Document QVMYQaynnDr7yJQE8QRMrobE

CONTENTS F^EWORD....................................................... Page 2 ^g T yhO basic data............................................................................................... 3 p A "Vf pi "IT113 What Is Cancer?...................................................................................... 3 \J XX XI \J XL XX How Treated?......................................................................................... 3 Can It Be Prevented?........................................................................ 3 1 jl A p'i r 11 Oj Who Will Get Cancer? ........................................................................ 3 JJ XO How Many Will Get Cancer?................................................................ 3 How Many With Cancer?..................................................................... 3 A T^T "T"X New Cases Annually........................................................................... 3 I1 How Many Die?......................................................................................... 3 *fc^**'^ National Death Rate........................................................................... 3 --> --^ ^ __ Survival Rate Is One-in-Three.......................................................... 4 I ( v I ] LJ U How Many Actually Being Saved?..................................................... 4 * "V#ill JLL kL How Many More Could Be Saved?..................................................... 4 Over One Million Now Living -- Cured............................................ 4 U.S. Cancer Deaths by Age................................................................ U.S. Cancer Deaths by Sex................................................................ Cancer and Children........................................................................... 4 4 4 jk yk jr T"* "T"* T A /X IVI Hi K I I ,l\l A.TA I J XV \aX.^ -L il Cancer Status Chart: Leading Sites............................................... 5 Cancer's Seven Danger Signals....................................................... 5 f* ^Vj TJ Estimated Cancer Deaths by Sex and Site.................................... 6 XX X^l V-/ XL JLv Estimated New Cancer Cases by Site, by State............................ 7 __ ____ Death Rates for Selected Cancer Sites, 24 Countries................. 8 U.S. Mortality for Five Cancer Sites by Age Groups.................... 9 ^2 /TM\ P'i T Tii f 11 "\J V-/ * i * XL X X Relation of Cancer to Leading Causes of Death............................ 9 /--s Applying Cancer Statistics Locally.................................................. 9 \1^ Trends for Selected Sites of Cancer, U.S., 1930-1962 ................. 10 'TT' J Trends in Death Rates, 1952-1962 .................................................. ACS CANCER PREVENTION STUDY............................................... 11 A 1X0$ WHY WE SAY "FIGHT CANCER WITH A CHECKUP..."........... 12 LWM** r* JJ/ / I S1**/Jr\ Xtf >4/0, f-Year Cancer Survival Rates..................................................... ARY OF ACS RESEARCH GRANTS......................................... RESEARCH.............................................................................................. PROFESSIONAL EDUCATION............................................................. 13 _ / 0.1-- 14 *7'hPwUiMA* 15 -- /`7 17 ' /v H_____ --L--V * CLINICAL FELLOWSHIPS.................................................................. 17 SERVICE................................................................................................. PUBLIC EDUCATION........................................................................... CONQUER UTERINE CANCER! ....................................................... BREAST CANCER................................................................................ COLON-RECTUM PROGRAM................................................................ SMOKING AND HEALTH..................................................................... Surgeon General's Report................................................................... FTC, Other Actions........................................................................... Added Smoking Data........................................................................... ACS Intensifies Drive........................................................................ Interagency Council Established..................................................... Teen-Age Program.............................................................................. Lung Cancer Death Rate..................................................................... LEUKEMIA.............................................................................................. INTERNATIONAL ASSOCIATION OF LARYNGECTOMEES.... UNFOUNDED CLAIMS FOR TREATMENT....................................... ECONOMIC LOSS CAUSED BY CANCER......................................... MAN'S PROGRESS AGAINST CANCER............................................ OPPORTUNITIES FOR GROWTH....................................................... THE VALUE OF THE ACS CRUSADE............................................... Tjfl^CS AND THE CANCER CRUSADE.......................................... 17 18 18 20 20 20 20 21 21 22 22 23 23 23 24 25 25. 25 26 27 28 HOW ACS FUNDS ARE ALLOCATED............................................... 29 WHAT ACS DOLLARS BUY................................................................ 30 How Cancer Contributions Compare.................................................. 30 THEY MIGHT HAVE LIVED................................................................ 31 CHARTERED DIVISIONS OF THE ACS............................(back cover) RSY0024581 FOREWORD This annual publication presents the latest facts and figures relating to cancer. It is prepared for writers, editors, speakers, teachers, students, and others who require a concise source of statistical data and background information about this disease phenomenon. As such, it is a practical reference volume for libraries. The main body of material was prepared by the Statistical Research Section of the Ameri can Cancer Society, based upon data from various sources. The most important of these are: End Results and Mortality Trends in Cancer, Monograph No. 6, National Cancer Institute, 1961. Morbidity From Cancer in the United States, Public Health Monograph No. 56, U.S. Depart ment of Health, Education and Welfare, 1959. Cancer in Connecticut, 1935-1951, Connecticut State Department of Health, 1955. Cancer Mortality for Selected Sites, No. 3, Tohoku University School of Medicine, Japan, 1964. Current Population Reports - Population Estimates, U. S. Bureau of the Census, 1964. Survey of Current Business, U. S. Department of Commerce, 1964. Vital Statistics of the United States, U. S. Public Health Service, National Vital Statistics Division, Annual. THE SWORD OF HOPE The Sword of Hope is the symbol that to most Americans means "Help Fight Cancer." As the registered trade-mark of the American Cancer Society, it has for 36 years reflected the ACS image and identity. Today it remains the insignia of the only voluntary health organiza tion fighting cancer on the broad fronts of research, education, service. It is the emblem that guides contributors who seek to make sure that their gifts go to the traditional ACS Cancer Crusade. For this reason, the Sword of Hope is displayed in all Crusade materials, literature, posters, ads, films, etc., and is shown at all meetings, lectures, exhibits, film showings. The sword originated out of a nation-wide poster contest in 1928. The blade was meant to express the crusading spirit of the cancer control movement. The twin serpent caduceus forming the hilt emphasizes the medical and scientific aspects of the attack. The original insignia carried the slogan "Fight Cancer With Knowledge." Variations of this theme have been used by the ACS since then. Today's "To Cure More-Give More" supple ments the Society's classic theme "Fight Cancer With a Checkup and a Check." G1Q64, AMERICAN CANCER SOCIETY, INC, RSV0024582 BASIC DATA What Is Cancer? Cancer is a disease that is characterized by abnormal growth and spread of cells. If this malignant process is not controlled or checked, the patient will die. However, many cancers can be cured if detected early in their development and treated by surgery or radiation. (For amplification see P. 12). How Treated? Cancer today is treated by surgery, x-rays, radioactive substances, and various drugs, chemi cals, hormones. Can It Be Prevented? Yes. Research has proved that most lung cancers are caused by cigarette smoking, and some skin cancers by frequent overexposure to direct sunlight. These can be prevented by avoiding their causes. Also, certain cancers caused by occupational factors - particularly bladder cancer in the dye industry - have been prevented by eliminating the cancer-producing agents that caused them. Who Will Get Cancer? Cancer strikes at any age. It affects children as well as adults, but it strikes with increasing frequency with advancing age. How Many Will Get Cancer? About 48 million Americans now living will eventually have cancer; one-in-four persons ac cording to present rates. Cancer will strike over the years in approximately two of three American families. How Many With Cancer? This year about 850,000 Americans will be under medical care for cancer. New Cases Annually There will be about 550,000 new cancer cases (diagnosed for the first time) in 1965. How Many Die? In 1964 an estimated 290,000 Americans died of cancer, and in 1963 it was 285,000. In 1962, 278,562 cancer deaths were reported by the U. S. National Vital Statistics Division. This year about 295,000 will die of the disease; that is, 805 persons a day, one every two minutes. Of every six deaths from all causes in the U.S., one is caused by cancer. National Death Rate There was a steady rise in the (age-adjusted) national death rate until 1950. Since 1950 it has leveled off. In 1930 the number of cancer deaths per 100,000 population (age-adjusted) was 112; in 1940 it was 120; by 1950 it had risen to 125; and in 1960 the number was still 125. Except for cancer of the lung and pancreas, and leukemia, age-adjusted cancer death rates in general are leveling and in some cases dropping off. (See charts P. 10.) 3- - RSV0024583 Survival Rate Is One-In-Three In the early 1900's few cancer patients had any hope of cure. In the late 1930's fewer than one-in-five was being saved - that is, alive five years after first being treated. A few years ago one-in-four was being saved. Today one cancer patient in three is being saved. The gain in lives saved amounts to some 46,000 patients each year. Of every six persons who get cancer today, two will be saved and four will die. Numbers 1 and 2 will be saved. Number 3 will die but might have been saved had proper treatment been received in time. Numbers 4, 5 and 6 will die of cancers which cannot yet be controlled; only the results of research can save these patients. This means that about half of those who get cancer could and should be saved -- by early diagnosis and prompt treatment. Thus, the im mediate goal of cancer control in the United States is the annual saving of 275,000 lives, or half of those who develop cancer each year. How Many Actually Being Saved? About 183,000 Americans will be saved from cancer this year. How Many More Could Be Saved? About 92,000 cancer patients will probably die in 1965 who might have been saved by earlier and better treatment. Over One Million Now Living - Cured There are now 1,300,000 Americans, alive today, who have been cured of cancer. By "cured" it is meant they are without evidence of the disease at least five years after diagnosis and treat ment. An additional 700,000 cancer patients diagnosed and treated within the last five years will live to enter the ranks of those we call cured. This means there are actually 2,000,000 Americans cured of cancer, although 700,000 will not formally be counted as cured until they have completed the five years. The decision as to when a patient may be considered cured, in the sense of being free of the disease, is one that must be made by the individual physician. For most forms of cancer, five years is the accepted time. However, some patients can be dis charged as free of the disease after one year, others after three years, while some may be fol lowed much longer than five years. U. S. Cancer Deaths By Age Currently there are about 22,500 cancer deaths of patients aged 15 to 44. Cancer is the lead ing cause of death among women aged 30 to 54. Almost half of all cancer deaths last year were among persons under 65. U. S. Cancer Deaths By Sex More men than women died of cancer last year. This has been true since 1949. The ratio in 1965 will be about 55 men to 45 women. Cancer And Children This year cancer will take the lives of more than 5,000 children under the age of 15. About half of them will die of leukemia, which is a cancer of blood-forming tissue. More school children will die of cancer than from any other disease. Today there are over 300,000 Ameri can children under 18 who have lost their fathers to cancer. Over 250,000 have lost their mothers. 4- - RSV0024584 Cancer Status Chart: Leading Sites SITE BREAST COLON AND rectum KIDNEY AND BLADDER LUNG MOUTH, LARYNX AND PHARYNX PROSTATE SKIN STOMACH UTERUS ^.EUKEMIA LYMPHOMAS ESTIMATED NEW CASES 1965 62,000 73,000 29,000 52,000 20,000 33,000 80,000 21,000 44,000 17,000 2 0,000 ESTIMATED DEATHS 1965 26,000 danger signal WHEN LASTING LONGER THAN TWO WEEKS SEE YOUR DOCTOR) LUMP OR THICKENING IN THE BREAST. SAFEGUARDS ANNUAL CHECKUP. MONTHLY BREAST SELF. EXAMINATION. COMMENT THE LEADING CAUSE OF CANCER DEATH W WOMEN. 43,000 CHANGE IN BOWEL HABITS', BLEEDING. ANNUAL CHECKUP, INCLUD ING proctoscopy. CONSIDERED A HIGHLY CURABLE DISEASE WHEN digital and Proctoscopic examinations are INCLUDED IN ROUTINE CHECKUPS- 14,000 URINARY DIFFICULTY. BLEEDING-IN WHICH CASE CONSULT YOUR DOCTOR AT ONCE. ANNUAL CHECKUP WITH URINALYSIS. PROTECTIVE MEASURES FOR WORKERS INHIGH*RISK INDUSTRIES ARE HELP ING TO ELIMINATE ONE OF THE IMPORTANT CAUSES OF THESE CANCERS. 47,000 PERSISTENT COUGH, OR LINGERING RESPIRATORY A t LMENT. PREVENTION: HEED FACTS ABOUT SMOKING. ANNUAL CHECKUP. CHEST X-RAY* THE LEADWG CAUSE OF CANCER DEATH AMONG MEN, THIS FORM OF CANCER 1 S LARGELY PREVENTABLE. 9,000 SORE THAT DOES NOT HEAL. DIFFICULTY IN SWALLOWING. HOARSENESS. ANNUAL CHECKUP. INCLUDING LARYNX. MANY MORE LIVES SHOULD BE SAVED BECAUSE' THE MOUTH IS EAS 1 LY ACCESSIBLE TO V ISUAL EXAMINATION BY PHYSICIANS AND DENTISTS. te.ooo 4,000 10,000 14,000 14,000 15,000 URINARY DIFFICULTY, SORE THAT DOES NOT HEAL, OR CHANGE IN WART OR MOLE* ANNUAL CHECKUP, INCLUDING PALPATION. ANNUAL CHECKUP. AVOIDANCE OF OVEREXPOSURE TO SUN. OCCURS MAINLY IN MEN OVER 60. THE DlS. EASE CAN BE DETECTED BY PALPATION AND URINALYSIS AT ANNUAL CHECKUP. SKIN CANCER IS READ tLY DETECTED BY OBSER VATION, AND DIAGNOSED BY SIMPLE BIOPSY. INDIGESTION. ANNUAL CHECKUP. A 40% DECLINE IN MORTALITY IN 20 YEARS, FOR REASONS YET UNKNOWN. UNUSUAL BLEEDING OR discharge ANNUAL CHECKUP INCLUD* ING PELVIC EXAMINATION AND PAPANICOLAOU SMEAR. UTERINE CANCER MORTALITY HAS DECLINED 50% DURING THE LAST 25 YEARS. WITH WIDER APPLICATION OF THE PAP" SMEAR, MANYTHOUSAND MORE LIVES CAN BE SAVED. LEUKEMIA IS A CANCER OF BLOOD-FORMING TISSUES AND IS CHARACTERIZED BY THE ABNORMAL PRODUCTION OF IMMATURE WHITE BLOOD CELLS, ACUTE LEUKEMIA STR IKES MAINLY CHILDREN AND IS TREATED BY DRUGS WHICH HAVE EXTENDED LIFE FROM A FEW MONTHS TO AS MUCH AS THREE YEARS. CHRONIC LEUKEMIA STRIKES USUALLY AFTER AGE Z5 AND PROGRESSES LESS RAPIDLY. CANCER EXPERTS BELIEVE THAT IF DRUGS OR VACCINES ARE FOUND WHICH CAN CURE OR PREVENT ANY CANCERS THEY WILL BE SUCCESSFUL FIRST FOR LEUKEMIA AND THE LYMPHOMAS. THESE DISEASES ARISE IN THE LYMPH SYSTEM AND INCLUDE HODGKIN'S AND LYMPHOSARCOMA, SOME PATIENTS WITH LYMPHATIC CANCERS CAN LEAD NORMAL LIVES FOR MANY YEARS. CANCER'S SEVEN DANGER SIGNALS 1. Unusual bleeding or discharge 2. A lump or thickening in the breast or elsewhere. 3. A sore that does not heal. 4. Change in bowel or bladder habits. 5. Hoarseness or cough. 6. Indigestion or difficulty in swallowing. 7. Change in a wart or mole. If your signal lasts longer than two weeks. go to your doctor to learn if it means cancer. 5RSV0024585 Estimated Cancer Deaths by Sex and Site - 1965 SITE All Sites Buccal Cavity & Pharynx Lip Tongue Salivary Glands Floor of Mouth Other & Unspecified Mouth Pharynx Digestive Organs Esophagus Stomach Small Intestine Large Intestine Rectum Liver & Biliary Passages Pancreas Other & Unspecified Digestive Respiratory System Larynx Lung Other & Unspecified Respiratory Breast Genital Organs Cervix Uteri Corpus Uteri Ovary Prostate T estis Other & Unspecified Genital Urinary Organs Kidney Bladder & Other Urinary Skin Eye Brain & Central Nervous System Endocrine Glands Thyroid Other & Unspecified Endocrine Bone Soft Tissue Leukemia Lymphomas Lymphosarcoma & Reticulosarcoma Hodgkin's Disease Multiple Myeloma Other Lymphomas All Other & Unspecified BOTH SEXES 295,000 6,850 125 1,625 700 500 1,100 2,800 95,000 5,400 18,400 750 32,100 10,800 9,500 16,300 1,750 50,500 2,650 47,000 850 26,300 40,450 10,000 3,900 8,900 15,800 650 1,200 14,200 5,700 8,500 4,400 400 7,000 1,450 1,000 450 1,650 1,250 14,200 15,300 7,100 3,300 3,800 1,100 16,500 MALE 161,000 5,100 100 1,200 450 400 750 2,200 51,650 4,200 11,400 400 14,700 6,100 4,500 9,500 850 43,350 2,400 40,400 550 200 16,750 -- -- - 15,800 650 300 9,500 3,600 5,900 2,600 200 4,100 600 350 250 950 650 8,300 8,800 4,100 2,000 2,100 600 8,500 FEMALE 134,000 1,750 25 425 250 100 350 600 43,350 1,200 7,000 350 17,400 4,700 5,000 6,800 900 7,150 250 6,600 300 26,100 23,700 10,000 3,900 8,900 * - 900 4,700 2,100 2,600 1,800 200 2,900 850 650 200 700 600 5,900 6,500 3,000 1,300 1,700 500 8,000 6- - RSV0024586 Estimated New Cancer Cases by Site, by State - 1965 State All Sites Stomach Colon & Rectum Lung Breast Uterus Prostate Leukemia Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 8,000 150 3,500 5,500 47,000 4,500 9,000 1,500 3,000 18,000 9,000 1,000 1,500 33,000 14,000 9,000 6,500 9,000 9,000 3,500 9,500 19,000 23,000 10,000 5,500 15,000 2,000 4,500 700 2,000 22,000 2,000 62,000 10,000 1,500 31,000 7,500 5,500 38,000 3,000 5,000 2,000 9,500 24,000 2,000 1,500 10,000 8,500 5,500 12,000 650 350 10 150 200 1,800 150 400 40 100 650 250 150 30 1,300 400 300 200 350 350 150 300 700 950 500 200 450 50 200 30 80 900 100 2,600 350 70 1,000 250 200 1,500 150 200 90 300 950 80 50 350 300 200 550 20 750 20 400 500 5,800 550 1,200 200 400 2,200 850 100 200 4,800 2,000 1,300 850 1,100 950 550 1,200 2,800 3,200 1,400 600 1,800 250 650 100 350 3,500 150 9,400 1,000 150 4,500 750 650 5,900 500 450 250 950 2,600 200 200 1,200 1,000 600 1,900 80 750 20 350 450 4,700 350 800 150 300 2,100 850 100 100 3,100 1,300 750 600 850 950 300 1,000 1,700 2,200 750 500 1,400 150 400 80 200 2,200 150 5,900 800 90 2,900 750 500 3,600 300 400 150 850 2,500 100 150 1,100 850 550 850 60 800 10 300 500 5,700 550 1,000 150 350 1,800 1,000 80 150 4,100 1,500 1,000 750 800 850 400 1,100 2,300 2,500 1,200 500 1,600 200 550 80 250 2,800 200 7,700 1,100 150 3,500 650 600 4,300 400 450 200 1,000 2,400 250 200 1,100 950 500 1,400 80 1,100 10 300 550 3,400 350 450 100 250 1,700 1,000 90 150 2,700 1,300 550 450 850 800 350 750 1,200 2,000 600 650 1,200 100 300 60 150 1,500 150 4,100 1,000 90 2,600 600 400 2,800 200 700 150 900 2,200 150 150 900 600 500 800 50 650 10 250 450 2,600 300 500 80 150 1,200 600 40 150 1,800 900 700 450 550 600 200 500 950 1,400 750 500 900 150 350 60 100 1,000 100 2,800 700 150 1,800 500 400 2,200 150 300 200 650 1,600 150 90 600 600 350 750 70 250 10 100 200 1,400 200 250 40 60 500 300 40 60 1,000 450 300 250 300 300 90 250 500 700 400 200 450 70 150 30 70 600 60 1,600 350 70 950 250 200 1,100 80 150 80 300 950 70 40 300 300 150 450 30 United States 550,000 21,000 73,000 52,000 62,000 44,000 33,000 17,000 Note; These estimates are offered as a rough guide and should not be regarded as definitive. They are calcu lated according to the distribution of estimated 1965 cancer deaths by state. Especially note that year to year changes may only represent improvements in the basic data. 7- - RSV0024587 Age-Adjusted Death Rates Per 100,000 Population for Selected Cancer Sites for 24 Countries {I960 - 1961) MOTE:. Figures in parentheses are ranks of rates within site and sex group. All Sites Male Female Stomach Male Female Colon & Rectum Male Female , Lung Male Female Leukemia Male Female Breast Female Uterus Female Pro state Male United States 141.(14) 107.(18) Austral ia 133.(20) 96.(22) Austria 193.(1) 134.(3) Belgium 169.(5) 122.(6} Canada 137.(16) 110.(13) Chile 156.(12) 145.(1) Denmark 157.(11) 140.(2) Eng. & Wales 175.(4) 113.(10) Finland 187.(3) 110.(14) France 168.(6) 105.(19) Germany (F.R.) 163.(8) 126.(4} Ireland 133.(19) 109.(15) Israel 121.(23) 115.(9) Italy 139.(15) 98.(21) Japan 135.(18) 96.(23) Netherlands 160.(10) 119.(7) New Zealand 136.(17} 108.(17) No. Ireland 147.(13) 109.(16) Nor way 125.(22) 103.(20) Portugal 104.(24) 79.(24) Scotland 188.(2) 126.(5)' Sweden 128.(21) 110.(12) Switzerland 162.(9) 113.(11) IJn. So. Africa 165.(7) 117.(8) 12.5(24) 18.4(23) 45.6(3) 31.4(7) 19.5(21) 71.0(1) 26.0(16) 25.4(17) 45.2(4) 25.4(18) 40.0(5) 23.8(19) 22.3(20) 34.6(6} 69.5(2) 31.1(9) 19.0(22) 27.9(13) 29.1(11) 31.3(8) 26.8(14) 26.1(15) 30.4(10) 28.6(12) 6.2(24) 9.7(21) 26.5(3) 18.1(7) 9.6(22) 45.8(1) 16.3(14) 13.3(19) 26.1(4) 12.7(20) 23.2(5) 16.7(11) 15.0(17) 18.5(6} 36.8(2) 16.5(12) 9.2(23) 16.4(13) 17.5(9) 17.4(10) 16.1(15) 14.3(18) 17.6(8) 15.8(16) 18.7(11) 16.9(10) 17.8(13) 17.1(9) 18.7(10) 13.2(14) 21.7(4) 18.3(5) 20.4(6} 19.8(3) 5.8(24) 7.4(23) 24.7(2) 20.5(2) 22.0(3) 17.9(7) 9.8(21) 9.5(21) 19.0(9) 14.9(12) 15.6(16) 11.9(17) 19.0(8) 17.6(8) 9.8(22) 9.0(22) 12.1(19} 10.1(20) 7.1(23) 6.3(24) 16.7(14} 15.7(11) 19.8(7) 18.3(6) 21.5(5) 18.9(4) 12.5(18) 10.2(19) 10.6(20) 10.6(18) 25.6(1) 21.5(1) 16.7(15) 13.0(15) 18.5(12) 12.4(16) 15.3(17) 13.8(13) 31.3(10) 4.7(10) 27.7(14) 3.5(18) 48.9(4) 5.6(6) 37.9(6) 3.9(13) 25.4(16) 3.6(17} 13.6(21} 5.0(9) 29.8(12) 5.5(7) 62.2(2) 8.1(2) 56.0(3) 3.3(21) 22.2(17} 3.4(20) 34.7(8) 4.5(11) 26.1(15) 5.8(5) 19.1(19) 6.6(3) 21.5(18) 3.9(14) 10.0(23) 3.7(16) 42.3(5) 3.4(19) 28.5(13) 4.4(12} 36.2(7) 5.2(8) 12.3(22) 2.5(23) 8.7(24) 2.4(24} 66.1(1) 8.7(1) 14.5(20) 3.7(15) 30.3(11) 3.0(22) 32.5(9) 6.2(4} 7.5(3) 4.9(7) 6.3(10) 4.4(13) 6.2(12) 4.1(18) 6.6(7) 4.2(17} 6.5(9) 4.5(11) 3.7(23) 3.4(21) 8.2(2) 5.2(5) 5.6(20) 3.9(19) 6.2(11) 4.8(8) 6.2(14) 4.4(12) 6.0(17) 4.4(14) 5.7(19) 3.3(22) 9.3(1) 5.4(1) 5.9(18) 4.3(16) 3.4(24) 2.6(24) 6.6(8) 5.0(6) 6.0(16) 5.3(3) 6.1(15) 4.5(10) 7.1(5) 5.3(4) 4.5(22) 3.2(23) 5.2(21} 3.6(20) 7.1(4) 5.3(2) 6.2(13} 4.4(15) 7.0(6) 4.6(9) 21.2(10) 19.0(14) 16.0(18) 20.3(11) 23.1(6) 9.7(23) 23.7(3) 23.5(4} 13.3(21) 15.4(19) 16.2(17) 19.2(13) 21.5(8) 14.5(20) 3.8(24) 24.2(1) 22.0(7) 18.3(15} 17.4(16) 11.4(22) 24.2(2) 19.6(12) 21.3(9) 23.3(5) 13.2(8) 9.4(21) 20.4(2) 13.9(6) 11.3(16) 20.6(1) 19.3(3) 10.6(17) 11.3(15) 12.5(12) 12.6(11) 7.7(23) 5.7(24) 13.2(9) 15.5(4) 10.4(18) 10.0(19) 9.6(20) 9.1(22} 14.1(5) 11.9(13) 11.4(14) 12.7(10) 13.9(7) 13.9(9) 14.7(6) 13.4(11) 14.2(7} 13.4(10) 9.7(19) 13.9(8) 11.9(15) 11.3(18) 15.3(4) 11.7(16} 9.6(21) 8.1(23) 8.4(22) 1.4(24) 13.3(12) 13.1(13} 11.3(17) 15.7(3) 9.6(20) 12.1(14) 17.1(2) 14.8(5) 19.7(1) RSV0024588 Source: Segi, Mitsuo, et a!., Cancer Mortality for Selected Sites, No, 3 Mortality For The Five Leading Cancer Sites By Age Groups And Sex (United States, 1962) MALE UNDER 15 FEMALE MALE 15 - 34 FEMALE LEUKEMIA 1,120 LEUKEMIA 951 BRAIN 514 RETICULO-AND LYMPHOSARCOMAS 196 BRAIN 413 KIDNEY 145 LEUKEMIA 582 HODGKIN'S DISEASE 432 brain 375 UTERUS 478 BREAST 475 LEUKEMIA 382 KIDNEY 124 BONE 74 BONE 92 reticulo-and LYMPHOSARCOMAS 83 TESTIS, ETC. 292 RETICULO-AND LYMPHOSARCOMAS 262 BRAIN 292 HODGKIN'S DISEASE 282 SOURCE: VITAL STATISTICS OF THE UNITED STATEST 1962 35 - 54 male FEMALE 55 - 74 MALE FEMALE LUNG 7,006 COLONRECTUM 2,418 BREAST 7,950 UTERUS 4,31 0 STOMACH 1 ,490 PANCREAS 1,376 OVARY 2,502 COLONRECTUM 2,108 BRAIN 1 .275 LUNG 1 ,574 LUNG 23,513 COLONRECTUM 1 0,949 BREAST 1 1 .564 COLONRECTUM 8,21 6 PROSTATE UTERUS 6,948 7.02B STOMACH 6,567 ovary 4,340 pancreas STOMACH 5,207 3,508 75 OVER male FEMALE PROSTATE 7,919 colon- rectum 6,150 COLONRECTUM 5,81 1 BREAST 4,734 LUNG 4,601 STOMACH 2,922 stomach 3,819 UTERUS 2,467 pancreas PANCREAS 2,091 2,065 Relation of Cancer to Leading Causes of Death: United States, 1962 Rank Cause of Death Number of Deaths Death Rate Percent of Total Deaths u 2. - 3. 4. 5. 6. 7. 8. All Causes Disease of Heart Cancer Cerebral Hemorrhage (Vascular Lesions) Accidents Motor-Vehicle Accidents All Other Accidents Certain Diseases of Early Infancy Influenza and Pneumonia Arteriosclerosis Diabetes 1,756,720 688,009 278,562 945.4 370.3 149.9 197,451 97,139 40,804 56,335 106.3 52.3 22.0 30.3 64,205 59,995 36,848 31,222 34.6 32.3 19.8 16.8 100.0 39.2 15.9 11.25.5 2.3 3.2 3.7 3.4 2.1 1.8 Source; National Vital Statistics Division Rank Cause of Death 9* Cirrhosis of Liver 10. Congenital Malformations 11. Suicide 12. Nephritis 13. Hypertension without mention of Heart 14. Ulcer of Stomach and Duodenum 15. Hernia and intestinoi Obstruction Other and 111 Defined Number of Deaths Death Rate Percent of T ota 1 Deaths 21,824 21,192 20,207 12,945 11.7 11.4 10.9 7.0 12,497 6.7 12,228 6.6 9,723 5.2 192,673 103.6 1.2 1.2 1.2 0.7 0.7 0.7 0.6 10.9 Applying Cancer Statistics Locally SIZE OF COMMUNITY ESTIMATED NO, CANCER CASES UNDER MEDICAL CARE IN 1965 1,000 z.ooo 3,000 4,000 5,000 10,000 25,000 50,000 100,000 200,000 500,000 4 9 13 18 21 43 107 215 430 860 2,150 ESTIMATED NO. WHO WILL DIE OF CANCER IN 1965 1 3 4 6 7 15 37 75 150 300 7S0 ESTIMATED NO. OF NEW CASES IN 1965 3 6 8 11 14 28 70 140 280 560 1,400 ESTIMATED NO, WHO WILL BE SAVED FROM CANCER IN 1965 1 2 3 4 5 9 23 47 93 186 465 ESTIMATED NO, WHO WILL EVENTUALLY DEVELOP CANCER 250 500 750 1,000 1,250 2,500 6,250 12,500 25,000 50,000 125,000 ESTIMATED NO. WHO WILL DIE OF CANCER IF PRESENT RATES CONTINUE 150 300 450 600 750 1,500 3,750 7,500 15,000 30,000 75,000 NOTE; The figures can only be the roughest approximation of octual data for your community. It is suggested that every effort be mode to obtain octual data from a Registry source. 9- - RSV0024589 Age-Adjusted Death Rates per 700,000 Population of 5 I cted Sites of Cancer, U. S., 1930-1962 Graphs show the extent of the increase in lung cancer in men and the decrease in uterine cancer in women over a generation. The reasons are explained elsewhere. But the sweeping decrease in stomach cancer and steady increase of leukemia remain mysteries of the kind that only further research will solve. FEMALE CANCER DEATH RATES* BY SITE MALE CANCER DEATH RATES*BY SITE United States, 1930-1962 -70- RSV0024590 Trends in Age-Adjusted Cancer Death Rates From 1950-52 to 1960-62 Sex Male Female Male Female Male Female Mai e Female Male Female Male Female Male Hemale Female Female Male Mole Female Male Female Site All Sites Al 1 Sites Esophagus Esophagus Stomach Stomach Colon & Rectum Colon & Rectum Pancreas Pancreas Lung Lung Breast Breast Uterus Ovary Pro state K idney K idney Leukemia Leukemia 1950-52 131.5 119.9 3.8 1.0 17.9 9.4 19.2 18.3 6.5 4.1 19.7 4.0 0.3 21.8 18.1 6.8 13.5 2.8 1.6 6.5 4.6 1960-62 143.7 109.8 3.8 1.0 11.8 5.9 18.8 17.0 8.2 4.8 33.4 5.0 0.3 22.2 13.2 Percent Change 49% -8% _ - -34% -37% -3% -7% +26% +17% +70% +25% +2% -27% 7.6 13.2 3.2 1.6 7.5 4.8 +12% -2% +14% - +15% 44% Comments Slight increase. Slight decrease* Constant rate. Constant rate. Steady decrease in both sexes for unknown reasons* Slight decrease in both sexes* Steady increase in males. Increase in females, then levelling off* Reasons unknown. Steady increase in both sexes due to cigarette smoking. Con stant rote* Slight fluctuations; overall no change* Steady decrease attributed in part to widening acceptance of regularcheckup with <cPap Test." Early increase, later levelling off. Early increase, later decrease. Steady slight increase. Constant rate. Steady increase. Slight early increase, later levelling off* ACS CANCER PREVENTION STUDY To pinpoint targets for future preventive programs is the purpose of the American Cancer Society's "Cancer Prevention Study," the most extensive medical statistical research project ever undertaken. In 1959, some 68,000 trained volunteer researchers in 1,121 counties enrolled 1,079,000 men and women over the age of 30. Each of these subjects filled out a detailed questionnaire giving information on family history, diseases, physical complaints, diet, en vironmental exposure, occupation, habits and other factors. Once a year the volunteers trace all of the subjects and once every two years each subject is requested to fill out a follow-up questionnaire. This enormous study, continuing for six years, is made possible by ACS volun teers. Without their assistance, it would be prohibitively expensive. A major report on smoking and health in humans based on 422,000 subjects followed for three years, was released in December, 1963 (see P. 21). A previous report based on two follow-ups had been prepared earlier in 1963 at the request of the Surgeon General's Advisory Committee on Smoking and Health. The findings in this report contributed largely to the conclusions of the committee that "cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action." Preliminary studies have indicated that the analysis of the data on physical complaints may provide important information leading to the early detection of cancer of certain sites. It is an ticipated that more major analyses will be forthcoming shortly. The study should provide clues as to causative or associated factors leading to the development of cancer of various sites. Among those factors under study are exercise, childbearing, breast feeding, menstrual difficul ties, circumcision, air pollution and many others. -11 - RSY0024591 WHY WE SAY "FIGHT CANCER WITH A CHECKUP... If The American Cancer Society urges all adult Americans to do two things to protect them selves against cancer: 1) have a medical checkup annually, no matter how well you feel; 2) learn Cancer's Seven Danger Signals and go to your doctor immediately if one of them lasts longer than two weeks. Here's the reason why; Cancer typically begins as a `'localized" disease. At the start, just one of the tiny cells of the body (or perhaps a few cells) undergoes an unfortunate change -- it becomes a malignant cell, cancer. The cancer cell reproduces itself by dividing into two cells which in turn re divide and so on. All of the descendants of the original cancer cell are themselves cancer cells. Thus the cancer grows. The great majority of cancers originate on the surface of some tissues such as the skin, the inner surface of the uterus, the lining of the mouth, stomach, intestines, bladder or a bronchial tube, or the lining of a duct in the breast, prostate gland or elsewhere. For a time, such cancers typically remain at the site of origin and are visible only under a microscope, but later growing into a mass that can be seen with the naked eye. While it remains confined to its source of origin this lesion is known as "carcinoma in situ," that is, "cancer in its original site." After a time, some of the cancer cells penetrate beyond the surface and "invade" the underlying tissues. This is "invasive cancer." After invading, the cancer continues to grow but for a time the cancer cells may remain more or less together as an intact mass, though perhaps spreading irregularly. So long as all of the living cancer cells remain where the disease started, it is said to be "localized." The more dangerous phases of cancer are the later ones. Some of the cancer cells even tually become detached and are carried through the lymph channels or blood vessels to other parts of the body. This process is known as "metastasis." But the body has a protective mechanism. The detached cancer cells may be trapped in a lymph node in the region of the original organ. This retards the spread for a time. This stage of the disease is known as "regional involvement." If left untreated the cancer cells eventually spread to many parts of the body. This is "advanced cancer." Death is then almost inevitable, although not necessarily quick. In theory, all cancers can be cured when it is possible to remove or destroy all of the cancer cells existing in the patient's body. This is easily accomplished by surgery when cancer is found in the "carcinoma in situ" stage. It can usually be accomplished by surgery or radiation therapy when found in the "localized" stage. It can often be done by surgery or radiation therapy when in the "regional involvement" stage. It can almost never be done once cancer cells have spread through the patient's body. The problem then is to detect cancer before it has spread so that it can be removed by surgery or destroyed by radiation. For unknown reasons, some cancers grow and spread slowly while others grow and spread rapidly. Some types spread with such rapidity that they are incurable at the present time. Fortunately, about half of all cancers are of the type that are presently curable. The table opposite shows the five-year survival rates of cancer of several different sites when treated in the "localized" and the "regional involvement" stages. The "car cinoma in situ" stage is not shown because it is almost 100% curable. Neither is the "advanced" or "distant spread" stage listed because it is virtually incurable. This is why we urge Americans to "Fight Cancer With a Checkup." This is why we educate them to heed the danger signals. If they do get cancer they will then have a better chance of cure. We also urge fighting cancer "With a Check," because our dollars support the research that will hasten the day when even advanced cancer can be cured or, better, prevented. -12- RSV0024592 FIVE-YEAR CANCER SURVIVAL RATES FOR SELECTED SITES SKIN THYROID UTERUS BREAST / COLON a RECTUM BLADDER OVARY KIDNEY PROSTATE STOMACH LUNG 'ADJUSTED FOR NORMAL LIFE EXPECTANCY source: END RESULTS AND MORTALITY TRENDS IN CANCER: NATIONAL CANCER INSTITUTE MONOGRAPH NO. 6 -13- RSV0024593 Summary ofAmerican Dancer Society Research Grants, Appropriations and Postdoctoral Fellowships Adrian College, Adrien, Mich. (1) $ 20.12B.00 Agricultural Research Service, Michigan (1) 58.886.00 Alabama, University of, Tuscaloosa (1) 15.000.00 Alaska, University of, College, Alaska (1) 24.894.00 Albert Einstein Medical Center, Penn. (1) 20.007.00 Alton Ochsner Medical Foundation. N, 0., La. tl) 75.000.00 Allegheny General Hospital, Penn. (1) 25.000.00 Amherst College, Amherst. Mass. (1) 8.185.00 Applied Research Laboratories. Florida (1) 48.120.00 Arizona, State University of, Tempe (1) 25.418.00 Arizona University. Tucson (1) 15.000.00 Arkansas, University of, Fayetteville (2) Baylor University. Houston, Texas [3) 30.000.00 94.119.00 Beth Israel Hospital, Boston, Mass, (l) 37.000.00 Bio Research institute, Cambridge, Mass. <1) 17.445.00 Boston University, Mass. (2) 31.800.00 Brandeis University, Waltham, Mess. (4) 1t9.707.0O Brookhaven National Laboratory, Suffolk (1) 30.000.00 Brown University. Providence, Rhode Island (3) 45.489.00 Buffaio, University of. New York (1) 44.812.00 California institute of Technology, Pasadena (1) 12.500.00 California, University of {12) 450.552.00 Chicago Medical School, Illinois (3; Chicago, University of, Illinois (8) Children's Hospital Medical Center. Mass. (1) 59.317.00 .271.252.00 21 956.00 Children's Hospital, Los Angeles, Caiit. (1) 19.983.00 Children's Hospital, Washington. D.c. (l) Children's Hospital of Philadelphia, Penn, (l) 11.931.00 49.589.00 Cincinnati. University of. Ohio (3) 48.308.00 Clarkson College of Technology, N. Y. (3) Colorado State Umv , Fort Collins (l) Colorado, University of, Boulder (4) Columbia University, New York (7) Connecticut, University of, Storrs (2) Cornell University. New York (3) Creighton University, Omaha, Nebraska (2) 41.036.00 15.000.00 60.510.00 158.586.00 30.571.00 81.248.00 32.759.00 Dartmouth College, New Hampshire (2) 41.108.00 Delaware, University of, Newark. Delaware (1) Downstate Medical Center, New York (1) 12.750.00 20.920.00 Duke University, Durham, North Carolina (10) 222.632.00 Duval Medical Center, Florida (1) 10.048.00 Emory University, Atlanta, Georgia {2) 40.211.00 Fisk University. Nashville, Tenn. (1) 23.423.00 Florida, University of, Gainesville (3) 46.236.00 Free Hospital for Women, Brookline, Mass. (1) 50.000.00 Georgetown University, Washington, D. C. (1) 28.672.00 Georgia, Medical College Of, Augusta (1) 7,000.00 Graduate Research Ctr. of Southwest. Dallas, Texas (I) Grasslands Hospital, Valhalla, N.Y. (1) Hahnemann Medical Coilege and Hospital, Phiia. (4) Harvard University. Boston <12) 46.579.00 55.583.00 69.445.00 251.961.00 Henry Ford Hospital, Detroit, Michigan (1) Highland View Hospital, Ohio (1) 13.437.00 8.608.00 Illinois. University of, Urban8 (4) 71.242.00 Indiana University, Bloomington (3) 68.525.00 Indiana University Foundation, Bloomington (1) 21.469.00 institute for Qancer Research, Philadelphia (3) 80.968.00 Institute for Disease, Inc., New York (1) 26.305.00 Iowa. State University of. Iowa City (2> 38.625.00 Issjjc Albert Research institute, New York (l) 50.132.00 J. T. Nix Clinic, New Orleans. La. (1) 28.000.00 Johns Hopkins University, Baltimore, Md. (5) 204.811.00 Kansas, University of, Lawrence (2) 40.000.00 Kent State University, Kent, Ohio (1) 17.703.00 Kentucky, University of, Lexington (4) 65.978.00 Lahey foundation, Boston, Mass, (l) 24.747.00 Loma Linda University. Los Angeles (2) 42.476.00 Los Angeles County General Hospital (1) 6.003.00 Los Angeles County Harbor General Hospital (l) 29.286.00 Louisiana State University, Baton Rouge (1) 19.104.00 Louisville, University of, Kentucky (1) 10.000.00 Loyola University, Chicago (1) 15,000.00 Maine, University of, Qrono (1) 18.863.00 Marquette University. Milwaukee (3) 39.990.00 Mary imogene Bassett Hosp., cooperstown. N- Y (1) 10.245.00 Maryland, University of, Baltimore (2) 66.105.00 Massachusetts General Hospital. Boston (6) 141.999.00 Medical College of South Carolina, Charleston (2) 28.412.00 Menorah Medical Center, Kansas City, Mo. (1) 11.262.00 Miami, University of. Coral Gables. Florida (2) 56.301.00 Michigan College of Mining and Technology (1) 11.929.00 Michigan State university, East Lansing (i) 15,000.00 Michigan, University of, Ann Arbor (5; 327.987.00 Milwaukee Health Department (1) 8.500.00 Minnesota, university of, Minneapolis (7) 277.233.00 Mississippi. University of. Jackson (2) 48.362.00 Missouri, University of, Columbia (2| 39,2Q1.0Q Montefiore Hospital Association of West Pa., Pittsburgh (1) 17.500.00 Montefiore Hospital, New York (3} Mount Sinai Hospital, los Angeles, Calif. (1) Mount Sinai Hospital. New York (1) 166.374.00 37.500.00 34.114.00 Mt. Holyoke College. South Hadley. Mass. (1) 7,4*7-00 Nassau Hospital. New York (1) 27.3f7.00 Nebraska. University of, Omaha (2) 25.503.00 New England Institute for Medical Research (1) 5.604.00 New England Medical Center Hospitar, Boston (I) 35.230.00 New York City Department of Health (1) New York Medical College, New York (2) 14.383.00 62.338.00 New York, State University of, Albany (i) New York University, New York (9) North Carolina, university of, Chapel Hill (2) Ohio State University, Columbus (2) 37.409.00 216.163.00 26.526.00 57.122.00 Oklahoma Medical Research Institute, Oklahoma City (2) 60.335.00 Oklahoma State University. Stillwater (3) Oklahoma. University of, Oklahoma City 11} Oregon State College. Corvallis (2) Oregon, University of, Eugene (2) Pasadena Foundation for Medical Research (1) 38.670.00 27.000.00 17.603.00 55,803 00 19.320.00 Pennsylvania State University. University Pk; (1) Pennsylvania, University of. Philadelphia (6) Philadelphia Tuberculosis Health Association, Pa. (1) 11.750.00 232.852.00 21.133.00 Pittsburgh, University of. Penn. (7) 191.662.00 Pre$byterian-J& Luke's Hospital, Chicago (1) 25.938.00 Princeton University, New Jersey (2) 47.947.00 Purdue University, Lafayette, Indiana (2) 31.648.00 Putman Memorial Hospital (1) 54.190.00 Rhode Island, University of. Kingston (1) 28.900.00 Rochester, University of, New York (1) 31.000.00 Rockefeller Institute, New York (2) 42.905.00 Roscoe B. Jackson Memorial Laboratory, Bar Harbor (6) 87.626.00 Roswell Park Memorial Institute, Buffalo (16) Rutgers, State University of New Jersey (1) 46260..406000..0000 Saint Anselms College. New Hampshire (1) 9.695.00 San Diego County General Hospital (I) 5.376.00 Sansum Clinic Research Foundation. Calif. (1) 28.238.00 Scnpps Clinic and Research Foundation, La Jolia, California (2) 46.228.00 Seton Hall University, Jersey City, N, J. (2) 58.955.00 Sloan Kettering Institute for Cancer Research, New York (14) 527.011.00 South Jersey Medical Research Foundation, Camden (1) Southwest Foundation for Research and Education (J) Southern California, University of, Los Angeles (4) 50.503.00 .47.945.00 111 668.00 Southern Illinois University, Carbondale (4) 120.322.00 Southern Research Institute, Birmingham, Ala. (2) 62.446.00 St. Johns Hospital. Santa Monica, Calif. (1) 11.405.00 St. Louis University, Missouri (1) 18.000.00 St. Luke's Hospital, New York (1) 16.137.00 St. Margaret's Hospital, Boston (1) 14.375.00 St. Mary's Hospital, Kansas City, Mo. (1) 3.000.00 St. Vincent's Hospital, New York (2) 34.545.00 Stanford University, Stanford, Calif. (5) 112.710.00 Temple University, Philadelphia (X) 25.275.00 Tennessee, university of, Memphis (2) S5.500.Q0 Texas, University of, Houston (6) 153.961.00 Tufts University, Medford, Mass. (5) 126.586.00 Tulane University, New Orleans. La. (4) University of Notre Dame, Indiana (1) 8100..505050..0000 Utah, University of, Salt Lake City (4) 74.517.00 Vanderbilt University. Nashville. Tenn. (2) 43.000.00 Vermont, University of, and State Agricultural College, Burlington (2) 46.540.00 Veterans Administration Center, New Jersey fl) 60.740.00 Veterans Administration Center, W. Virginia (1) 8.705.00 Veterans Administration Hospital, New York (1) 13.765.00 Virginia, Medical College of, Richmond (3) Virginia, University of, Charlottesville (1) 7200..406010..0000 Wake Forest College, Winston Salem, N. C. (2) 19.023.00 Washington University, St. Louis, Mo. (6) Washington, University of, Seattle (3) 211.964.00 104.721.00 Wayne State University, Detroit (3) 112.383.00 West Virginia University. Morgantown (3) 55.144.00 Western Foundation tor Clinical Research, Montana (1) 3.900.00 Western Reserve University, Cleveland (5) Wisconsin, University of, Madison (12) 186.283.00 291.614.00 Wistar institute of Anatomy and Biology, Philadelphia (2) 130.748.00 Womans Medical College of Pennsylvania (2) 22.544.00 Worcester Foundation for Experimental Biology, Mass. (9) 321.037.00 Yale University, New Haven, Conn (9) 343.397.00 Yeshiva University, New York (9) 218.259.00 Postdoctoral Fellowships (27) 329.739.00 Postdoctoral Research Scholarships (6) 126.619.00 For Support cl Journal "Cancer Research" (1) 13.900.00 Special Publication Costs for Journal "Perspectives in Biology and Medicine" (1) 400.00 To Provide Partial Support of the institute of Laboratory Animal Resources of the Division of Biology and Agriculture, National Academy of Sciences -National Research Council (1) 5,000.00 To Provide Cost for Cooperative Study on Thermographic Scanning (1) 10,000.00 To Support a Symposium on Hormone Related Tumors (1) 34,400.00 Total (473) 811,990,175.00 NOTE: Numbers In parentheses indicate number of grants per institution as of July 31,1964. -14- RSV0024594 RESEARCH THE GOAL: To find what causes cancer. To find new ways to cure it. To find ways to pre vent it. To alleviate pain and suffering. THE PROGRAM: In fiscal 1963-64 (through August 31, 1964) the American Cancer Society had national research expenditures of $12,404,429. Of this, $11,980,175 was awarded in grants through July 31 (See P- 14). The National Office and Divisions have devoted more than $138 million to cancer research since the support program began in 1945. From 1937 through 1964, the American Cancer Society and the National Cancer Institute, major supporters of cancer research, have devoted approxi mately $900 million to this work-a great deal of money expended over 27 years, but only about one quarter of the 1963 appropriations for one year of the National Aeronautics and Space Administration. The Society in 1965 is helping to support research by more than 1,000 key investigators working in American hospitals, universities and other institutions, plus thousands more of young men and women serving as technicians or being trained for larger responsibilities. This is done through research grants, institutional research grants, and six different categories of personnel grants. Additionally, the ACS now supports the Eleanor Roosevelt International Cancer Fellow ship Program; in February, 1964, 22 Fellowships were awarded to investigators of 17 countries, and 72 scientists from 27 countries have been aided since the program began in 1961. Advisory Groups To help the Society evaluate the many applications received from scientists, there have been established five Advisory Committees, each with 15 members, in the fields of: 1 -- etiology (cause); 2 - pathogenesis (course); 3 - therapy (treatment); 4 - institutional grants; 5 - per sonnel grants. Serving on the parent Research Advisory Council are 11 committee members. These 86 men include leading scientists of the nation. Many are professors, deans or heads of departments at universities and medical schools. Practically all scientific disciplines are covered: surgeons, biochemists, radiologists, virologists, internists, biologists, pathologists, immunologists, anatomists, physiologists. The committees meet three times a year -- December, March, June - to conduct their screening of applicants to decide which among them shall be judged most worthy of ACS financial support. From the Research Advisory Council the recommendations go to the Research Committee of the Society's Board of Directors and then to the Board itself for final approval. Research Grants As of September 1, 1964, the Society had 395 research project grants in effect that were aimed at finding answers to fundamental questions about cancer. In the area of etiology - what are the causes? Why does cancer begin in one cell, one organ, or one individual and not in another? What biochemical molecules within cells show the first signs of abnormality? Is a virus, a chemical, a hormone, an irritant, the provoking agent? Are there patterns of diet or health habits that offer clues to cancer incidence? In the area of pathogenesis -- after cancer begins, what holds the early malignant growth in check or permits its spread? What is the controlling role of hormones, of the body's im mune mechanisms, of enzymes, of abnormal proteins in the blood? What biochemical differ ences exist between normal and cancerous cells which, if properly understood, could be corrected? - 15 - RSV0024595 In the area of therapy -- how can the treatment of cancer patients be improved? What are the newest advances in surgical and radiation techniques, in immunology, in the search for new drugs which can add comfort and years to the lives of these patients? What new diag nostic procedures can be found to detect cancers such as leukemia, lung cancer, breast can cer, and cancer of the pancreas, prostate, kidney or bone, which would permit earlier, more effective treatment? Institutional Research Grants The Institutional Research Grant was pioneered by the Society to meet a basic need. Such a grant is a fluid fund awarded to an institution to support research pertaining to cancer which cannot be financed by other forms of support. The grants go to selected universities and other institutions, where they are allocated by local administrative committees of physicians and scientists to qualified investigators who wish to explore a new idea, develop a tangen tial approach to their main line of endeavor, perfect a new laboratory technique, engage in research on a part-time basis, or stimulate a student - undergraduate, graduate or medical to interest himself in the cancer research field. Present average institutional grant is $25,000. In the past six years, several thousands of individual allocations -- most of them for well under $3,000 - have been awarded under this program for fresh ideas and techniques by local committees in 78 institutions throughout the country. Totally, the ACS has invested $13,049,380 in this program since 1956. Personnel Grants ' The six types of'grant offered under this category are designed to meet specific investigative needs in these fields: 1. Postdoctoral Fellowships, for individuals who have completed their M.D. or Ph.D. training but who require further training on some specific aspect of cancer research. 2. Postdoctoral Research Scholarships, for those who have trained as M.D.'s but who de sire training in the basic sciences, and those trained as Ph.D.'s in fundamental research but who lack training and experience with clinical medicine. 3. Predoctoral Research Scholarships, for exceptionally promising medical students whose objectives are careers in academic and investigative medicine, in order to train them simul taneously in both the basic and clinical sciences. 4. Scholars, for established investigators who require some additional training in one spe cific area necessary for the further progress of their research activity. 5. Faculty Research Associates, for individuals who have received all the training re quired for independent research work, but who need an academic appointment that provides op portunity to conduct research of their own design. 6. Research Professorships, to help universities provide lasting positions for extraordi narily gifted and promising investigators in the field of cancer research, the Society has established ACS Research Professorships for the academic lifetime of these scientists. These are permanent positions for top men in the medical, biological and related physical sciences. Each grant is backed up with a $100,000 trust fund, with yearly stipends coming out of current Crusade contributions. As of September 1, 1964, there were 22 such Professorships. -16- RSV0024596 PROFESSIONAL EDUCATION THE GOAL: To bring to the all-important medical and allied professions useful information on cancer and the latest developments in diagnosis and treatment so as to reduce death and suffer ing. To help assure optimum treatment for cancer patients, the Society provides opportunity for physicians and dentists to obtain advanced clinical training so that they may become skilled clinicians and future leaders and teachers in the fight against cancer (see below). THE PROGRAM: The day-to-day function is to see that doctors, nurses and others involved in the medical sciences, including medical students, be advised of the changing clinical methods growing out of ongoing research and practical experience and persuaded to utilize them. Each year the Society sponsors scientific sessions and cancer conferences (i.e., the 5th National Cancer Conference at Philadelphia in 1964, with the NCI), and many refresher and postgraduate courses for physicians are conducted in collaboration with national, state and county medical societies. The ACS also publishes and distributes its own professional journals and such edu cational aids as monographs, films, exhibits, etc. CLINICAL FELLOWSHIPS The Society's National Clinical Fellowship program, which started in July, 1948, has invested up to July 1, 1964, a total of more than $8 million for the training of over 1,800 physicians and dentists. Through this program - now exceeding the million dollar a year level - the Society provides postgraduate training in cancer for physicians and dentists at approved teaching centers. These doctors then bring the special knowledge and ability gained to the areas in which they practice, sharing their experience with other physicians through tumor clinics and medical societies and making it of benefit to cancer patients in local communities across the nation. During the past year, 1963-64, 189 clinical fellows and 36 advanced clinical fellows were trained. For the 1964-65 year, 208 clinical fellows and 36 advanced clinical fellows began their training on July 1. SERVICE THE GOAL: To aid in saving lives from cancer by supporting physicians' efforts to provide earlier and improved treatment of cancer, and their continuing evaluation of end-results. To bring greater comfort to cancer patients and to ease the burden on their families. THE PROGRAM: The Society expects all of its organized Units to conduct a minimum service program, outlined in a new Service manual, which includes a local information and counseling service approved by the local service committee and medical society. This provides pertinent information and assistance to the cancer patient or his family concerning community medical and social resources, loan and gift services, and transportation service. Depending on local needs and means, the program may be expanded by Units to include medication, nursing, home maker services and rehabilitation. Community projects having the endorsement of state and local medical societies may be supported to include cancer detection in physicians' and den tists' offices and at detection centers, diagnostic services, and community programs including term support of cancer registries and hospital cancer clinics. -17- RSV0024597 PUBLIC EDUCATION THE GOAL: To help save lives by reaching Americans where they live, where they work, where they meet, and persuading them to consult their physicians at a time when many cancers are curable - at the early recognition of a danger signal or by the annual health checkup. This leads to early diagnosis, early treatment, and more cures. THE PROGRAM: Through meetings of every sort, through mass media, leaflets, and films, etc., the Society spreads its message. The most effective educational technique is the two-way ex change, in which people have the opportunity to voice their own ideas, their own fears, their questions about cancer and to hear the facts from the American Cancer Society. Special pro grams are slanted to reach people in age or sex groups with high incidence rates. Other programs cover "priority sites," such as lung, uterus, breast, and colon-rectum, which have both a high incidence rate and a high life-saving potential and where early diagnosis is the first vital objective. The scope of this program is indicated in current public education projects emphasizing: 1) Increasing efforts to inform the public of the causal relationship between cigarette smoking and lung cancer with special emphasis on reaching school children before the habit is formed or becomes deeply rooted. Latest ACS educational tools are three films, Is Smoking Worth It?, The Huffless, puffless Dragon, for children, and Who, Me?, for adults. 2) Stressing the value of the life-saving health habit of regular monthly breast self-examina tion. Focal point of this program is the film. Breast Self-Examination. 3) Stressing importance,of the "Pap test", as part of an annual physical examination, in the early detection of uterine cancer. Latest ACS film, Time and Two Women. 4) Encouraging all U.S. adults to request a colon-rectum examination at the time of the annual checkup. Latest ACS film, Life Story. 5) Increasing emphasis on reaching men, and persuading them to have the annual health checkup. 6) Encouraging person-to-person programs such as "Save-a-Life" parties, house-to-house visits, special exhibits and open forums. The annual "Tell Your Neighbor" campaign, con ducted as part of the April Cancer Crusade, is focal point for this phase of the life-saving drive. CONQUER UTERINE CANCER! Uterine cancer, once a most dreaded form of disease, could be dramatically arrested as a cause of death - if every adult woman would have a "Pap" test as part of the annual health check up. Though the disease can now be detected before symptoms appear, at a time when it is most curable, some 14,000 women will die in 1965 of cancer of the uterus, or womb. About 44,000 new cases of uterine cancer will be diagnosed this year. Most uterine cancer occurs in the cer vix or neck of the uterus. The U.S. death rate for uterine cancer shows a steady decline. It has been cut almost 50 per cent in 25 years among white women. Among Negro women, where the rate of incidence is twice as high as for white women, the death rate has been cut 35 per cent. Two factors contribute to this progress: the unremitting program of education for women which the Society has conducted since 1937, and improvement in detection and treatment. The educational campaign is now seen to have paralled a gradual but steady drop in death rates. In 1942, the age-adjusted death rate per 100,000 females was 23.8, By 1947, this had declined to 22.7. By 1962 the long-term effects of the program had helped bring the figure to 12.9. -18- RSV0024598 The "Pap" smear is based on the study of cast-off cells which are shed normally by living tissue. In a checkup, a physician can take a uterine sampling simply, quickly, and without pain. The technique is named for Dr. George N. Papanicolaou who developed it with financial support from Cornell University, the Commonwealth Fund, the National Cancer Institute, and the American Cancer Society, which invested about $1 million in research and in winning ac ceptance for this method of cancer detection. The acceptance of the habit by women and their physicians is encouraging. The rate of pro gress is shown in these findings from a study recently completed by the Gallup Organization in the United States; In 1961, 30 out of every 100 women reported that they had the "Pap" test at least once; by 1963, 48 out of 100, a substantial increase, said they had had it once. In 1963, 22 out of 100 had the test; in 1960, 13 out of 100 had it. In 1963, 77 of every 100 women reported they had heard of the test; in 1961, this figure was 59. Relating these figures to the 58 million women in the United States, it is estimated that some 44 million have heard of the test and some 27.8 million have had it. About 12 million had it in 1963, almost double the 1960 figure. Thus, some 16.2 million women have heard of the test but have not yet had it, and of the 27.8 million who have had it, about one-third had it in 1960 or earlier, and should have it again, and annually. The Society's latest drive to "Conquer Uterine Cancer!" combining research, professional and public education and service to patients, was launched in 1961. In 1962 the program was wholeheartedly endorsed by the 14,500-group General Federation of Women's Clubs which co operated promotionally and urged "Pap" smears on its entire 300,000 membership. This con tinuing drive has since won organizational acceptance by the National Council of Catholic Women, the National Council of Negro Women, the Pilot Club International. Future efforts will reach the so-called "high-risk groups" among the low-income population where cancer of the cervix has a higher incidence and results in a greater death toll. An outstanding example of broad civic action against uterine cancer is the PAP (Prompt Action Prevents) program begun in Cuyahoga County, Ohio, cosponsored by the local Unit of the ACS and the Cleveland Academy of Medicine. In one year almost one half of the 500,000 Cleveland women over the age of 21 went to their physicians, or to clinics, for the pelvic ex amination and cytologic study, as a result of this program. What is unique about it is the meticulous planning that unites all the county's physical resources and many of its leading citizens and physicians in a common effort to wipe out a form of cancer that has been de scribed as "almost entirely preventable." To test whether women would be more responsive to gathering material for the "Pap" smear themselves, rather than going to a physician, the Society's Maryland Division undertook a pilot project employing an irrigation kit, simple instructions, and a mailing tube to be sent to a central cytologic laboratory. To validate this experiment, the Society's Board of Directors voted a grant of $60,940 to initiate a broad quality control program at the Jackson Memorial Hospital of the University of Miami in Florida over a two-year period to September 1, 1965. Working with three separate con trol groups, the program is intended to ascertain if the irrigation method is as reliable for the detection of uterine cancer as the known method of highest reliability, the cervical scrape. The program will also determine if the irrigation method performed under optimum conditions-by the doctor-is as reliable as the cervical scrape, and if it is as reliable if the patient performs it herself. The state of Florida was chosen for this project because of its diversified ethnic and age groups. Other studies to find and correct problems in this new method are supported by the Society, and the USPHS is conducting a similar test at Marquette University in Milwaukee. - 19 - RSV0024599 BREAST CANCER This is the leading cause of cancer death in women today. There will be an estimated 62,000 new cases in 1965 and an estimated 26,000 deaths. It was the first site of cancer to be singled out by the ACS as target for a national public education program. Physicians know that earlier detection could save more lives; for this reason the Society encourages regular breast selfexamination in all its educational materials. A Breast Self-Examination film produced in 1950 was replaced by a new one released last year with the same title. Despite all efforts to date, the breast cancer death rate remains high. This could change for the better if more women reg ularly practiced self-examination and consulted their physicians at first symptom. Delayed treatment is not only dangerous for the individual, but frustrating to the physician - who knows that the five-year survival rate for localized breast cancer is 82 per cent as against 48 per cent when there is regional spread beyond the original site. To help reduce these odds, the ACS Minnesota Division originated a program to assist in detecting early breast cancer and to instruct women in the technique of self-examination; a one-day session at Crookston screened 1,122 women and referred 51 suspicious cases to private physicians for follow-up. Similar clinics have been held successfully in Rhode Island and Suffolk County, N.Y.; more are planned for 1965. COLON-RECTUM PROGRAM Cancer of the colon and rectum will strike 73,000 Americans this year, more than any other type of cancer, and it occurs about equally in men and women. Some 43,000 die of it annually-- though three out of four patients can be saved by early diagnosis and treatment. Key to early diagnosis is proctoscopy as part of the health checkup. This is an examination with a lighted tube which is passed into the rectum and lower colon by which the physician can inspect the walls visually. Medical authorities feel that this procedure can today help save more lives from cancer than any other step in the annual checkup. In conjunction with professional education aimed against cancer of this site, the American Cancer Society is conducting a public education program. Chief tool is a documentary film, Life Story, telling in simple, direct terms the facts about cancer of the colon and rectum, how it is detected and stressing the hopeful aspects of the disease if treated early. As physicians' groups endorse it, the program is being introduced in community after community. Goal is a proctoscopic examination as part of every annual checkup; a film showing technique titled Proctosigmoidoscopy, A Part of the Physical Examination, produced by the Oregon Division, is being widely shown to the medical profession and medical students, and some ACS Divisions are sponsoring special training courses for physicians in these techniques. SMOKING AND HEALTH Surgeon General's Report "Cigarette smoking is causally related to lung cancer in men; the magnitude of the effect . . . far outweighs all other factors. The data for women, though less extensive, point in the same direction. The risk of developing lung cancer increases with duration of smoking and the num ber of cigarettes smoked per day, and is diminished by discontinuing smoking." A vast body of clinical, epidemiological, experimental, pathological and other evidence amassed in many countries for over a decade was thus affirmed on January 11, 1964, by the long-awaited report on Smoking and Health of the U.S. Surgeon General. The 387-page report grew out of a 14-month study into all the available evidence by an impartial commission whose members were cleared by the tobacco industry and the concerned health agencies. - 20 - RSV0024600 It stated that not just lung cancer is involved, that the mortality ratio of cigarette smokers over nonsmokers is particularly high for a number of other diseases including bronchitis and emphysema, cancer of the larynx, oral cancer, cancer of the esophagus, and peptic ulcer. Smoking cigarettes was also cited as a factor in heart and circulatory diseases. This U.S. Public Health Service "Advisory Committee on Smoking and Health" was ap pointed in 1962-a blue ribbon jury of eminent scientists. The American Cancer Society, to gether with the American Heart Association, the National Tuberculosis Association and the American Public Health Association, had urged such action in an earlier (1961) joint letter to president Kennedy which suggested that such a commission might also assess the social re sponsibility of business, the voluntary agencies .and of government in the education of youth and the protection of the public. FTC, Other Actions The Federal Trade Commission lost no time in following up the Surgeon General's report. One week later the FTC came out with the recommendation that cigarette packages, cartons and advertising carry a warning to the effect that smoking them is a health menace and may cause death from cancer and other diseases. Also proposed was a ban on advertising that suggests smoking promotes good health or well-being, or that one brand is less dangerous than others. These proposals were adopted by the FTC in June, following hearings, as an official ruling to take effect in 1965. However, there are indications it will be challenged in the courts. The cigarette companies established a voluntary "code" to be administered by former Governor Robert B. Meyner of New Jersey which is intended to curb some advertising and pro motional abuses within the industry. The National Cancer Institute is beginning a program of basic research to further explore the factors involved in the cigarette-lung cancer linkage, and the National Heart Institute is looking into the effects of quitting smoking. And a $10 million fund for research into the general relationship of smoking to disease was given by six major tobacco companies--American, Brown & Williamson, Liggett & Meyers, P. Lorillard, Philip Morris and R. J. Reynolds-to the American Medical Association which, in December, appropriated a supplemental $500,000 to launch an independent research program that would seek, in the words of its chairman, Dr. Maurice H. Seevers, of the University of Michigan, "to find what in the tobacco is harmful, the mechanism of the injury and what can be done to remove it." The AMA, at its June 1964 convention, formally recognized "a significant relationship be tween cigarette smoking and the incidence of lung cancer and certain other diseases, and that cigarette smoking is a serious health hazard." The AMA urged elementary and secondary schools to include programs on smoking and health in their health education curricula and dis semination of "vital health education material on the hazards of smoking to all age groups through all available means of communication." Added Smoking Data A month before the Surgeon General's report, Dr. E. Cuyler Hammond, ACS Director of Sta tistical Research, reported to the annual clinical meeting of the American Medical Association some early results of a six-year ACS Cancer Prevention Study. Based on a continuing study of 422,094 men for an average 34.3 months, this report: 1) con firmed earlier smoking studies; 2) showed a higher death rate for those who begin smoking cigarettes under age 15 and, prospectively, a death rate increasing with degree of inhalation; 3) determined that 50 per cent more heavy smokers were hospitalized over a two-year period than nonsmokers; 4) answered those who suggest that the observed statistical association does not take into account fundamental differences between individuals; showed in a "matched - 21 - RSY0024601 pair" analysis of 36,975 sets of persons (alike in various hereditary and environmental re spects except that one group smoked and the other didn't) that smokers had about twice as many deaths as nonsmokers. Since then, some other facts concerning the smoking habits of women and of doctors came to light. Separate studies revealed that women are smoking more cigarettes; doctors are smok ing less. A Harvard study showed that more women than men are now smoking cigarettes57.4 per cent of the mothers of Newton, Mass., vs. 49.9 per cent of the fathers. A report on the smoking habits of 56,000 physicians published in the March 1964 Modern Medicine, indi cated that more than three fourths of them are not now smoking cigarettes. ACS Intensifies Drive Since issuance of the USPHS report, the American Cancer Society has taken a number of actions to intensify its own continuing role in the cigarette-and-health denouement which its famous Hammond-Horn study of 1952-55 did so much to help pioneer. The Society endorsed the FTC recommendations and urged the development of a uniform way of measuring tar and nico tine content in cigarette smoke to facilitate proper labelling. The Society's Board of Directors, recognizing its responsibility in encouraging and develop ing research to find ways to help smokers who want to give up the habit, approved a grant of $59,518 to Roswell Park Memorial Institute, Buffalo, N.Y., in support of clinical studies de signed to test various techniques of withdrawal. As of March 1, 1964, the ACS had six grants in effect, totalling $255,293 on "Smoking and Health." Another major forward step by the Society was to call a "National Conference on Cig arette Smoking and Youth" with 11 cosponsoring organizations, which was held in New York City June 10-11, 1964. Sixty-eight national agencies concerned with the health, welfare and education of youth were invited to send one national board member and one staff member; 44 agencies did. Attendance totaled 168 persons, including leaders in the communications fieldnewspapers, magazines, radio, television--and board members from the cancer, heart and tuber culosis health agencies. Keynote speaker was the Surgeon General, Dr. Luther Terry, Eight workshop sessions covered the fields of: 1) schools and colleges; 2) communications; 3) doctors and dentists; 4) youth-serving organizations. Proceedings of the conference are to be published and widely distributed. Interagency Council Established In July, the USPHS took leadership in the establishment of a National Interagency Council on Smoking and Health, a voluntary association of national agencies and organizations organ ized "to develop and implement effective plans and programs aimed at combatting smoking as a health hazard" and dedicated "to the promotion of the public health through cooperative action." The Council includes the following agencies: American Association of School Administra tors, American Cancer Society, American Dental Association, American Heart Association, American Public Health Association, Association of State and Territorial Health Officers, De partment of Classroom Teachers of the NEA, National Congress of Parents and Teachers, Na tional Tuberculosis Association, U.S. Children's Bureau, U.S. Office of Education, U.S. Public Health Service. Dr. Lewis C. Robbins, Chief of the USPHS Cancer Control Program, acted as interim chair man; Dr. Harold S. Diehl, Senior Vice President for Medical Affairs and Research of the American Cancer Society, was named vice chairman. -22- RSV0024602 Teen-Age Program Children whose parents, mentors, idols, peers smoke are more likely to acquire the smoking habit than others; this was learned as long as 1958 when the ACS conducted a pioneering study of the smoking patterns of 22,000 Oregon high school students. Later studies have yielded further relevant data suggesting that increasing educational efforts should be made to reach children in the pre-teen age brackets. To this end, the ACS has produced a new film for 6th graders titled The Huffless, Puffless Dragon. Key tools for elementary and junior high school students is a film Is Smoking Worth It? and a filmstrip titled Til Choose the High Road. For secondary school distribution there is yet another filmstrip, To Smoke Or Not To Smoke?, of which almost 33,000 copies have been is sued since 1963. A student leaflet, Shall I Smoke? has reached a distribution of almost 10 million. Who Me? is a new film, for adult audiences, produced by the Society in 1964. Lung Cancer Death Rate Lung cancer in 1965 will kill approximately 47,000 persons in the United States, some 40,000 men and 7,000 women. The increase in this disease in men is continuing at a rate un equalled by any other disease, and is the leading cause of male cancer deaths-the rate being 10 times what it was 30 years ago. Lung cancer is a largely preventable disease; it is esti mated that more than 75 per cent of lung cancer is caused by cigarette smoking. It is not felt that cigarettes are the only cause of lung cancer; air pollution is .also considered a factor. Un fortunately, it is difficult to diagnose lung cancer in time for cure. Only about five per cent of all cases are being cured today. More men in the United States die from lung cancer than from automobile accidents. Pub lished figures show that there are approximately 100 male deaths a day from lung cancer alone and it is estimated there are about 500 deaths a day from cardiovascular and pulmonary condi tions attributable to cigarette smoking. The report of the Special Committee on Smoking and Health of the New York State Senate, dated March 10, 1964, contains the statement that 36 per cent of all deaths among men aged 50 through 69 in the State of New York are caused by diseases related to cigarette smoking. As President of the ACS, Dr. Wendell G. Scott, of St. Louis, Mo., told the FTC that the Society will concentrate education efforts on teen-agers "because in them the habit has not been formed or deeply rooted" and on physicians "because they are the leaders in forming health opinion and health habits." Dr. Scott added: ".. .we are dealing with a major health problem that requires thoughtful, vigorous action from all of us." LEUKEMIA Leukemia is cancer of the blood-forming tissues. Long considered primarily a disease of children, it actually strikes many more adults, and at an increasing rate. In children it is usually the acute form and the survival period is shorter. Leukemia can be arrested for a time by newly developed drugs and combinations of drugs. There is no preventive or cure. Many scientists believe, however, that cures will be found for leukemia sooner than for any other cancer. In 1964, the ACS--already doing more against leukemia than any other national voluntary health organization--stepped up its service program for leukemic patients in accordance with existing service policies. The expanded program guide defines minimum services that should -23- RSV0024603 be made available. Nature and scope of support for a patient will differ from Division to Divi sion, from Unit to Unit, and will depend on local ability to meet the need through available re sources and funds. Leukemia patients often have extraordinary needs, and the expanded serv ice program will endeavor to supply them where feasible. In many areas, the services already offered by the Society and the community are excellent. If leukemia strikes, families in need are urged to consult the nearest ACS Unit to find out what help is available from the Society and other community agencies. As a service to physicians the Society has published a background booklet, Leukemia. dealing with diagnosis, treatment, differences between acute and chronic leukemia, and sup portive therapy techniques. As a service to the general public, the Society issued a pamphlet, Facts About Leukemia. Also contributing to a better understanding of this cancer form was the issuance of the public Affairs Committee, Inc. pamphlet Leukemia; Key To The Cancer Puzzle? written by ACS Science Editor Pat McGrady. There will be 17,000 new victims of leukemia in 1965, and over 14,000 deaths. The disease strikes both sexes and all ages. Most victims are adults. However, the disease constitutes ap proximately half the cancer cases of American children between ages 3-14 where cancer is the leading disease death cause. The ACS has always been in the forefront in the leukemia fight. The Society grants more money to research in leukemia than to any other site of cancer; 477 grants totaling $12,491,379 in the past seven years. In March 1964 there were 76 grants in the amount of $2,281,870 that were directly or indirectly related to leukemia. This program embraces the quest for a simple practical test to detect leukemia before it develops:'in the blood stream, the search for more ef fective drugs for treating the disease, and studies relating_to radiation, viruses and basic leukemic cell structure and function. INTERNATIONAL ASSOCIATION OF LARYNGECTOMEES Dedicated to the rehabilitation of those who have lost their voices to cancer, the IAL is the largest known voluntary organization of its kind. It was founded in 1952, and is supported by the American Cancer Society. It is composed of 100 member clubs in 38 states of the United States, in Canada, Israel, Australia, Japan and New Zealand. Other clubs in the U.S. and abroad are in process of formation. Stated purpose of the IAL is: "to promote and support the total rehabilitation of laryngectomized persons by the exchange and dissemination of ideas and information to the clubs and to the public; to facilitate the formation of new clubs; to foster improvement in laryngectomee programs; and to work towards the establishment of minimum standards for teachers of post laryngectomy speech." Programs of the IAL include: 1) seminars and institutes for prospective teachers; 2) public and professional education in first aid and artificial respiration required for laryngectomees; 3) registry of laryngectomized postlaryngectomy speech instructors; 4) international annual meetings; 5) encouragement of the new patient with helpful literature; 6) assistance in over coming the prejudices of employers, so that laryngectomees may obtain employment or re employment. IAL activities are administered by volunteer international officers and directors elected by dele gates of member clubs, and an appointed executive secretary, all laryngectomees. Voice thera pists, physicians and rehabilitation workers form an advisory board to act as voluntary consultants. -24- RSV0024604 Official publication of the Association is the bimonthly IAL News, circulated free to 15,000 persons in 45 countries. Ranging in membership from 10 to 300 laryngectomees, IAL clubs provide such services as individual and group speech therapy, psychological counseling, visits to new patients, safety training, public education and social activities. Assistance to clubs is encouraged by the ACS Service manual as a set policy of the Society. Many of the clubs are sponsored by Units and Divisions, and the club members, in turn, assist in the programs, projects and Crusade of the Society. UNFOUNDED CLAIMS FOR TREATMENT The ACS provides information to physicians and the public on unfounded claims concerning new or unproved methods of treatment for cancer, and aids in the creation or strengthening of state laws to control worthless cancer remedies. An index to such new or unproved methods in the Society's files has been issued. ECONOMIC LOSS CAUSED BY CANCER Each year cancer illness costs the national economy about 50,000 man-years of productivity. Cancer also costs American business and industry the loss of valuable executives at the peak of their efficiency and of trained workers at the height of their productivity. The dollar loss is inestimable. The annual hospital bill for cancer is estimated at about $450 million. Man's Progress Against Cancer CATEGORY Saved (alive five years after treatment) Uterine cancer Lung cancer Research support 1937 Fewer than one-in-five Chief cause of cancer death in women Mounting: no hope of control Less than $1,000,000 1964 One-in-three Death rate cut 50%. Could be reduced much more Still mounting: but upward of 75% could be prevented More than $215,000,000 Cancer clinics and registries approved by American College of Surgeons State control measures Chemotherapy 240 in USA and Canada Seven states Almost no research 963 -- plus expansion of teaching, research, treatment centers All 50 states Major research attack has produced 24 useful drugs One-in-two patients could be saved today by early diagnosis and prompt treatment. -25 - RSV0024605 OPPORTUNITIES FOR GROWTH While notable progress was made in 1964 in the fight against cancer, opportunities unmet because of insufficient funds continue to exist. Growth of the Society's programs, steadily maintained since the war, can be continued only through increasing public support. There follows a sampling of projects for which money is needed. 1. In research, the ACS last year spent approximately $12 million, but needs at least double that to adequately carry out its voluntary role in this field. Merely to maintain the pace in can cer research today, we need approximately $1 million, above to the current level of support, to meet needs for new equipment and added salary needs. We need an additional $2 million to allow ACS-supported scientists to explore the new ideas which arise in their laboratories. We need $2 million to allow new young scientists to enter our research program. We need an additional $1 million to continue to train new people entering this research field, and at least $750,000 additional to implement the Institutional Grants program. 2. The Society needs to stimulate research in the following areas; a) breast cancer, its cause and more effective diagnosis and treatment, as well as more research in basic endo crinology; b) epidemiology, further research into why certain individuals get cancer and others do not, and what their habits of living have to do with cancer prevalence and incidence; c) immunology, whether or not the body has a defense mechanism against cancer and, if so, ways to correct this system when it fails; d) behavior research, to find out why people, par ticularly young people, begin to smoke and why they find it difficult to give up the habit. These areas of research could absorb $5 million. 3. Expansion of the Clinical Fellowship program for training physicians in cancer. The So ciety should double the amount expended in this important life-saving area. Applications re ceived for the new award period beginning July 1965 numbered 387. Funds could support 243. In the Advanced Clinical Fellowship program for 1964-65, there were applications from 59 candidates, 35 of whom were under training July 1, 1964. 4. A new program of physician education is needed for short-term training of specialists in highly skilled techniques of cancer treatment such as the application of chemotherapeutic agents, new super-voltage x-ray therapy techniques and most recently developed surgical pro cedures. Each physician would receive 3 to 6 months of such training at $300 per month. Needed, another $1 million. 5. Some scientists believe that long before symptoms appear people who are to become ill dif fer biochemically from the healthy. The Society proposes an initial program to be conducted ad ministratively with a major medical center in a large city-probably New York City-which would collect and store samples of blood plasma from 60,000 healthy persons each year for six years, then freeze it to dormancy so that it could be compared biochemically with another plas ma specimen taken later when any of these people become seriously ill. Cost, about $6 million. 6. Employment of qualified personnel to initiate and conduct more imaginative service programs in Units and Divisions by enrolling and training volunteers who will marshal all the diverse manpower and resources of the community--nursing service, social workers, drugs, prostheses, medical supplies, etc--to provide whatever will contribute to the recovery or easement of the medically indigent cancer patient who is referred by his doctor. Needed here, up to $1 million to get such programs going in key communities throughout the land. 7. The Society has drafted a major public education attack on cancer to: a) recruit skilled health educators to enlist and train thousands of volunteers to intensify public education efforts in high-population areas; b) strengthen program through exploratory and evaluation studies of health behavior and present educational techniques; c) provide more educational materials, particularly for training volunteers. Estimated cost; $300,000 first year, expanding to $1 million in fifth and last year. - 26 - RSV0024606 THE VALUE OF THE ACS CRUSADE The annual Cancer Crusade saves lives and raises funds. During the Crusade, volunteers bring their neighbors life-saving information and at the same time accept contributions to vital programs of research, education and service. The Crusade focuses national, state and local attention on cancer - on progress being made, on problems lying ahead. During this period people learn more about this disease and how to take personal action against it. In newspapers, on television and radio, in magazines, in person-to-person appeals, the story of the individual's role in cancer control and of the need for funds is told. The Crusade is a key opportunity for men and women to demonstrate actively their concern for one of our nation's critical problems. Independent drives are part and parcel of the American way of life. Colleges, museums, hospitals,, and other civic projects are largely supported by separate drives. Independent drives raise the largest share of the $9.3 billion contributed annually to private philanthropy. Over $500 million are raised by United Funds. In city after city there are strong United Funds and strong independent drives. Both ways of fund raising have advantages; the one need not and usually does not weaken or attack the other. Over the last 25 years cancer has taken the lives of more than 5,400,000 American men, women and children. Many who have lost a relative or close friend to cancer are leaders in the Society's 2,000,000 volunteers. Their personal experience with cancer gives them a motiva tion; they could not be satisfied to work with an organization whose purposes, goals, and message were merged with dozens of others in a United Fund. United Funds in general in crease their allocations to member agencies as the community grows; their programs ar^ re lated to the expansion and the competing demands of the community. That is why, even in the days when the Society followed a policy of local option, the great majority of its Units were never members of United Funds. One of the central concepts of the volunteers of the American Cancer Society is their sense of urgency. They want the killer cancer brought under control as quickly as possible. The deaths last year of some 290,000 Americans vividly demonstrate the need for far more funds than are now being raised. Volunteers for the American Cancer Society feel they work, give, and collect funds for a national need that is overriding in its importance - the need to end the waste, anguish, and despair caused by cancer. National research committees carefully screen and approve re search projects, in all parts of the country. Films and brochures that deal with the extraordi nary complexities of cancer are prepared by national staff working with national committees of volunteers. The national perspective is vital in the fight on cancer. Every home owner knows the nuisance of too many drives, too many people calling and asking for funds by telephone, by letter, by visit. Several years ago the American Cancer Society joined the American Heart Association in a call for a responsible study of multiple health campaigns to set priorities and standards for giving for the public. The Society scrupulously observes high standards of fund raising and the standard accounting principles of the National Health Council. Based on careful studies by committees of scientists and laymen, the Society hopes to increase its annual support of research, education and service to $60 million in 1970. This will require the kind of dedication, the intense determination, that volunteers feel after they have been close to cancer's cruelty. When control of cancer is finally achieved the ACS will close its doors forever. The more successful each Crusade, the sooner that day. -27- RSV0024607 THE ACS AND THE CANCER CRUSADE The Society WHAT THE ACS IS: The American Cancer Society, Inc., is a voluntary organization of more than 2,000,000 Americans united to conquer cancer. It is the only national organization fight ing cancer through balanced programs of research, education and service. A fundamental policy of the Society is the decision of its Board of Directors to terminate its activities when the control of cancer is finally established. HOW ORGANIZED: The American Cancer Society, Inc. is composed of a National Society, with 59 chartered Divisions, and 3,104 Units. THE NATIONAL SOCIETY: A 176-member "House of Delegates" provides a basic represen tation from the 59 Divisions and additional representation on the basis of population. It is governed by a Board of Directors of 104 voting members, half physicians and half laymen. The National Society is responsible for over-all planning and coordination, and provides technical help and materials to Divisions and Units. The National Society administers the ACS research program, a program of medical grants and clinical fellowships, and is charged with carrying out programs of public and professional education on the national level. THE 59 DIVISIONS: These are governed by 3,222 members of Divisional Boards of Directors, again half medical and half lay, in all the states, including Alaska and Hawaii, eight metro politan areas, and the District of Columbia. More than 14,000 physicians and dentists serve as volunteers on Division and Unit Boards. THE UNITS: The Society's 3,104 Units are slightly more numerically than the total number of counties in the U.S. -- 3,070. There are 54,883 community leaders who direct the Society's programs at this "grass-roots" action level. The strength of the Society lies in the more than 2,000,000 volunteers fighting cancer in their communities. The Cancer Crusade THE TIME: The Spring, reaching a climax in April, which is designated "Cancer Control Month" by the President of the United States. THE GOAL: Unlimited dollars to wage an unlimited fight to help save through research all Americans who now die of cancer, and to conduct the Society's life-saving education and service programs. THE THEME: "1,300,000 Americans are Cured of Cancer; to Help Cure More, Give More" supplementing the slogan "Fight Cancer With a Checkup and a Check." THE CRUSADERS: More than 2,000,000 volunteers join in bringing an encouraging message of hope and educational materials about cancer to their friends, their neighbors and their col leagues -- and accept contributions for the cancer control program. THE TEMPO: The public has given generous and growing support to the Crusade. In 1944, the Society raised $800,000; in 1954, the figure was $21,700,000; in 1964, more than $33 mil lion, giving the Society a total of over $41 million from all sources. - 28 - RSV0024608 SOURCES OF INCOME Financial support of the American Cancer Society in 1964 reached over $41 million from all sources. The Cancer Crusade raised over $33 million. National Headquarters and chartered Divisions received more than $8 million from bequests and legacies. Legacy Income Legacies - in which the Society becomes beneficiary of willed funds - is an increasingly important source of ACS income. Income from legacies indicates confidence in the leadership of the Society and a determination by many to continue the fight against cancer even after their lifetime. This form of income, since 1952, in relation to Crusade receipts, is shown in the following table: Year 1952 1953 1954 1955 1956 1957 Crusade $16,438,184 19,802,980 21,670,152 24,427,102 27,234,613 29,659,508 Legacies $ 590,123 883,959 1,181,207 1,183,439 1,765,849 2,281,479 Year 1958 1959 1960 1961 1962 1963 Crusade $29,796,676 30,372,944 28,356,626 30,791,708 33,313,773 33,151,138 Legacies $2,894,239 4,237,179 5,372,115 6,151,247 5,758,100' 7,608,928 - HOW ACS FUNDS ARE ALLOCATED RESEARCH (34%) -- Providing grants to key scientists, program grants to institutions, and epidemiological research studies. PUBLIC EDUCATION (20%) -- Providing the programs and materials which bring people to physicians in time for early detection, when most cancers are readily curable. PROFESSIONAL EDUCATION (9%) -- Providing physicians with latest information growing out of ongoing cancer research and clinical ex perience. SERVICE (19%) FUND RAISING (10%) - Providing detection, diagnosis, treatment and rehabilitation facilities, plus home services for patients and their families. -- Providing for the Society's annual Crusade meetings, travel, training schools for volunteers, etc. ADMINISTRATION (8%) -- Providing support of programs, Board and committee meetings, travel, purchasing, accounting, etc. TOTAL (100%) - 1963-1964 PROGRAM BUDGET 29 - RSV0024609 WHAT ACS DOLLARS BUY Here are examples of a few of the actual expenditures met by the American Cancer Society in support of its cancer control programs. In connection with research items, costs vary from institution to institution, and the prices listed below can only approximate what the cancer research dollar buys. $1 . . . One chemical flask $5 . . . Five dozen tissue culture tubes $10 . . . One month's supply of microscope slides $15 . . . Ten rats, three pure-bred rabbits, or food and care of 1,500 mice for one day $20 . . . One mouth rebreathing apparatus and nebulizer $35 . . . One day's supply of radium needles $50 . . . One instrument sterilizer $70 . . . One blood cell calculator, used in leukemia studies $100 . . . One week's salary for a research associate having an advanced technical degree $125 . . . One lead shield for radiation experiments $135 . . . One clinical centrifuge $150 . . . Two monkeys $200 . . . One camera lucida $250 . . . One isotope scanner $500 . . . Microvolt ammeter $1,000 . . . Fifty units of human serum $2,600 . . . One heart-lung machine for drug perfusion $6,000 . . . One half gram of cobalt 60 for radiation research $35,000 . . . One electron microscope $100,000 . . . High-voltage, total body radiation instrument $1,000,000 . . . One adequately equipped cancer research laboratory for 25 technicians How ACS Total Income Compared With Other Types of Voluntary Spending in 1963 (ACS Total Income, 1963: $40,760,066) Category Alcoholic Beverages Tobacco Products Toilet Articles and Preparations Jewelry and Watches Admission to Motion Pictures Pari Mutuel Net Receipts Admission to Spectator Sports Approximate Amount $11,080,000,000 8,112,000,000 3,525,000,000 2,260,000,000 1,275,000,000 616,000,000 301,000,000 Ratio to Cancer Contributions 272 times as much 199 times as much 86 times as much 55 times as much 31 times as much 15 times as much 7 times as much - 30 - RSV0024610 THEY MIGHT HAVE LIVED Cancer strikes all people, from the noblest to the meanest, richest to poorest, and some of the most gifted are among its victims. Each year cancer takes many leaders from the worlds of government, science, sports, the arts-frequently at the height of their careers. If a general cure or preventive for cancer had been found in their time, some of the following might have lived longer to influence their respective fields and the course of contemporary history. From August 1963 to September 1964, chronologically, cancer took the lives of these wellknown figures, among others: Playwright Clifford Odets, Bridge Expert Sidney Silodor, Ambas sador James D. Zellerbach, Actor Richard Barthelmess, Orchestra Leader Glen Gray, pacific Gas & Electric Chairman Norman R. Sutherland, Sculptor Bernard Reder, General Mills Chair man Harry A. Bullis, Golf Champion Horton Smith, General John Reed Hodge, Author Aldous Huxley, Hearst Publications Chairman J. D. Gortatowsky, Colorado's ex-Governor John C. Vivian, Yale professor Alexander M. Witherspoon, Expressionist Painter Nicholas Takis, Football Coach Ray (Scooter) McLean, New York City's First Lady Susan Edwards Wagner, King Paul of Greece, Movie Magnate George p. Skouras, Author-Naturalist Rachel Carson, Painter-Sculptor Rico Lebrun, Novelist Hamilton Basso, Mining Heiress Margaret Schulze Downey, Industrialist Arthur H. Bunker, Lieut. Gen. Alexander R. Bolling, Author-Historian Bradford Smith. Other cancer victims especially eminent in their fields were; Secretary of State John Foster Dulles, House Speaker Sam Rayburn, Senators Robert A. Taft and Brien McMahon, Ambassador Joseph Drexel Biddle, Generals Claire L. Chennault, Hoyt S. Vandenberg, Joseph (Vinegar Joe) Stilwell, Yale University President A. Whitney Griswold, Ford Foundations President Horace R. Gaither Jr., Nuclear Scientists Enrico Fermi and Martin D. Whitaker, Jungle Doctor Tom Dooley, Dr. John Von Neumann. From the arts: Painter William Baziotes, pianist Alec Templeton, Ballet's the Marquis de Cuevas, Choreographer Doris Humphrey, Architect Eero Saarinen, Gastronomist Duncan Hines, Coloratura Amelita Galli-Curci, Baritone John Charles Thomas, Composer Percy Grainger, Jazzman Sidney Bechet, Bandleader Leo Reisman, Designers Jacques Fath and Claire McCardle. Authors: Ludwig Bemelmans, Oliver La Farge, Van Wyck Brooks, Boris Pasternak, Damon Runyon, James Hilton, Betty McDonald, Vicki Baum, Harold Lamb, Gertrude Stein. Movie stars: Gary Cooper, Dick Powell, ZaSu Pitts, Charles Laughton, Thomas Mitchell, Hoot Gibson, Jack Carson, Humphrey Bogart, Kay Kendall, Marion Davies, Leo Carillo. The theater's: Oscar Hammerstein II, Guthrie McClintic, Mark Hellinger, George M. Cohan, Gertrude Lawrence, Jane Cowl. Sports figures: Ernie Davis, George Trautman, Robert Carl Zuppke, Willie Hoppe, Babe Ruth, Ty Cobb, Babe Didrikson Zaharias, Ed (Porky) Oliver, Bill Corum, Bill Cunningham. Industrialists: Irving Sands Olds, Frederick Maytag II, Robert Ellsworth Gross, Samuel Zetnurray, Charles R. Hood; Banker George Whitney; Investment Counsellors Ira Haupt and Paul V. Shields. -31 - RSY0024611 CHARTERED DIVISIONS OF THE AMERICAN CANCER SOCIETY, INC American Cancer Society Alabama Division, Inc, 2029 Warrior Road Birmingham, Alabama 35208 American Cancer Society Alaska Division, Inc. Valentine Building Juneau, Alaska 99801 American Cancer Society Arizona Division 4700 N, 12th Street Phoenix, Arizona 85014 American Cancer Society Arkansas Division, inc, 1012 West Second Street Little Rock, Arkansas 72203 American Cancer Society California Division 875 O'Farrell Street San Francisco, California 94109 American Cancer Society Colorado Division 1764 Gilpin Street Denver, Colorado 80218 American Cancer Society Connecticut Division, Incorporatei 1044 Chapel Street New Haven, Connecticut 06510 American Cancer Society Delaware Division, Inc. Academy of Medicine Building Lovering Avenue and Union Street Wilmington, Delaware 19806 American Cancer Society District of Columbia Division, fne. 810 18th Street, N.W. Washington, D. C. 2000$ American Cancer Society Florida Division, Inc. 416 Tampa Street Tampa, Florida 33602 American Cancer Society Georgia Division, inc. 2025 Peachtree Road, N.E. Atlanta, Georgia 30309 American Cancer Society Hawaii Division, Inc. Hale Pono Building 625 Keeaumoku Street Honolulu, Hawaii 96814 American Cancer Society Idaho Division, inc, 726 Vista Avenue Boise, Idaho 63705 American Cancer Society Illinois Division, Inc. 37 South Wabash Avenue Chicago, Illinois 60603 American Cancer Society Indiana Division, Inc. 215 East New York Street Indianapolis, Indiana 46204 American Cancer Society Iowa Division, Inc. 117V* North Federal Avenue Mason City, Iowa 50402 American Cancer Society New Hampshire Division, Inc. 16 Bridge Street Manchester, New Hampshire 03101 American Cancer Society Kansas Division, Inc. 824 Tyler Street Topeka, Kansas 66612 American Cancer Society Kentucky Division, inc. Medical Arts Building 1169 Eastern Parkway Louisville, Kentucky 40217 1 American Cancer Society New Jersey Division, Inc. 621-3 Central Avenue Newark, New Jersey 07107 American Cancer Society New Mexico Division 1323 Central Avenue, N.E. Albuquerque, New Mexico 87106 American Cancer Society Louisiana Division, Inc. 348 Baronne Street New Orleans, Louisiana 70112 The American Cancer Society Maine Division, Inc. Corner Fedora) and Green Streets Brunswick, Maine 04011 American Cancer Society Maryland Division, Inc. 20 . Eager Street Baltimore, Maryland 21202 American Cancer Society (Massachusetts Division), Inc, 138 Newbury Street Boston, Massachusetts 02116 American Cancer Society Michigan Division, Inc. 1205 East Saginaw Street Lansing, Michigan 48906 American Cancer Society Southeastern Michigan Division, inc. 2695 West Grand Boulevard Detroit, Michigan 48202 American Cancer Society Minnesota Division, Inc. 3702 E. Lake Street Minneapolis, Minnesota 55406 American Cancer Society Mississippi Division, Inc. 733 North State Street Jackson, Mississippi S9201 American Cancer Society New York State Division, A Corporation 1010 James Street Syracuse, New York 13203 American Cancer Society Nassau Division, Inc. 1551 Kellum Place Mineola, New York 11501 American Cancer Society New York City Division, Inc. 7 East 52nd Street New York, New York 10022 American Cancer Society Queens Division, Inc. 118.55 Queens Boulevard Forest Hills, Now York 11375 American Cancer Society Suffolk Division, Inc. 297 Main Street Sayville, New York 11782 American Cancer Society Westchester Division, Inc. 107 Lake Avenue Tuckahoe, New York 10707 American Cancer Society North Carolina Division, Inc. 705 West North Street P.O. Box 5547 Raleigh, North Carolina 27607 American Cancer Society Missouri Division, Inc. 715 Jefferson Street P.O. Box 505 Jefferson City, Missouri 65102 American Cancer Society North Dakota Division, Inc. 510 Fourth Avenue North Suite 502. Universal Bldg. Fargo, North Dakota 68102 American Cancer Society Montana Division, inc. 3022 Fourth Avenue, North First Fed. Savings & Loan Bldg. Billings, Montana 59101 American Cancer Society Nebraska Division, Inc. 4201 Dodge Street Omaha, Nebraska 68131 American Cancer Society Ohio Division, Inc. 1367 E, 6th Street Cleveland, Ohio 44114 American Cancer Society Oklahoma Division, Inc. 1401 North Robinson Street Oklahoma City, Oklahoma 73103 American Cancer Society Nevada Division, Inc. 101 West Arroyo Street Reno, Nevada 89502 American Cancer Society Oregon Division, inc. 729 S.W. Alder Street Portland, Oregon 97205 American Cancer Society Pennsylvania Division, Inc, 301 Muench Street P.O. Box 2667 Harrisburg, Pennsylvania 17106 American Cancer Society Philadelphia Division, Inc. 20 South 15th Street Philadelphia, Pennsylvania 19102 American Cancer Society Rhode island Division, Inc. 333 Grotto Avenue Providence, Rhode Island 02906 American Cancer Society South Carolina Division, Inc. 401 The Columbia Bldg. Columbia, South Carolina 29201 American Cancer Society South Dakota Division, Inc. 1st Citizens National Bank Bldg. Watertown, South Dakota 57201 American Cancer Society Tennessee Division, Inc. 121 Seventeenth AveM S. Nashville, Tennessee 37203 American Cancer Society Texas Division, Inc. 5014 Bull Creek-Road_ Austin, Texas 78731 American Cancer Society Utah Division, Inc. 176 Social Hail Avenue Salt Lake City, Utah 84111 American Cancer Society Vermont Division, Inc. 8 Langdon Street P.O. Box 412 Montpelier, Vermont 05602 American Cancer Society Virginia Division, Inc. 303 W. Franklin Street Richmond, Virginia 23220 American Cancer Society Washington Division, Inc. 123 West Harrison Street Seattle, Washington 98119 American Cancer Society West Virginia Division, inc. 325 Professional Building P.O. Box 267 Charleston, West Virginia 25S21 The American Cancer Society Wisconsin Division 704 East Gorham Street P.O. Box 1626 Madison, Wisconsin 53701 American Cancer Society Milwaukee Division, Inc. 728 North Jefferson Street Milwaukee, Wisconsin 53202 American Cancer Society Wyoming Division, Inc. 1118 Logan Avo, Cheyenne, Wyoming 82001 National Headquarters: American Cancer Society, lnc.# 219 E. 42nd St,r New York, N. Y. 10017 20QM-10/84No. 7008 RSV0024612