Milestones in cancer prevention, early detection and screening research from the 1970s to today.
December: National Cancer Act Signed
President Richard M. Nixon signs the National Cancer Act, which authorizes the NCI Director to coordinate all activities of the National Cancer Program, to establish national cancer research centers, and to establish national cancer control programs.
NCI Awards Cancer Control Grants for Ovarian Screenings
Cancer control grants are awarded to state health departments to increase ovarian cancer screenings for low-income women.
Senate Select Committee on Nutrition Produces Report on US Dietary Goals
Lead by Senator George McGovern, the Senate Select Committee on Nutrition produces a report on “The Dietary Goals for the United States.” This publication recommends a low-fat, high-fiber diet to lower the risk of diseases such as diabetes and cancer. The report stimulates interest and increased research in the area of nutrition.
Community Hospital Oncology Program Originates
NCI begins to organize the Community Hospital Oncology Program (CHOP), a predecessor of the Community Clinical Oncology Program (CCOP).
Public Health Service Publication Provides Diet Guidelines
The Surgeon General publishes “Healthy People: Health Promotion and Disease Prevention,” which provides nutrition advice. This is the first public health service publication to provide diet guidelines.
October: NCI Diet Recommendations Announced
NCI announces that a balanced, low-fat diet can reduce the risk of roughly 30% of cancers. Diet recommendations include low alcohol intake and increased amounts of fiber.
October: NCI Approves Concept for Community Clinical Oncology Program (CCOP)
The concept for a community-based program is approved by NCI. The program is aimed at providing cancer care and research to underserved areas and creating a conduit for technology transfer.
Chemoprevention Research Program Established
The chemoprevention research program is established to locate cancer-reducing micronutrients or synthetic compounds.
NCI Provides Grants for Cancer Prevention Research under Small Business Innovation Law
Congress authorizes the Small Business Innovation Research (SBIR) Program under the Small Business Innovation Development Act (P.L. 97-219) to stimulate private sector contributions to federal research and development needs. NCI uses this program to provide grants for cancer prevention research.
Smoking, Tobacco, and Cancer Intervention Research Program Launched
The Smoking, Tobacco, and Cancer Program (STCP) intervention research program is launched to test specific intervention conduits such as the media, schools, and health care providers.
New Prevention Research Program Begins
NCI begins a new program to address prevention research in diet, chemoprevention, early detection, and identification of high-risk occupations.
July: NCI Funds the New Community Clinical Oncology Program (CCOP)
The CCOP, 62 clinical oncology centers throughout the nation that are responsible for enrolling patients in NCI trials, is funded. These centers conduct cancer treatment, prevention, and control clinical trials in an effort to develop clinical prevention and symptom management.
December: NCI Adds New Division Devoted to Prevention and Control
The NCI creates the Division of Cancer Prevention and Control (DCPC).
Division of Cancer Prevention and Control (DCPC) Starts Programs, Trials, and Studies
The DCPC establishes the Cancer Control Science Program to publicize cancer control knowledge. Clinical trials in chemoprevention and diet and nutrition begin, and the DCPC adds preclinical efficacy and toxicology studies.
May: NCI Discusses Dietary Health Claims with Company
NCI meets with the Kellogg Company to discuss health claims in a publicity campaign for All-Bran cereal that promotes the cancer prevention benefits of high-fiber, low-fat foods.
May: Coordination of Linxian China Dysplasia Trial Starts
The Linxian China Dysplasia Trial begins with coordination between the Cancer Institute of the Chinese Academy of Medical Sciences and the NCI. People with severe esophageal dysplasia begin taking either vitamin and mineral supplements or placebos in order to test the etiologic and preventative role of vitamins and minerals in the late stages of esophageal carcinogenesis.
Alpha-Tocopherol, Beta Carotene (ATBC) Cancer Prevention Study Starts
The purpose of the ATBC study was to determine whether certain vitamin supplements would prevent lung cancer and other cancers in a group of 29,133 male smokers in Finland. The 50- to 69-year-old participants took a pill daily for five to eight years that contained either alpha-tocopherol (a form of vitamin E), beta-carotene (a precursor of vitamin A), both, or a placebo (inactive pill that looked like the vitamin). (Read the NCI Q&A)
Community Clinical Oncology Program Expands to Large Prevention and Control Trials
CCOP expands its research portfolio to include large-scale cancer prevention and control trials.
NCI Develops Working Guidelines for Cervical and Breast Cancer Screenings
Along with other organizations, the NCI develops Working Guidelines for cervical and breast cancer screenings, including regular mammograms by age 40 and annual mammograms after age 50.
Cancer Prevention Fellowship Program (CPFP) Begins
The CPFP is instituted to provide clinicians and scientists with a strong foundation to train in the field of cancer prevention and control. The fellowship offers training toward an MPH degree at an accredited university during the first year, followed by mentored research with investigators at the NCI, and opportunities for cutting-edge research in the basic, quantitative, social and behavioral sciences, and clinical cancer prevention.
Law Mandates Medicare Coverage of Mammography Screenings
President Reagan signs P.L. 100-360, The Medicare Catastrophic Coverage Act of 1988. It mandates that as of January 1, 1990, mammography provisions include biennial screening for women aged 65 and older and annual screenings for women aged 50 to 64. Women who are between the ages of 40 and 49 should have screenings available every other year, and by the time a woman is 40 she should have at least one mammogram.
January: NCI Approves the Minority-Based Community Clinical Oncology Program (MB-CCOP)
NCI approves the MB-CCOP, which is aimed at providing minorities and people in underserved areas greater access to preventative trials and cancer treatment.
Chemoprevention, Intervention Trials Underway
The Division of Cancer Prevention and Control (DCPC) is responsible for 27 intervention clinical trials, including synthetic retinoids and natural chemoprevention substances such as vitamins A, C, E, B12, folate, and beta-carotene.
National 5-A-Day Public Health Message Supported
In conjunction with the Produce for Better Health Foundation, the Division of Cancer Prevention and Control (DCPC) begins supporting the National 5-A-Day message, which encourages the American public to eat at least five servings of fruits and vegetables a day.
American Stop Smoking Intervention Study (ASSIST) Starts
Working in conjunction, the American Cancer Society and the Division of Cancer Prevention and Control (DCPC) announce the start of ASSIST. The study sets the goal of having a smoke-free society by 2000.
April: Breast Cancer Prevention Trial (BCPT) Begins Enrollment
The BCPT begins enrolling women to test the chemopreventive drug tamoxifen. A total of 13,388 women age 35 and older who are at increased risk of breast cancer are accepted into the trial.
December: NCI Drops Mammography Guidelines
The NCI drops its previous mammography guidelines by no longer advising that women under 50 should have annual mammograms.
Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Begins Enrollment
Participant enrollment begins for the PLCO trial, a large population-based randomized clinical trial evaluating cancer screening by chest x- rays, flexible sigmoidoscopy, transvaginal ultrasound, blood tests, and digital rectal exams in more than 150,000 men and women ages 55 to 74.
Trial Results Show Fecal Occult Blood Test (FOBT) Screening Reduces Colorectal Cancer Mortality
Results from an NCI-supported, randomized controlled clinical trial show that annual screening with guaiac FOBT can help reduce colorectal cancer mortality by about 33%.
CCOP Network Helps with Colorectal Adenoma Prevention Study (CAPS)
The CCOP network assists the Cancer and Leukemia Group B in the CAPS. This study evaluates the effectiveness of aspirin in reducing early-stage colorectal tumors.
October: Enrollment for the Prostate Cancer Prevention Trial Begins
PCPT starts enrolling participants. The intention of the 18,882-man trial is to determine whether or not the drug finasteride can prevent prostate cancer in men. The drug is approved for the treatment of benign prostatic hyperplasia, but it is believed that it also reduces levels of the male hormone that is involved in prostate cancer development.
October: NCI Convenes International Workshop on Breast Cancer Screening
An NCI-convened international workshop on breast cancer screening reviews published and unpublished data from eight randomized controlled clinical trials, including the HIP trial that was launched in 1963, and concludes that screening with mammography reduces breast cancer mortality among women ages 50-69.
Trial Finds Beta-Carotene Increases Lung Cancer in Finnish Males
The Alpha-Tocopherol (vitamin E)/ Beta-Carotene Prevention Study (ATBC) findings indicate that beta-carotene in fact increases lung cancer incidence in Finnish males.
ASCUS/LSIL Triage Study (ALTS) Begins Enrollment
ALTS starts enrolling participants. This study concerns treatment of mild abnormalities found on the cervix during Pap tests. Women in the trial might have: immediate colposcopy, no treatment until the screenings indicate a high-grade lesion, or human papillomavirus (HPV) testing.
NCI Establishes Separate Divisions for Prevention and Control/Population Sciences
The NCI reorganizes and divides the Division of Cancer Prevention and Control (DCPC) into the Division of Cancer Prevention (DCP) and the Division of Cancer Control and Population Sciences (DCCPS). The DCP focuses more exclusively on cancer prevention, while the DCCPS explores population genetics, epidemiology, behavior, society, and welfare of cancer survivors.
Breast Cancer Prevention Trial (BCPT) Shows Tamoxifen Reduces Breast Cancer Incidence
Results from the BCPT show that the drug tamoxifen reduces the incidence of breast cancer by 49% among women who are at increased risk of the disease. The Food and Drug Administration subsequently approved tamoxifen for the prevention of breast cancer in high-risk women.
Early Detection Research Network (EDRN) is Founded
The EDRN is established to coordinate development, evaluation, and application of biomarkers of cancer and cancer risk in a network of institutions. EDRN includes biomarker developmental labs, clinical and epidemiologic centers, biomarker validation labs, and a data management and coordinating center.
Rapid Access to Preventive Intervention Development (RAPID) Program Begins
DCP begins to develop the RAPID program, which provides contract support to investigators who need help to advance laboratory and clinical testing on various chemopreventive agents and molecules.
Study of Tamoxifen and Raloxifene (STAR) Commences
The STAR clinical trial begins. Its goal is to compare the effectiveness of both drugs in reducing breast cancer incidence and to compare adverse side effects. Over 22,000 women spanning 200 clinics will take one of the two drugs for 5 years. Enrollment is completed in November 2004.
Adenoma Prevention with Celecoxib (APC) Trial Starts Enrollment
Enrollment for the APC clinical trial begins, assigning more than 2,000 participants 200 mg of celecoxib (Celebrex®) twice a day. The drug is expected to block cyclooxygenase (COX) enzymes, which are turned on by precancerous and cancerous tissues. The trial is part of a larger search for effective non-steroidal anti-inflammatory drugs acting as cancer-preventing mechanisms.
July: Selenium and Vitamin E Cancer Prevention Trial (SELECT) Begins Recruiting Men
The SELECT starts recruiting men over the age of 55 to test the effectiveness of these two dietary supplements as prostate cancer prevention agents.
Initial Results Released from the ASCUS/LSIL Triage Study (ALTS) on HPV Testing
Initial results from the ALTS indicate that HPV testing can determine whether atypical squamous cells of undetermined significance (ASCUS) will progress into cervical cancer. HPV testing is found not useful for women with low-grade lesions due to the high incidence of HPV in women with these specific abnormalities.
National Lung Screening Trial (NLST) Begins
The NLST trial is launched. It is aimed at comparing the effectiveness of two early lung cancer detection tests, single-view chest x-ray and spiral-computed tomography.
May: Results from the Colorectal Adenoma Prevention Study (CAPS) Released
Results from the CAPS clinical trial indicate that daily use of aspirin can reduce the development of colorectal tumors by 35% in patients with a pre-existing history of polyps.
June: Results from the Prostate Cancer Prevention Trial (PCPT) Released
PCPT results show that the drug finasteride, which reduces the production of male hormones in the body, lowers a man's risk of prostate cancer by about 25%, demonstrating that prostate cancer, like breast cancer, can be prevented.
August: “Decades of Progress 1983 to 2003” Published
The first 20 years of the NCI Community Clinical Oncology Program (CCOP), the precursor to the NCI Community Oncology Research Program (NCORP), are documented.
December: Adenoma Prevention with Celecoxib (APC) Trial Suspended
The APC clinical trial is suspended based on an increased incidence of major cardiovascular events in participants taking celecoxib (Celebrex®). Other NCI trials continue with a revision to consent forms, and research into the benefits of celecoxib continues. Despite suspension of the trial and obvious negative side effects, the DCP observes 33% to 45% fewer adenomas in those within the APC trial, indicating further research possibilities such as anti-inflammatory pathways.
November: Results of the Breast Cancer Prevention Trial (BCPT) Updated
Updated BCPT results show a continued reduction of invasive breast cancer incidence as well as a decrease in some negative side effects. These side effects, first noted following the 1998 study, include increased risk of stroke, pulmonary embolism, and deep vein thrombosis.
April: Initial Results of the Study of Tamoxifen and Raloxifene (STAR) Released
Initial results of the STAR clinical trial show that postmenopausal women who are at increased risk of breast cancer can reduce their risk of developing the disease if they take the drug raloxifene, an antiestrogen agent already approved by the Food and Drug Administration for the treatment and prevention of osteoporosis. Mature results from STAR later show that raloxifene is somewhat less effective than tamoxifen in preventing breast cancer but that it also has less toxicity, including a substantially lower risk of endometrial cancer.
October: Initial results from the Selenium and Vitamin E Cancer Prevention Trial (SELECT) Released
Initial results from the SELECT clinical trial indicate that selenium and vitamin E do not contribute to the prevention of prostate cancer. In fact, test results suggest a slight increase in prostate cancer incidence in subjects taking vitamin E.
March: Prostate Results from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial Released
Results from the PLCO trial show that screening men 55 years of age and older with PSA tests and digital rectal exams was not effective in reducing prostate cancer mortality.
August: Early Detection Research Network (EDRN) Continues as New Grants Awarded
The EDRN continues the biomarker discovery and validation program with the awarding of 32 new grants to fund 20 biomarker development laboratories, eight clinical validation centers, three biomarker reference laboratories, and a data coordinating management and center.
February: Alliance of Glycobiologists for Detection of Cancer Identify Key Antitumor Antibodies
The Alliance of Glycobiologists for Detection of Cancer find that cancer patients produce antibodies that target abnormal proteins with sugar molecules attached made by their tumors, suggesting that antitumor antibodies in the blood may be a source of sensitive biomarkers for cancer detection. (Read the NCI Press Release)
November: Initial Results of the Lung Cancer Screening Trial (NLST) Released
Initial results of the NLST clinical trial show that screening with low-dose helical computerized tomography (CT) reduced lung cancer deaths by about 20% among current and former heavy smokers. (Read the NCI Q&A)
January: “Accomplishments in Cancer Clinical Trials” Published
Highlights of the NCI Community Clinical Oncology Program (CCOP), the precursor to the NCI Community Oncology Research Program (NCORP), are updated in a report.
October: Lung Results from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Released
PLCO clinical trial results show that annual screening for lung cancer using a standard chest x-ray does not reduce the risk of dying from lung cancer when compared with no annual screening. (Read the NCI Q&A)
June: Ovarian Results from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Released
PLCO results show that screening for ovarian cancer with transvaginal ultrasound (TVU) and the CA-125 blood test did not result in fewer deaths from the disease compared with usual care. In addition, false-positive results from the two screening methods often led to unnecessary surgeries and other serious complications. (Read the NCI Q&A)
January: Prostate Data Updated from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial
PLCO trial data show that after 13 years of follow-up, men who underwent annual prostate cancer screening with prostate-specific antigen (PSA) testing and digital rectal examination had a 12% higher incidence of prostate cancer than men in the control group, but had the same rate of death from the disease. No evidence of a mortality benefit from screening was seen in subgroups defined by age, the presence of other illnesses, or pre-trial PSA testing. (Read the NCI Q&A)
May: Colorectal Results from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Released
Results of the PLCO trial confirm that screening people 55 years of age and older for colorectal cancer using flexible sigmoidoscopy reduces colorectal cancer incidence and mortality. In the PLCO, screened individuals had a 21% lower risk of developing colorectal cancer and a 26% lower risk of dying from the disease than the control subjects. (Read the NCI Press Release)
June: NCI Community Oncology Research Program (NCORP) Approved for Start
NCORP is approved by the NCI Board of Scientific Advisors, opening the way for the program to bring state-of-the art cancer prevention, control, treatment and imaging clinical trials, cancer care delivery research, and disparities studies to individuals in their own communities. It replaces, but expands on the success of the Community Clinical Oncology Program (CCOP), including the Minority-Based CCOPs; supersedes, but adds elements of the NCI Community Cancer Centers Program (NCCCP); and creates a network for cancer care delivery research. (Read the DCP News Note)
December: National Lung Screening Trial (NLST) Researchers Issue Finding on Overdiagnosis
A detailed analysis of the primary NLST findings showed that screening can detect slow-growing tumors that otherwise may not cause clinical symptoms, and can lead to overdiagnosis. The probability was 18.5% that any lung cancer detected by screening with low-dose CT was an overdiagnosis, and 22.5% that a non-small cell lung cancer, the most common form, detected by low-dose CT was an overdiagnosis. Overdiagnosis represents the potential harm of additional cost, anxiety, and morbidity associated with treatment. (Read the NCI Q&A)
August: Prostate Cancer Prevention Trial (PCPT) Findings Updated
Based on follow-up of trial participants for up to 18 years, the PCPT updated findings show that survival of the men on finasteride is equivalent to men who did not take the drug, and the reduction in risk of prostate cancer persists. (Read the NCI News Note)
February: Selenium and Vitamin E Cancer Prevention Trial (SELECT) Findings Updated
In an update, SELECT researchers report that men who had high levels of selenium at the start of the trial, as assessed by measures of selenium in their toenail clippings, had almost double the chance of developing a high-grade prostate cancer if they took the selenium supplement compared to men with low levels of selenium at the start of the trial. Additionally, men with low selenium levels at the start of the trial had double the chance of developing a high-grade prostate cancer if they took the vitamin E supplement. (Read the NCI Q&A)
May: Prevention of Early Menopause Study (POEMS) Clinical Trial Results Announced
The POEMS clinical trial results show young women with breast cancer were able to better preserve their fertility during cancer treatments by using hormone-blocking drug injections that put them into temporary menopause. (Read the NCI Press Release)
August: NCI Community Oncology Research Program (NCORP) Gets Underway
The NCORP awards 53 new 5-year grants to researchers across the country to conduct multi-site cancer clinical trials and cancer care delivery research studies in their communities. (Read the NCI News Note)
January: Cancer Prevention and Control Central Institutional Review Board (CIRB) Established
The addition of the Cancer Prevention and Control (CPC) CIRB extends the benefits of centralized IRB review to investigators participating in clinical trials sponsored by the Division of Cancer Prevention. The CPC CIRB’s role is to review studies developed by the DCP-sponsored NCI Community Oncology Research Program (NCORP) and the Consortia for Early Phase Trials Program. (Read the DCP News Note.)
June: NCORP Sites Participate in Enrolling Patients in the NCI-MATCH (Molecular Analysis for Therapy Choice) Precision Medicine Trial
The trial seeks to determine whether targeted therapies for people whose tumors have specific gene mutations will be effective regardless of their cancer type. (Read the NCI Fact Sheet.)
July: DCP Leads a Key Initiative in the National Institutes of Health (NIH) Glycoscience Common Fund Program
The program supports the development of accessible and affordable new tools and technologies for studying the role complex carbohydrates in health and disease. (Read the DCP News Note.)
August: Consortium on Imaging and Biomarkers is Created with Grants to Eight Principal Investigators
The consortium focuses on combining imaging methods with biomarkers to improve the accuracy of screening, early cancer detection, and diagnosis of early stage cancers. Imaging information is obtained from various means, such as computed tomography (CT), positron emission tomography (PET), magnetic resonance (MR) imaging, and optical-based imaging for real-time visualization of lesions. (Read the DCP News Note.)
October: NCI Awards Grants to Create the Consortium for Molecular Characterization of Screen-Detected Lesions
Supported by the Division of Cancer Prevention and the Division of Cancer Biology, the consortium has seven molecular characterization laboratories and a coordinating center, and focuses on the critical areas of characterizing molecular and cellular features of screen-detected pre-cancers and early cancers, and the tumor microenvironment. (Read the DCP News Note.)
February: The White House Announces $1 billion in Investments in the National Cancer Moonshot initiative
Prevention, including cancer vaccine development and early cancer detection, are two of the five opportunity areas. (Read about the initiative.)