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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the National Cancer Policy Board, which is responsible for the report, were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the authors as well as the NRC and IOM in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity and evidence. The content of the review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their participation in the review of this report: Harvey Fineberg, Coordinator, Harvard University; Virginia Weldon, Monitor, Monsanto Corporation; Neal Benowitz, University of California, San Francisco; Frank Chaloupka, University of Illinois, Chicago; Jack Henningfield, Pinney Associates and Johns Hopkins University; Thomas Houston, American Medical Association; Michael Pertschuk, The Advocacy Institute; and Kenneth Warner, The University of Michigan.

While the individuals listed above have provided many constructive comments and suggestions, responsibility for the final content of this report rests solely with the National Cancer Policy Board, the NRC and IOM.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

This study was supported through funding provided by the National Cancer Institute (Contract No. N02-CO-71024), Centers for Disease Control and Prevention, American Cancer Society, Amgen, and Abbott. The views presented in this report are those of the National Cancer Policy Board and are not necessarily those of the funding organizations.

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Copyright 1998 by the National Academy of Sciences. All rights reserved.

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