November 5, 2021
On October 12, the U.S. Food and Drug Administration (FDA) granted the first authorization to an e-cigarette product, a Vuse Solo device and two replacement cartridges in tobacco flavor. E-cigarettes have been sold in the U.S. for more than a decade with minimal regulation, though none had been given authorization by the FDA until now. Manufacturers were given until September 9 of last year to submit applications for the agency’s authorization to remain on the market. The FDA reported in September it had rejected applications for more than a million e-cigarettes and related products, mainly due to their potential appeal to underage teens. The FDA limited its approval to tobacco-flavored products, denying additional applications for flavored products that continue to attract youth users, as shown in a recent National Youth Tobacco Survey.
The Prevent Cancer Foundation, along with numerous public health, medical, education and community organizations, has urged the FDA to prohibit non-flavored tobacco products, including e-cigarettes, citing public health risks, particularly to youth. All tobacco products, including e-cigarettes, pose risks to health and should adhere to evidence-based public health protections. The FDA should continue to deny all flavored e-cigarette applications, including menthol flavors.
Fifty years ago, President Richard Nixon signed the National Cancer Act of 1971 into law, declaring a War on Cancer and paving the way for remarkable advancement in the study and treatment of these diseases. The Act created the infrastructure needed for a nationally coordinated approach to cancer; designated the National Cancer Institute (NCI) director as a presidential appointment; set up the National Cancer Advisory Board and President’s Cancer Panel; allowed for a bypass budget directly to the president; and created the first cancer centers and cancer control programs. It also expanded the National Clinical Trials Network.
Since the Act’s passage, we have made significant progress against cancer. In the last several decades, the rates of new cancer cases and cancer deaths have declined. Much of this decline is due to reduced lung cancer rates because fewer people are smoking, but there have also been long-term declines in breast, prostate and colorectal cancer rates. Advances in screening and treatments for each of these cancers have contributed to the falling rates. We have also seen the development of highly effective vaccines, such as the human papillomavirus (HPV) vaccine, which can prevent most cases of cervical cancer and at least five other types of cancer. The hepatitis B vaccine and hepatitis C tests and treatment can prevent or cure these viruses, which are leading causes of liver cancer.
As the cancer community celebrates 50 years of the National Cancer Act, we must recognize we have a long way to go. Cancer is still the second most common cause of death in men and women in the U.S. Cervical cancer is highly preventable with the HPV vaccine and screening, but it remains the second leading cause of cancer death among women in their 20s and 30s. Cancer disparities persist, with Black Americans having the highest death rates for most cancers. The COVID-19 pandemic is likely to cause more late-stage or missed cancer diagnoses as many Americans delayed medical appointments during the pandemic. We are sure to face more challenges ahead, but with continued collaboration and infrastructure put in place by the National Cancer Act, we can continue to see great progress.
On October 25, the U.S. Preventive Services Task Force (USPSTF) announced its plan to strengthen the way it communicates about sex and gender in recommendation statements. The article, “USPSTF Approach to Addressing Sex and Gender When Making Recommendations for Clinical Preventive Services,” published in the Journal of the American Medical Association (JAMA) highlights that while clinicians care for people across the spectrum of gender diversity, research studies of clinical preventive services often do not fully consider biological sex and gender identity, which leaves the USPSTF without necessary data to make distinct recommendations.
According to the USPSTF, published data indicate that there are approximately 1 million people in the U.S. who identify as transgender or gender nonconforming. USPSTF aims to develop research plans now that consider whether the preventive service is expected to be applied according to biological or physiological sex characteristics, gender identity, or both. The USPSTF will also consider how applicable services and recommendations are to transgender, gender nonbinary, gender diverse and intersex people. The USPSTF’s approach also includes seeking input from appropriate disproportionately impacted groups, considering the gender of participants in studies that are used to develop recommendations and noting when such evidence is unclear.
When issuing recommendations, the USPSTF will utilize gender-neutral language when appropriate and indicate whether a recommendation should be applied based on someone’s sex at birth, current anatomy or gender identity.