The Agency in the Age of the Great Society and its Aftermath

In the late 1960s, MFUA staff began to raise concerns about the longevity of the raw material for their studies, particularly the hospital admission punch cards from World War II. As the basis for most of the agency's studies, these punch cards had to be protected against deterioration or, worse, loss, as had been the case with similar Navy admission cards a decade earlier. MFUA estimated the cost of transferring the fragile cards to more permanent magnetic tape in the tens of thousands of dollars, much more than the agency had at its disposal. Forced to look for outside funding, the agency secured money from the National Cancer Institute in fiscal year 1969 and stored the entire series on tape as a basic resource for future studies. 119

Even as its materials aged, the Medical Follow-up Agency, now staffed by 31 persons (5 professionals, 26 support staff) and with an annual budget of more than a half million dollars, reached important milestones in a number of its ongoing studies in 1967. The VA-funded series of controlled therapeutic trials of chemotherapy in conjunction with cancer surgery reached its tenth year in 1967. In addition to providing authoritative evaluations of the various adjuvant cancer agents tested to improve cancer-free survival after surgery, these trials provided important follow-up data on cancer survival as related to patient characteristics and treatment. Also in the same year, the agency finished a mortality study of patients who had undergone "curative" lung resection for bronchial cancer. The clinical examinations of men with herniated lumbar disks were completed in this year as well, and the agency began an epidemiologic study on the same condition to determine the significance of such variables as tissue degeneration, metabolic disorders, chronic stress, and occupational factors in mortality outcomes. Other ongoing studies during 1967 included an examination of viral and other factors in the etiology of cancer, a cooperative study of lower-limb amputations that aimed to elucidate factors of importance in the rehabilitation process for amputees, and a study of the possible relation of cholesterol levels in the blood to cerebrovascular disease.120

Despite this evidence of scientific progress, funding again became an issue for the Medical Follow-up Agency in the late 1960s. Its core support came under attack from within the National Institutes of Health. In part, this attack reflected changing circumstances: Keith Cannan, who had been so instrumental in obtaining funding from the National Institutes of Health, no longer headed the agency's parent Division of Medical Sciences, and NIH staffers with short institutional memories no longer remembered just why they were funding the MFUA. Moreover, NIH faced its own internal budgetary problems. In this, NIH was not alone; the postwar prosperity that had funded the massive expansion of government at all levels was beginning to falter. First the Vietnam War, and later the economic



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