The 1971 National Cancer Act: Investment in the Future

On Dec. 23, l971, President Richard M. Nixon signed into law bold legislation that mobilized the country's resources to fight cancer. The National Cancer Act infused enough dollars and authority into the National Cancer Institute (NCI) to make the "conquest of cancer a national crusade."

The Act had its roots in a 1970 Senate resolution calling for a study of the status of cancer research. Subsequently, the Senate authorized a group of scientists and cancer advocates to draft a legislative plan for a broad-reaching national program for the "conquest of cancer." The report of the Yarborough Commission, named after Texas Senator Ralph W. Yarborough who spearheaded the effort, became the blueprint for the National Cancer Act.

The legislators' hope was that the creation of a National Cancer Program, overseen by a small number of experts and with direct access to the president of the United States, would greatly accelerate the pace of cancer research and its translation into treatment.

The Act authorized NCI to carry out a National Cancer Program and mandated that:

The Program be developed by the NCI director with the advice of the National Cancer Advisory Board (NCAB), a presidentially appointed committee of 18 members, including both distinguished scientists and laypersons from the community-at-large. The NCAB also has 12 ex officio members from other government agencies.

A three-member panel, the President's Cancer Panel (PCP), appraise the Program, by holding periodic public hearings and submitting an annual progress report directly to the president.

The annual budget of NCI, called the bypass budget, be submitted directly to the president bypassing traditional approval by the National Institutes of Health (NIH) or the Department of Health and Human Services required of other NIH institutes.

The NCI director and members of the NCAB and PCP be presidential appointees.

The Act also gave the director of NCI broad authority, in consultation with the NCAB, to:

Create new cancer centers and manpower training programs.

Appoint advisory committees, allowing the director to explore new issues/opportunities.

Expand the physical plant at NIH, as well as cancer research facilities across the country.

Award contracts for research, which were used to create the Frederick Cancer Research and Development Center, International Cancer Information Center, and Chemoprevention Branch.

Collaborate with other federal, state, or local public agencies and private industry, which is particularly useful for drug screening and establishing numerous partnerships with private industry.

Conduct cancer control activities, such as antismoking, diet and lifestyle, and early detection.

Establish an international cancer research data bank that collects, catalogues, stores, and disseminates results of cancer research undertaken in any country.

Award research grants.

The built-in flexibility of the Act has allowed NCI to explore new research directions and areas of greatest opportunity. Adjustments in the Act have been made over the years, but the major authorities have remained unchanged. Even though the biology of the more than 100 types of cancers is far more complex than imagined in l971, and effective treatments for many cancers have remained elusive, the original vision of the legislators has been largely realized.

The National Cancer Act, and the 25 years of public investment in medical research that followed, produced an extraordinary record of scientific discovery and spawned a nationwide network of cancer centers, trained cancer experts, and developed programs in community outreach and cancer prevention.

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