A Leader's Legacy: Transforming the American Cancer Society

John R. Seffrin, PhD

There are few words more associated with the American Cancer Society (ACS) than education, which made the choice for the 2014 Giants of Cancer Care award for education an easy one—John R. Seffrin, PhD, who spent 40 years with the ACS before retiring in May. Seffrin says that eliminating cancer as a major public health problem requires both education and improved public policy, with an emphasis on elevating cancer prevention and ensuring access to quality healthcare.

“The ultimate conquest of cancer is as much a public policy issue as it is a medical and scientific challenge. The science alone is not going to be enough to eradicate the condition, especially if we don’t deal with the issue of health disparities,” Seffrin stated.

Seeing the big picture is what has propelled him since becoming chief executive officer of the ACS in 1992. He has been a tireless campaigner for tobacco prevention efforts including advocating increases in federal cigarette taxes and serving as a founding member of the Campaign for Tobacco-Free Kids. His leadership in global cancer issues has garnered international attention, along with honorary doctorates from four American universities.

And, notably, his vision has led to a remarkable transformation of the ACS itself, which evolved from an organization made up of 60 different boards to one that now has a standardized operating model. Seffrin initiated a transformation of the 102-year-old nonprofit in 2010 that led to a complete restructuring, merging 11 corporate divisions into one central organization and eliminating multiple governing bodies in favor of a single board of directors. The transformation centralized virtually all back-office services, streamlined the fundraising portfolio, and realigned staffing resources.

“Reorganization has allowed us to standardize services and gain efficiencies. We have one fiduciary board of directors that is half the size of the former national board, with a much greater ability to direct the priorities, goals, and resources of the entire organization. Previously, each corporate division was governed by its own board, each with its own budget and program of work,” Seffrin explained. Implementing nationwide decisions was a slow, cumbersome process but the organization’s new structure allows it to be very nimble. He has fielded calls from other large nonprofit organizations, such as the YMCA, who asked just how he was able to accomplish it.

In his 2011 paper, How the American Cancer Society Will Help Bring Cancer Under Control Earlier in the 21st Century: A Moral Imperative, he pointed out that the world was changing and the previous operating model—how the organization was structured and governed, how decisions were made, and how the organization did business—fundamentally had not.

“Although we have made great progress with our current model, going forward it will allow, at best, for only incremental progress,” he wrote. The ACS would not be able to make the kind of progress that it otherwise could if it did not change. He had data to show the progress made in research, treatment, education, and prevention that reduced cancer deaths over the years, but he also showed that there were thousands more lives that could be saved.

Early Influences

“Very few organizations have been able to publish data and show the kind of progress made in terms of reducing death rates and lives being saved. But, by the same token, we have lots of data to show that the number of lives saved could be a lot more if we were able to do business differently,” Seffrin said.Seffrin’s first encounter with cancer dates to his childhood. His grandmother, who was living with his family at the time, died of cancer when he was 10 years old. He has since lost his mother to cancer, and his wife, Carole, is a breast cancer survivor.

A significant influence in Seffrin’s life was his mother, who always believed he would do something important. She always saw the good in people, Seffrin said. “And she instilled in me the importance of being a forgiving person. In your professional life, if you can truly forgive, then you can move on. And this helps you stay the course and continue to lead.”

The first step in forgiveness is understanding, and Seffrin’s favorite novel, To Kill a Mockingbird, emphasizes the role of understanding the human condition. He said the level of writing in the novel is remarkable and is a key reason why he considers it a classic. “I grew up in the North, so it helped me better understand the Southern point of view,” he said.

Another significant influence in Seffrin’s life occurred when he was an undergraduate student in biology at Ball State University in Muncie, Indiana. A professor, William Bock, PhD, took an interest in his future plans and encouraged him to pursue a graduate degree. At the time, Seffrin’s only intention was to graduate and get married.

“I took his interest in me as a compliment,” said Seffrin. “But I had no initial intentions of acting on his recommendation.”

Perks of the Job

A week later, Bock caught up with Seffrin again, and handed him an index card with the names of three graduate schools he thought were the best. Bock wanted him to work on a master’s degree in health education. Seffrin ended up going to the same school Bock had attended—the University of Illinois. He then went on to pursue and complete his doctoral degree at Purdue University. Looking back, Seffrin says that Bock’s suggestion changed the path of his life.Seffrin has been on the front lines of the war against cancer not only as CEO of the ACS, but for many years before that as one of the society’s approximately 3 million volunteers nationwide. Under his leadership, the ACS has become the world’s largest volunteer health organization fighting cancer.

The organization didn’t get where it is today without an energetic visionary at its helm. “I was in academia for two decades before leading the ACS,” he said, during which time he had a number of opportunities to leave and join other nonprofit organizations.

“Even if my career path had remained in academia, I’m certain I’d also have been engaged in a cause of one kind or another.”

Since joining the ACS, “the only constant in my weekly routine is travel. It is hectic and no two weeks are exactly alike.”

One of the perks of the job was meeting with so many dedicated, gifted, and generous people, Seffrin said. That might include meeting with cancer researchers at The University of Texas MD Anderson Cancer Center, holding a strategic meeting with volunteers, or engaging with ACS’s intramural research scientists.

“ACS has a world-class epidemiology department— the largest in the private nonprofit sector—conducting a rich variety of ongoing research projects. Working with that team is part of what’s so fulfilling about this career,” Seffrin said.

Averting a Tsunami

“Right now, the team is following 300,000 participants over time, which will improve our understanding of cancer’s causes, and how better to prevent and cure it,” Seffrin said.It has been a stellar career. In January 2014, Seffrin announced his plans for retirement after 40 years with the ACS. A search committee has been assembled to find his successor.

Seffrin would like to dedicate the balance of his career to providing leadership on a global scale.

“I want to avert this tsunami of noncommunicable diseases, including cancer,” he said.

“We have an opportunity to create a world that will be both healthier and economically much more productive if we do the right things and bring cancer under control in this century.”

The ACS has made so much progress in helping researchers understand how cancer develops at the intracellular level, and especially how it has become a major problem at the population level.

“This is an exciting time, especially if we can muster the courage and enlighten policymakers as they make their decisions. My hope is that I can play a role in getting our country, and other countries around the world, to make cancer control, research, and therapy a high priority,” Seffrin said.

Seffrin’s Efforts Helped Save Lives

During the reception that honored recipients of the Giants of Cancer Care awards, Seffrin received a very meaningful compliment from Paul A. Bunn Jr, MD, recipient of the award for lung cancer, executive director of the International Association for the Study of Lung Cancer, and founding director of the University of Colorado Cancer Center. “I don’t feel like a giant, but the ACS and John Seffrin have done more to save lives by pushing for a cigarette tax in Colorado than most of the scientists in the room,” said Bunn. “They are the true giants.” Robert E. YouleChair, Board of DirectorsAmerican Cancer Society, Inc.

“There is no question that John Seffrin’s leadership of the world’s largest voluntary health organization helped changed the cancer fight for good. While he was at the society’s helm, we accomplished some truly extraordinary things.

“It was under his leadership that we celebrated the first-ever declines in cancer mortality rates in the United States, which have now declined more than 20%. That progress means today we’re averting 500 cancer deaths every day.

“John also has always been known as a strong tobacco control advocate, and it’s been during his lifetime that we’ve seen a 50% drop in smoking rates in the United States. He’s been a strong supporter of that decline, and has been a champion for tobacco control both in the United States and around the world.

“As an organization, the American Cancer Society is in a vastly different place today than when John became our chief executive back in 1992. We’ve gone from a charity that went door to door collecting donations and providing local services, to a global institution that is poised to lead a worldwide fight to bring this disease under control.

“Today in the United States, we have 14 million Americans who are cancer survivors, thanks to the progress we’re making—a number that would have been unthinkable when John Seffrin got started in the cancer fight. But it’s not today, and that’s thanks in part to leaders like him.”

Dr. Seffrin's Selected Papers

• Brawley OW, Glynn TJ, Khuri FR, Wender RC, Seffrin JR. The first Surgeon General’s report on smoking and health: the 50th anniversary [published online November 18, 2013]. CA Cancer J Clin. 2014;64(1):5-8.
• Byers TE, Franklin BA, Henry RR, et al. Speaking with one voice on worksite wellness: the American Cancer Society, the American Diabetes Association, and the American Heart Association. Am J Health Promot. 2011;26(1):eiii-ev. doi:10.4278/ ajhp.26.1.c2.
• Seffrin JR. Conquering cancer in the 21st century: leading a movement to save more lives worldwide. Health Educ Behav. 2011;38(2):111-115.
• Seffrin JR, Brown NA, Connor CD, et al. Tobacco and NIH: more than addiction. Tob Control. 2011;20(3):175-177.
• Farmer P, Frenk J, Knaul FM, et al. Expansion of cancer care and control in countries of low and middle income: a call to action [published online August 13, 2010]. Lancet. 2010;376(9747):1186-1193.
• Glynn T, Seffrin JR, Brawley OW, et al. The globalization of tobacco use: 21 challenges for the 21st century. CA Cancer J Clin. 2010;60(1):50-61.
• Seffrin JR, Hill D, Burkart W, et al. It is time to include cancer and other noncommunicable diseases in the millennium development goals [published online August 14, 2009]. CA Cancer J Clin. 2009;59(5):282-284.
• Reed E, Seffrin J, Giavazzi R, et al. Vascular endothelium summary statement III: cancer prevention and control [published online November 21, 2006]. Vascul Pharmacol. 2007;46(5):321-323.
• Fiore MC, Croyle RT, Curry SJ, et al. Preventing 3 million premature deaths and helping 5 million smokers quit: a national action plan for tobacco cessation. Am J Public Health. 2004;94(2):205-210.
• Seffrin JR, Wilson JL, Black BL. Patient perceptions. Cancer. 1991;67(6 suppl): 1783-1787.
• Bal DG, Woolam GL, Seffrin Jr. Dietary change and cancer prevention: what don’t we know and when didn’t we know it? CA Cancer J Clin. 1999;49(6):327-330.
• Torabi MD, Seffrin Jr. Evaluation of the effects of cancer education on knowledge, attitude, and behavior of university undergraduate students. J Cancer Educ. 1989;4(1):39-47.