Washington Briefs:

LCA Congratulates Dr. Francis Collins On

His Confirmation As New NIH Director:

Calls Upon Him to Devise  Coordinated

And Comprehensive Plan To Address Lung Cancer Lethality

August 7, 2009

Dr. Francis Collins

Director

National Institutes of Health

9000 Rockville Pike

Bethesda, MD

Dear Dr. Collins,

We congratulate you on your confirmation as Director of the National Institutes of Health (NIH).  During your extraordinary career you have profoundly changed our understanding of disease and burnished the reputation of the United States as the world leader in medical research and innovation.  

Your research into the identification of genetic variants associated with type 2 diabetes and the genes responsible for cystic fibrosis, neurofibromatosis, Huntington’s disease and Hutchinson-Gilford progeria syndrome has brought hope that these devastating conditions can be contained and even prevented from manifestation. Your prescient insistence that the human genome must be mapped has opened the door to new avenues of research that could barely have been imagined not that long ago. Clearly years, perhaps even decades of research will be required to understand and harness the powerful new tools that your vision has given to medical science. But your achievement will always stand as one of the great turning points in medical history.

In addition, your previous experience at NIH as Director of National Center for Human Genome Research will also enable you to take the reins quickly and reinvigorate all the institutes with your dynamic leadership.  

An area of particular need for your visionary approach is lung cancer research. Only heart disease surpasses lung cancer in mortality in the United States.  It is the biggest cancer killer by far, taking more lives each year than the next four most common cancers - breast, prostate, colon and pancreatic - combined.  Yet it has never been addressed with a coordinated, well developed or innovative plan.

In 2002, the National Cancer Institute’s Progress Review Group stated that… “We have funded lung cancer research far below levels that characterize other common malignancies and far out of proportion to its massive public health impact”.   This has not changed. 

We praised Congress and the President for giving the Food and Drug Administration (FDA) the authority to regulate tobacco products.  We filed an amicus brief to support the courageous efforts of Judge Kessler in convicting cigarette manufacturers of fraud and racketeering.  We vigorously support the role of tobacco control as a fundamental strategy for reducing the mortality of lung cancer. However unlike heart disease, lung cancer risk does not significantly decrease with smoking cessation, accounting for the current epidemic of lung cancer in former smokers, which constitutes over 50% of lung cancer diagnoses.  Clearly research to more effectively find and manage curable lung cancer in former smokers is a critical need for the over 45 million former smokers in the United States, many of which are victims of Big Tobacco's insidious marketing strategies.

And we must not forget that in addition to former smokers, another 15% diagnosed with lung cancer will have never smoked. Indeed, that number is so high that non-smokers lung cancer is the sixth biggest cancer.  

Even beyond the incidence is the tragic lethality of lung cancer.  Only 16% of lung cancer is being diagnosed at an early, curable stage.  Most die within a year of diagnosis.  End stage drugs prolong life for a few weeks or months and at great cost.  Despite great advances in imaging, screening has been mired in controversy and no RO1 grants have been awarded for research in this area in the past 5 years.  Innovative proposals for managing early lung cancer, chemoprevention, drug delivery systems and new risk assessment protocols have been passed over. 

The nation looks to the NIH leadership to provide the wisdom to balance the investments and to ensure the areas of greatest public health need are robustly addressed. We hope that you recognize lung cancer which accounts for more deaths than the next four major cancers combined, requires a sense of urgency, a well-coordinated, multi pronged strategy that goes beyond basic science. We need to commit every available tool, every avenue of research and translational science to reducing mortality as quickly as possible.

Hundreds of thousands of families who have already been hurt by this disease and the many more at high risk look to you - one of the most visionary doctors in the history of medicine -  with hope that outcomes in lung cancer can finally be changed.

We applaud your confirmation and commit to working with you to bring this about.

Sincerely,

Laurie Fenton Ambrose

President & CEO

Lung Cancer Alliance