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Nixon's War on Cancer - where NCI stands forty years on

18 Oct 2011

Forty years ago today - 18 October 1971 - President Richard Nixon converted the US Army's former biological warfare facilities at Fort Detrick, Maryland, into a facility that housed research activities on the causes, treatment and prevention of cancer.

This date is of great significance since it is considered the first concrete action that Nixon took in his legendary "war on cancer".

In January 1971 in his state of the union address Nixon had said, "The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned towards conquering this dread disease. Let us make a total national commitment to achieve this goal."

Finally on December 23 1971, Nixon signed the National Cancer Act of 1971, declaring "I hope in the years ahead we will look back on this action today as the most significant action taken during my administration." The Act gave the National Cancer Institute (NCI), which had been created in 193, unique autonomy and budget authority within the National Institutes of Health (NIH), allowing it to broaden its scope and coordinate the national effort against cancer with the establishment of new institutes and the hiring of scientists.

Under the reorganisation, which came into place in July 1972, the NCI was composed of the Office of the Director and four divisions: Cancer Biology and Diagnosis, Cancer Cause and Prevention, Cancer Treatment, and Cancer Grants (renamed successively the Division of Cancer Research, Resources and Centers, and later the Division of Extramural Activities). Then on June 20, 1973, NCI director Frank J Rauscher, announced that eight institutions were to be recognised as comprehensive cancer centres with the intention of bringing the results of research as rapidly as possible to a maximum number of people. Today there are 65 NCI-designated cancer centres in 34 states.

In addition to the comprehensive cancer centres, and the NCI research labs in Bethesda, the NCI has been largely responsible for putting a cancer research infrastructure in place across the entire US. They were responsible for setting up cancer registration data bases, like the SEERS data base and regional cancer trial networks, with the intention of allowing every cancer patient in the US to have access to a trial.

"There's no doubt in my mind that NCI has been responsible for driving the research process and fast tracking many cancer drugs and encouraging Pharma to take them up," says Gordon McVie, from the European Institute of Oncology in Milan.

McVie, who is a former director general of Cancer Research UK, recalls how the Cancer Act did not just affect America, but focused the entire world's attention on cancer and the need to provide additional financial resources for research. "Nixon's war metaphor was perfect. It galvanised people into action and helped create the view that cancer could be defeated," he says.

Before the Act all the cancer research funding in the UK, says McVie, came from charitable donations. "But thanks to the endorsement of the American president, the UK government at last started to take cancer seriously and provide funding for research."

The NCI also proved generous in funding European cancer research institutions. "It's ironic that at one point NCI was providing more financial support for the EORTC in Europe than the European Commission," he says.

In September 2011, the American Association for Cancer Research (AACR) published a report outlining the progress that has been made since 1971. The report recalls how between 1990 and 2007 the death rates for cancer in the US dropped by 22 % for men and 14% for women, and that how in 1975 only 50% of people diagnosed with cancer could expect to live for another five years, but now nearly 70% can. Among children the gains have been even greater with 80% of youngsters expected to survive childhood cancers today, compared with 53% in 1975.

"We now have a deep understanding of the fundamental nature of cancer and why and how cancer develops and spreads throughout the body," adds the report.

It goes on to provide a vision for the future where all cancer treatment and prevention strategies will be "based on both a person's own genetic makeup and the genetic makeup of their specific cancer", but acknowledges in order to achieve this there will need to be a continued commitment to tackle cancer and improve funding. The reality is that over the last eight year the NIH has lost about 13% of its purchasing power due to inflation and the increasing costs of research and technology.

The AACR Cancer Progress Report 2011 urges Congress to provide the NIH and NCI with sustained budget increases of at least 5 percent above the biomedical inflation rate to " ensure the future scientific advances needed to capitalize on past research investments, spur innovation, and make a difference in the lives of people worldwide".

AACR Immediate Past President Elizabeth H. Blackburn, says, "Today, more than any time in history, cancer researchers are maximizing the impact of the fundamental discoveries made over the past 40 years and are translating them into improved patient care. Sustained funding increases for the NIH and NCI are an urgent national priority that will improve the health of Americans and strengthen America's innovation and economy."