After the National Cancer Act of 1971
Twenty Five Years of Advances Against Cancer

 

The past quarter century has seen remarkable advances against cancer, many coming as a direct or indirect result of passage of the National Cancer Act in 1971. Among them:

 

Cancer Mortality Rates (from analyses available by January 1997)

  • Overall cancer death rates fell 2.6 percent from 1991 to 1995.
  • Lung cancer death rates for men fell 6.7 percent from 1991 to 1995.
  • Death rates for colorectal cancer dropped 18.6 percent from 1973 to 1993, and 5.4 percent between 1991 and 1995.
  • Death rates for breast cancer fell 6.3 percent between 1991 and 1995.
  • Death rates for prostate cancer fell 6.2 percent between 1991 and 1995.
  • Testicular cancer death rates dropped 65.7 percent from 1973 to 1993.
  • Hodgkin's disease death rates dropped 58.4 percent from 1973 to 1993.
  • Death rates for cancers in children (up to age 14) fell 44.4 percent from 1973 to 1993; leukemia, the most common childhood cancer, dropped 52.9 percent in that period.

 

Technologies

  • Recombinant DNA techniques developed for cloning genes, mid-1970s.
  • Hybridoma technology developed for production of monoclonal antibodies, 1975.
  • Southern blot technique developed to identify DNA fragments, 1975.
  • Methods developed to sequence DNA fragments, 1975 to 1976.
  • Restriction fragment length polymorphism (RFLP) technique used in cancer, 1983.
  • Polymerase chain reaction technique (PCR) developed, mid-1980s.
  • Severe combined immunodeficiency (SCID) mice developed, mid-1980s.
  • Fluorescence in situ hybridization (FISH) technique developed, about 1990.

 

Cancer Genetics

  • First of some 50 now-known human proto-oncogenes discovered (src), 1976.
  • Most frequently mutated gene in human cancer, p53, discovered, 1979.
  • First of some 20 now-known tumor suppressor genes cloned (RbI), 1986.
  • First human gene therapy for cancer (melanoma) introduced, 1991.
  • First of the hereditary nonpolyposis colon cancer genes cloned (hMSH2), 1993.
  • Inherited breast cancer genes cloned (BRCA1 and BRCA2), 1994 and 1995.

 

Epidemiology

  • Surveillance, Epidemiology, and End Results (SEER) Program established, 1973.
  • Statistical methods developed to control simultaneously for several factors in the analysis of studies and to quantify cancer risks, 1970s and 1980s.
  • Studies in human populations link cancer risk to infectious agents, such as human papillomavirus (cervical cancer) and hepatitis B (liver cancer), 1970s and 1980s.
  • Studies link cancer risks to hormonal drugs, such as diethylstilbestrol (DES) taken during pregnancy and hormonal replacement therapy, 1970s and 1980s.
  • Studies associate risk of certain cancers with dietary and nutritional factors, such as low intake of fruits and vegetables and obesity, as well as to sedentary lifestyle, 1980s.
  • Studies clarify the patterns of cancer risk following exposure to ionizing radiation, 1970s and 1980s.
  • Biochemical and genetic assays integrated into epidemiologic studies (molecular epidemiology), 1980s.
  • Statistical genetic techniques developed to define modes of inheritance, localize genes, and evaluate gene-environment interactions in cancer risk, 1970s through 1990s.
  • Precursors, such as specific moles as precursors to melanoma, linked to several forms of cancer, late 1970s and early 1980s.
  • Several common genetic variants linked to the risk of lung and other cancers, 1990s.

 

Treatment

  • Interleukin-2 discovered, 1976.
  • First human testing of a biological therapy (alpha interferon), 1978.
  • Total mastectomy replaced radical mastectomy for breast cancer, 1979.
  • Limb-sparing surgeries developed for sarcomas of the extremities, late 1970s.
  • First effective antinausea drugs developed to alleviate side effects of chemotherapy, early 1980s.
  • First human cancer vaccine (hepatitis B virus vaccine for liver cancer) introduced, 1981.
  • Lumpectomy plus radiation found equivalent to mastectomy for breast cancer, 1985.
  • Modified prostatectomy, designed to preserve potency and urinary continence, introduced, 1986.
  • Adjuvant chemotherapy proven to increase disease-free survival in early breast cancer, 1988.
  • Adjuvant chemotherapy found to increase survival in colon cancer, 1989.
  • Adjuvant radiation and chemotherapy found to improve survival in rectal cancer, 1991.
  • Continuous pain-medication infusion pumps developed, early 1980s.
  • Combination chemotherapies proven effective, first for Hodgkin's disease and later for a variety of cancers.

 

Anticancer Drugs (year of FDA approval)

  • Doxorubicin (1974).
  • Cisplatin (1978).
  • Tamoxifen (1978).
  • Levamisole (1990).
  • Paclitaxel (1992).
  • Topotecan (1996).

 

Prevention

  • Prevalence of adult cigarette smoking dropped from 37 percent in 1971 to 24 percent in 1993.
  • Dietary guidelines to reduce cancer developed, 1984.
  • Flexible sigmoidoscopy and colonoscopy developed to help detect and remove precancerous growths, 1980s.
  • First chemoprevention trial to show efficacy (vitamin A analogue against mouth and throat tumors), 1990.
  • American Stop Smoking Intervention Study for Cancer Prevention (ASSIST), largest tobacco prevention and control project in the United States, launched, 1991.
  • National Cancer Institute-sponsored studies in China show importance of nutrition in preventing cancer, 1991.

 

Detection and Diagnosis

  • Computed tomography (CT) introduced in the United States, 1973.
  • Positron emission tomography (PET) developed, mid-1970s.
  • Magnetic resonance imaging (MRI) introduced, early 1980s.
  • The Bethesda System Conference developed system for standardized reporting of Pap smear results, 1988.
  • Mammography Quality Standards Act passed, 1992.
  • Transition from film-based radiology to digital computer-assisted medical imaging, 1990s.

 

Cancer Concepts

  • Established that proto-oncogenes play important roles in normal cellular control, 1970s.
  • Cytochrome P450 enzyme system shown to activate many carcinogens, 1970s.
  • Metastatic cells shown to arise from pre-existing subpopulations in primary tumors, 1978.
  • Multistep nature of carcinogenesis proven by 1990.

 

Information Transfer

  • CANCERLINE, a national database of published cancer research, established, 1974.
  • Cancer Information Service (1-800-4-CANCER) opened, 1976.
  • First national cancer patient education program (I Can Cope) founded, 1977.
  • PDQ (physician data query) database goes online, 1983.
  • First major DNA sequence databases established in the United States (GenBank) and Germany, 1982.
  • Human Gene Mapping database established, 1989.

 

Cancer Specialists

  • Certification in medical oncology (6,550 certified to date) first offered, 1973.
  • Number of medical oncologists certified annually grew from 351 in 1973 to 597 in 1995.
  • Membership in the American Society of Clinical Oncology, established in 1964, grew to about 10,500 in 1996.
  • Certification in gynecologic oncology (559 now certified) first offered, 1973.
  • Society for Surgical Oncology (1,600 members now) established from earlier group, 1975.
  • Oncology Nursing Society (24,000 members now) established, 1975.
  • Certification in radiation oncology (3,130 now certified) first offered, 1989.

 

Statistics are from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database (January 1997) and from the American Cancer Society's Cancer Facts and Figures­1997, which contains estimates based on SEER data.

The Cancer Information Service provides a nationwide telephone service for cancer patients, and their families, the public, and health care professionals. The toll-free number is 1-800-4-CANCER (1-800-422-6237); services are provided in English and Spanish. People with TTY equipment may call 1-800-332-8615.

 

Back to How to Get It

Return to Cancer Research Main Page