After the beginning of the "war on cancer" in 1971 (1
), there was a gradual buildup of cancer prevention, research, and treatment initiatives. By the end of the 1980s, however, the observable effect in reducing the incidence and mortality from cancer was less than had been anticipated. Even with the new research and program initiatives launched by CDC, the National Cancer Institute (NCI), and the American Cancer Society (ACS), it was unclear whether the goals set in the US Public Health Service's Healthy People initiative (2
) and NCI's Cancer Control Objectives for the Nation: 1985-2000
) would be met.
What was needed was a more comprehensive and integrated approach that involved state agencies, local governments, private industry, professional organizations, volunteer organizations, the media, and other sectors affected by cancer (1
In 1994, CDC, along with ACS, NCI, the Commission on Cancer of the American College of Surgeons, the North American Association of Central Cancer Registries, the Intercultural Cancer Council, the National Association of Chronic Disease Directors, and other public health leaders at state and national levels began promoting a comprehensive approach to cancer control. The approach coordinated and integrated cancer prevention and control programs across traditional funding boundaries. These organizations were later joined by C-Change (formerly the National Dialogue on Cancer) and the Lance Armstrong Foundation to become the National Partnership for Comprehensive Cancer Control (National Partners). A critical part of the success in developing and sustaining the new approach came from the timely and coordinated assistance of the National Partners.
From 1995 through 1998, CDC held meetings and workshops to gather input on the feasibility of implementing cancer control programs at the state level. CDC also conducted a baseline assessment of existing efforts and case studies of cancer control planning processes. From this effort, CDC published the initial definition and framework for comprehensive cancer control (CCC), a description of the essential elements, and a planning model (4
In 1998, CDC began a pilot program that provided funding for 5 states and 1 tribal health board that had existing cancer control plans: Colorado, Massachusetts, Michigan, North Carolina, Texas, and the Northwest Portland Area Indian Health Board. This was the beginning of CDC's NCCCP. Miller et al describe these 6 programs in this issue of Preventing Chronic Disease