Originally published September 15, 2021
James L. Mulshine, MD, and Fred R. Hirsch, MD, PhD, FASCO
The National Cancer Act (NCA) of 1971 established a national priority to address the widely shared dread of a cancer diagnosis. The goal of the NCA was to strengthen the National Cancer Institute (NCI) to more effectively carry out the national effort against cancer. After the NCA was signed into law by then-President Richard Nixon, the budget of the agency was increased 4-fold by the end of that decade. Through time, as a result of enhanced funding, the NCA’s most notable impact was significant progress in the exploration of viral carcinogenesis and treatment of established cancers. However, from the inception of the NCI, there was a notion that it should also evaluate the potential of prevention and early detection measures, as outlined by President Franklin Roosevelt during the first NCI building dedication in 1940. A success story that has not been widely appreciated is the NCI’s impact in providing an effective early detection approach to lung cancer, which has quietly evolved into a well-validated cancer screening method despite formidable speed bumps along the way. We will briefly outline this story.
Looking Back: Exploring Collaborative Efforts in Early Screening Options
After time in the laboratory of the renown cervical cancer cytologist Georgios Papanikolaou, MD, PhD, Geno Saccomanno, MD, PhD, adapted that cytologic approach to a sputum test to diagnose early lung cancer from examination of the exfoliated cells of the respiratory epithelium. Dr. Saccomanno established a research institute in Grand Junction, Colorado, which was the transportation hub for uranium mining that was conducted in the second half of the 20th century in southwest Colorado. A large number of workers involved in uranium mining developed lung cancer, which fueled enormous interest in improving the diagnostic efficiency for this cancer.
