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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.
Printed in the United States of America
NATIONAL CANCER POLICY BOARD
Department of Pathology, Harvard Medical School
JOSEPH SIMONE (Vice-Chair), Medical Director,
Huntsman Cancer Foundation and Institute, University of Utah
JOHN BAILAR,* Chair,
Department of Health Studies, University of Chicago
NORMAN DANIELS, Professor of Philosophy,
JOSEPH DAVIE,* Vice President,
Department of Research, Biogen, Inc., Cambridge, Mass.
ROBERT DAY, President and Director,
Fred Hutchinson Cancer Research Center, Seattle
KATHLEEN FOLEY,* Chief of Pain Service,
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York City
BERTHA FORD, Coordinator,
Cancer Clinical Trials, The Arthur G. James Cancer Hospital and Research Institute, Columbus, Ohio
ELLEN GRITZ, Professor and Chair,
Department of Behavioral Sciences, University of Texas M.D. Anderson Cancer Center, Houston
ELIZABETH HART, President and CEO,
Hart International, Dallas
JOHN LASZLO, Independent Consultant,
WILLIAM McGUIRE,* Chief Executive Officer,
United Health Care Corporation, Minnetonka, Minn.
DANIEL NATHANS,† Senior Investigator,
Howard Hughes Medical Institute, Bethesda, Md., and
Professor of Molecular Biology and Genetics,
Johns Hopkins University School of Medicine
SANDRA NICHOLS, Director,
Arkansas Department of Health, Little Rock
DIANA PETITTI, Director,
Research and Evaluation, Kaiser Permanente Medical Care Program, Pasadena, Calif.
AMELIE RAMIREZ, Associate Professor,
Department of Medicine, Baylor College of Medicine
WILLIAM ROPER,* Dean,
University of North Carolina School of Public Health, Chapel Hill
JOHN SEFFRIN, Chief Executive Officer,
The American Cancer Society, Atlanta
JANE SISK, Professor,
Columbia University School of Public Health
ELLEN STOVALL, Executive Director,
National Coalition for Cancer Survivorship, Silver Spring, Md.
FRANCES VISCO, President,
National Breast Cancer Coalition, Philadelphia
ROBERT YOUNG, President,
Fox Chase Cancer Center, Philadelphia
RICHARD J. BONNIE, John S. Battle Professor of Law, and Director,
Institute of Law, Psychiatry, and Public Policy, University of Virginia School of Law
ROBERT MULLAN COOK-DEEGAN, Director
STACEY PATMORE, Senior Project Assistant
KATHLEEN McCORMALLY, Research Assistant and Summer Intern
CATHARYN LIVERMAN, Program Officer
MICHAEL STOTO, Senior Staff Officer,
Division of Health Promotion and Disease Prevention
JANE DURCH, Program Officer,
Division of Health Promotion and Disease Prevention
CLAUDIA CARL, Reports and Information Office
MICHAEL EDINGTON, Reports and Information Office