One thing was frightfully obvious: cancer mortality was not declining in the United States. There is “no evidence,” Bailar and Smith wrote darkly, “that some thirty-five years of intense and growing efforts to improve the treatment of cancer have had much overall effect on the most fundamental measure of clinical outcome—death.” They continued, “We are losing the war against cancer notwithstanding progress against several uncommon forms of the disease [such as childhood leukemia and Hodgkin’s disease], improvements in palliation and extension of productive years of life.… Some thirty-five
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