1. DiGiulio, Sarah

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"I have mixed feelings about retiring," John Seffrin, PhD, American Cancer Society Chief Executive Officer, said in a phone interview in March. "I've worked hard to get to this point-but I've never been more excited about the future of the organization and the future of cancer control.

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"If we stay the course, and if we do the right things, I think we could make this cancer's last century."


Seffrin retires as ACS CEO this month after serving in the role since 1992-and serving as a volunteer with the Society for 20 years before that. He first announced his plans to retire last year, though that he planned to remain in the role until a national search for his successor had been completed and that successor was in place.


And as that transition happens, Seffrin's passion in the fight against cancer remains unwavering. He noted: "We're on the hopeful side-and the hopeful side of cancer has never been more hopeful."


In his interview with OT, Seffrin shared some highlights of his more than four decades with ACS, as well as thoughts for what is ahead for himself, for the society, and for the future of cancer care and research.


What were some of the biggest milestones you've seen in cancer research and care in the time you've served as ACS CEO?

"I've seen a lot of positive changes. The biggest trend and the most important one is that we're saving a lot more lives from cancer today than we were two decades ago.


"We've seen 20 successive years of downturn in the standardized cancer mortality rates in America-for the first time in our history. That means approximately 1.5 million people will have a birthday this year who wouldn't have had one if the cancer death rates had stayed the same as they had in 1991."


What would you say are some of the biggest milestones for ACS?

"We've been funding beginning cancer investigators for well over half a century, and we are very proud of that. We are the only non-governmental organization in the world that has funded 47 beginning cancer investigators who have gone on to win the Nobel Prize.


"A big change has been the Society's commitment to cancer prevention. This past year we launched our Cancer Prevention Study-3. Cancer Prevention Study-1 went into the first Surgeon General's Report on Cancer and Health. The second one followed 1.2 million Americans throughout their lives. And this third one follows 300,000 individuals and we're getting DNA. That data will be mined for a long time.


"And in addition to continuing to fund research and do research, the organization has also really come to have a high impact on public health advocacy. We advocate for what needs to be done in terms of more funding for NIH or NCI or shaping policies so everyone has access to quality health care. We formed the American Cancer Society Cancer Action Network, ACS CAN, which is a 501c4 organization, which allows us to do more advocacy. We're the only one of the big cancer voluntary organizations in America that has that sister organization.


"And I think one of the biggest milestones was the Society stepping in and calling for-as far back as 2006-systemic health care reform. The Affordable Care Act was passed just five years ago, but we stepped out four years earlier before the bill was passed saying that we need to reform health care."

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Could you elaborate on ACS's role and your role in being part of that change?

"I showed the Board [of Directors] data that said there were three big things that needed to happen to meet our 2015 goals-the goals we set [as a Society] to reduce human suffering and save human lives. One of those was to double our efforts in research. The second was to promote our efforts in prevention and public policy. And the third was to provide access to quality health care to everyone when and where they needed it.


"In that analysis the one thing that would keep us from ever reaching our 2015 goals (whether in 2015, in 2020, or 2025) was the lack of access to quality health care.


"We dedicated our paid advertising budget to help the American public see the broken health care system through the broken lens. We had the data to change public attitudes and make people more aware. And now-as controversial as the Affordable Care Act is-it's illegal to take someone's health insurance away from them if they get diagnosed with cancer. It's illegal to set a lifetime or a per-annum cap on how much the insurance company will pay if you get a diagnosis of cancer. These are sea changes; these are huge changes.


"Forget the politics for a minute. We're not going to go back to what we had before. If there are any changes in future Congresses (and there probably will be), it will be to make the Affordable Care Act even better. The decision's been made to build out a different and better health care system. That's a huge, society-wide decision that's been made-and the American Cancer Society played a very important role in bringing that to the public's attention."


Looking ahead to the next 20 years, what hurdles in cancer research and care do you see as being most important for ACS and the field to tackle?

"Without any question, this is the most exciting time to be involved in cancer work in all of history. I really believe-and I don't make statements for which there isn't evidence to back it up-if we have the courage to do the right things, we could talk about bringing cancer under control as a major public health problem in this century.


"Cancer is well on its way to becoming the number one cause of death in the world for the first time in human history. And it will become the number one cause of death in the next 24 to 36 months in America if it isn't already. But if we do the right things we could reduce cancer rates dramatically and bring it under control as a major public health problem.


"That would mean that we would prevent the preventable, treat the treatable, and provide palliative care to everyone when they need it.


"And if we did all those things-and they're doable-we could see dramatic reductions in the number of premature deaths and the amount of suffering to cancer in this country first and then hopefully around the world.


"If we sit on our hands and we are comfortable with the status quo-if we're not willing to step out and take risks, then cancer will become the number one cause of death in the world. And that will happen sooner rather than later.


"In the next 25 years we will see a tsunami of noncommunicable disease, including heart disease, lung disease, and diabetes-with cancer at the lead-if we don't intervene. That's not guesswork; that's published reports from the World Economic Forum and the Harvard Report on Public Health. We know how many people there are, we know what their age is, and we know what happens as you get older if you don't do the right things with respect to prevention and access to quality health care.


"These are exciting times, but there is a lot at stake."


What do you mean by "right things"?

"We have a number of best buys. We have interventions in public health that have been proven to work anywhere in the world they've been tried. Things like raising excise taxes on tobacco works. Things like shaping public policy; providing a safe work environment to the billion people who don't smoke who now go to work every day in a smoking environment; and getting rid of smoking in all public places.


"The right things are the things that are proven safe and effective. These things may or may not be popular; they may or may not be controversial; and they must compete with the many other needs out there.


"Raising state and federal excise taxes is controversial. Of course the industry fights it, and many politicians want to run the other direction when you talk about raising any kinds of taxes. We're not always welcome or popular.


"But, why do we need to do this? Because we know it works. It keeps fewer kids from getting addicted and it helps more adults cut back or stop all together. Sometimes you have to be unpopular and say that screening for a particular cancer is not safe and effective; we have the evidence that you can do harm.


"There are a lot of things that we didn't know about and we had no evidence that these things would work back when I started 40 years ago as a volunteer. We now have bushels and baskets full of evidence that they work-we just have to do them. The conquest of cancer is as much a public policy issue as it is a medical and scientific challenge."


What are your plans for retirement? Do you still intend to be involved with ACS?

"I've said before, a joke on myself-I don't fish and I'm not interested in learning how to play golf, so I have to do something.


"I do want to carve out some time for my family. But, I hope to retire to a role of still being engaged in the cancer space-and more broadly, perhaps globally, in the noncommunicable disease space. I'm not exactly sure what that's going to look like and what that's going to be. But I don't anticipate I'll get too far away from the cancer problem-and I'll try to do anything I can to be of help.


"This is a wonderful job and the greatest privilege of my life. This is not an exaggeration-but, I've loved every minute of it, despite the setbacks and issues. I do anticipate that I'll stay engaged in one way or another."


"Dr. John Seffrin is one of the world's most articulate and passionate advocates for cancer prevention. He has been a steadfast champion for reducing individual cancer risk by not smoking, by weight control and exercise, and by cancer screening. He has provided enlightened leadership for the American Cancer Society and has been an international spokesman for a broad range of anti-cancer initiatives," OT Editorial Board Chairman ROBERT C. YOUNG, MD, Emeritus Chancellor of Fox Chase Cancer Center-who served as ACS National President for 2001-2002-said in an email.


"John has led the American Cancer Society successfully for over two decades by articulating an eloquent vision of what the Society could and should do to reduce the cancer burden. He has also been clear about what aspects of the cancer problem could be more successfully pursued through partnerships with other organizations.

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"He has the personal skills and charisma to be a very important ambassador of the cancer community to other major health-related organizations as well as government organizations throughout the world."


"John was a superb leader of the American Cancer Society for a very long time-and he oversaw a lot of change during that time," OT Editorial Board Member HAROLD P. FREEMAN, MD, Founder, President, and CEO of the Harold P. Freeman Patient Navigation Institute-and also a former ACS National President (1998-1989)-said in a phone interview.


"John set the society to focus on many important issues, such as public education, support for research, and concern for populations with disparities. He brought a public health approach to the American Cancer Society.

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"He's sensitive and thoughtful. He's very articulate and he knows how to communicate, not only to the public, but to the policy makers. He led with a great dexterity and thoughtfulness."


New CEO Announced

On April 2, the ACS announced that Gary M. Reedy would be the new CEO, effective April 27. He has been a volunteer leader with the Society for 15 years, and until making the change had been Worldwide Vice President of Government Affairs and Policy with Johnson & Johnson, along with approximately 30 years of domestic and international experience in the health care industry.