declared war on cancer half a century ago. Today’s regulatory hurdles won’t help us win

Bruce Ratner is a philanthropist and real estate developer. He is a co-author Early detection: catching cancer when it is curable.

In late 2015, my brother Michael Ratner was admitted to the hospital with nausea. He was eventually taken to Memorial Sloan Kettering Cancer Center for treatment of a metastatic brain tumor. He was 71 years old and one of the most famous human rights defenders in the world. Despite his stature and excellence, Sloan Kettering was dead on May 11, 2016.

My brother’s tragic end highlights everything we are doing wrong with cancer. When President Richard Nixon declared war on cancer on December 23, 1971, he hoped that cancer would be cured within five years. More than half a century later, we were still no closer to winning this war.

We spend $200 billion each year treating cancer, yet it remains the second leading cause of death in the U.S., killing more than 600,000 Americans each year. It is time to reconsider our approach to this terrible disease. Although Nixon’s war is not yet won, we have learned a tremendous amount about cancer over the last 50 years, including that early detection is the best thing we can do to reduce cancer deaths. Treatment is, of course, necessary, and the wonderful oncologists at Sloan Kettering and other leading cancer centers are doing a tremendous job, but they are fighting an uphill battle against cancers that are detected too late.

There are already several effective tests to detect cancer early, including well-known screening tests such as low-dose (and cheap) CT scans for lung cancer, mammography for breast cancer, pap smears for cervical cancer, and PSA blood tests for prostate cancer and colonoscopies for colon cancer. Unfortunately, these tests are not enough. Approximately 70% of all cancer deaths are due to cancers for which recommended screening is not currently performed.

We must take advantage of the emergence of an entirely new generation of advanced technologies that use genetic sequencing and machine learning to help with early detection and further improve the fight against cancer. This includes multiple cancer detection (MCED) tests, some of which are already available to patients and doctors and can detect cancer and save lives. More tests are expected to be available soon. These tests can detect many types of cancer and detect them while it is still early enough to do something about them. These tests look for pieces of DNA in the blood to check for the presence of cancer and, if detected, determine its origin so it can be targeted and prevented. One of the most promising tests has a false-positive rate of less than one percent.

While these technologies are promising, the road to implementation takes much longer than makes sense. Huge regulatory hurdles stand in the way. Concerns about the cost of new tests and questions about whether early detection saves lives are unfortunately hampering progress in efforts to save lives. The Food and Drug Administration is investigating MCED and has approved additional testing, but that may require waiting for longitudinal studies that will follow patients for decades before giving the green light for widespread use. Antitrust regulators, in what appears to be a direct opposition to President Biden’s widely announced Cancer Moonshot agenda, are skeptical of vertically integrated mergers that could accelerate the adoption of such tests.

Smaller companies often need the resources of larger companies to both increase market access and meet regulatory demands from the government. In one case, the Federal Trade Commission’s involvement scared off a large investor, which could have slowed adoption by depriving a smaller innovator of needed resources from a more established entity.

We are on the cusp of exciting new technologies that will help us win the war our government declared half a century ago. Unfortunately, it is this same government that may be hindering the progress of this war at a time when it is so desperately needed.

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