legislation called for expansion of research for the prevention of cancer caused by occupational or environmental exposures to carcinogens. The focus on viral infections in cancer research did a great deal to promote virology, but the mechanisms by which viruses caused cancer remained unclear. As a result, the War on Cancer was a strange war, one in which it was not quite clear who the enemy was, nor was there an effective method of defeat.

Soldiers in the War on Cancer

The cancer centers played a major role in the War on Cancer. They were the focal point for clinical and nonclinical research, and from these centers the latest and best methods for the treatment, prevention, and control of cancer were discussed with professionals and the lay public. These centers grew in number, and the level of funding that they received grew as well, but the efforts were not coordinated into a national plan. The greatest emphasis was on trying to understand the underlying mechanisms of cancer development.

The National Cancer Act also mandated the collection, analysis, and dissemination of information that would be useful in the prevention, diagnosis and treatment of cancer. This resulted in the development of the Surveillance, Epidemiology, and End Results (SEER) program in 1973. The rationale for the establishment of the SEER program was that data collection could be useful in the effort to understand the cancer problem, especially when the rates of cancer are significantly different in various groups of the population. In fact, the data pointed to wide disparity in the rate of mortality from cancer among the African-American population, compared with that among the white population. Race or poverty was often stated as an explanation for this disparity, but a completely satisfactory answer was not available. The data pointed to a need for special attention to cancer in the African-American population and may have been a major factor in approving the development of the Drew-Meharry-Morehouse Consortium Cancer Center in 1988. Other initiatives also focused on what the Institute called "special populations." These included the Black Leadership Initiative on Cancer, the Hispanic Leadership Initiative, and the Appalachian Leadership Initiative. The last initiative was formed in recognition of the fact that rural, poor whites experienced the same burden of cancer as ethnic minority groups. A Leadership Initiative for American Indian and Alaska Native populations or other groups was never formed. These efforts were stimulated by the groups involved and were supported by the Institute, but they were not the result of an Institute strategy to reduce the burden of disease in these populations.

Legislation established the position of Associate Director for Prevention



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