Primary Care Holds Key to Winning War on Cancer, Says Speaker

Primary care has played a major role in the dramatic drop in cancer-related deaths during the past several years, making it a critical component in winning the war against cancer, said the immediate past president of the American Cancer Society, or ACS, during the AAFP's 2007 State Legislative Conference here on Nov. 17.

"If you think about one of the things that is working and has made a difference in cancer mortality, it is access to primary care services," said FP Richard Wender, M.D., chair of the department of family and community medicine at Thomas Jefferson University Hospital in Philadelphia and past president of the ACS, who delivered the conference keynote address.

In May 2002, the ACS board of directors established a goal of achieving a 50 percent reduction in age-adjusted cancer mortality from 1990 to 2015; in 2006, the society published a report showing that annual cancer deaths declined at a rate of about 1 percent per year from 1990 to 2002. Since that point, the decline has accelerated to a rate of 2.1 percent per year. At the current rate, about 1.9 million cancer-related deaths will be prevented by 2015, according to Wender.

"Believe me, when the board passed the goal (of a 50 percent reduction by 2015) a lot of people criticized us -- 'Unachievable; can’t be done,'" said Wender. "If we maintain the pace we appear to be on now, we'll achieve about a 35 percent reduction. No one thought that was possible. It is pretty exciting."

Wender attributed the decline in cancer deaths to three predominant factors: primary care, prevention and early detection, a combination that is needed to "achieve our cancer goals," he said. He called on the nation to adopt a "cancer health care agenda," driven by public health considerations and based on public health analysis, research investment and primary care.

"We need an emphasis on primary care," Wender said. "We need to expand access to primary care and cancer care services. We need systems of care to replace the clinicians as the sole pilot of care. We need payment mechanisms that support these systems."

Wender cited a report released last summer by the The Commonwealth Fund that said a regular source of primary care, even if it doesn’t meet the standards of the patient-centered medical home, results in improved care at lower costs.

"Primary care is important," Wender said. "The medical home is an even greater value. There is no more powerful intervention to guaranteeing improved access and improved quality delivery than ensuring access to a medical home for everyone in the nation."