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An Iceberg, a Terrible Disease, and a Chance to Act

Joe BidenJoe Biden
The Biden Cancer Initiative will home in on data standardsAlex Brandon — AP

Reports, from a group of British scientists yesterday, that an iceberg the size of Delaware was just “hours, days, or weeks” away from separating from the ice continent of Antarctica were met with alarm by untold millions of people, no doubt.

The news was a sobering new data point supporting the long-accepted thesis that a rapidly changing climate is transforming the face of the earth.

But it was also a reminder of something else: We know what we know about the world, in large part, because we measure it. And in many, many cases—such as with ocean temperatures, rising sea levels, or ice shelf traveling speeds—scientists have recorded the data for decades, systematically, consistently, and with precision. Those facts make our understanding ever more certain.

“The soon-to-be-iceberg part of Larsen C Ice Shelf,” reported Martin O’Leary and Adrian Luckman of Project MIDAS, had “tripled in speed to more than ten meters per day between 24th and 27th June 2017”—tearing from the seam of the ice like the knee stitching of a 10-year-old pair of Levi’s.

As stark as the latest data are, however, similar data predicted as much in 2006, when Stan Jacobs of Columbia University’s Lamont-Doherty Earth Observatory, chronicled the “state of disequilibrium” in the Southern Ocean. By then, and in just the previous few decades, northern sections of the Larsen Ice Shelf had “retreated significantly,” said Jacobs. The change, he concluded, was “attributed largely to atmospheric warming and melt pond penetration of cracks in the ice.”

No surprise, the data showed the same phenomenon in 2003, when Ted A. Scambos, at the University of Colorado at Boulder and colleagues, detailed—with satellite photographs, maps, and endless troves of oceanographic readings—the deterioration of the northern Larsen Ice Shelf going back to 1902.

The takeaway from this is that the latest calving of a continent is both shocking and not shocking; the latter, because—hell, we KNEW it was coming. That is the beauty of measuring. Of simple counting, as I wrote in my book The Truth in Small Doses.

And that takes me to Frederick Ludwig Hoffman, a great practitioner of counting who few people have ever heard of today—but who ought to be well remembered. Sometime in the years before 1913, Hoffman, the in–house statistician for the Prudential Insurance Company of America, began noticing something odd. “Prudential’s methodical actuary,” as I wrote in Truth, “had gone through his company’s own life insurance payouts for the previous year and had discovered that two words kept recurring in the ledgers: malignant neoplasm.”

It went against all expectations, against all of the assumptions of previous underwriting. But there were the hard numbers. One in every twelve deaths in male policyholders 45 and older was the result of cancer; for women of that age, the share was nearly one in six. “That made cancer, in Prudential’s experience, the leading cause of death for middle-aged and older women and the third-leading cause for men.”

The death tolls had risen sharply and irrevocably over the decades, as Hoffman could see from his own company’s data, even if few public officials had seemed to notice, let alone be alarmed by, the trend. But the actuary wasn’t content to just look at his own firm’s records. Over the next several years, Hoffman—who would go on to form the American Cancer Society and whose work would help inspire the creation of the National Cancer Institute in 1937—sifted through data from more than two dozen other American insurers, as well as dozens of additional life insurance companies and medical societies outside the U.S. “He canvassed officials in state after state, city after city, in twenty-four countries, compiling records from Tasmania, Australia, to Lima, Peru.”

By 1913, when he began to publicly report his conclusions, he predicted: “If the present rate of increase continues unchecked, the annual cancer mortality in the continental United States will soon exceed 100,000!”

Hoffman, it turns out, had underestimated the toll by a factor of six. The latest official estimate is that 600,920 Americans will die of cancer in 2017. It is, in short, a giant iceberg of disease that keeps getting bigger.

And that, at long last, brings me to a truly important editorial written by several members of the board of directors of the new Biden Cancer Initiative—which we ran on this morning. I hope you’ll all read it. (Subtly adding link here again.)

As the authors—David Agus, Elizabeth Jaffee, Greg Simon, Kim Thiboldeaux, and Jeff Zients—rightly contend, there are still (almost unimaginably) significant “lacks” that substantially limit our progress in the long war on cancer. Among them: “a lack of data standards in treating cancer, lack of data sharing in the research and development enterprise, lack of patient input and participation in clinical trials,” and more.

It is time to tackle these issues—and a host of other cultural barriers to progress—head on, and I have faith in the mission of the Biden Cancer Initiative to do that. I applaud any effort to bring a sense of urgency to the war on cancer. This one, I think, has a real chance of succeeding.

Indeed, I’m counting on it.

This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.