Motion and still pictures tell the cancer story clearly and quickly. Many hundreds of still pictures showing research and other cancer activities were taken during the year. Especially noteworthy was the release of the society's color motion picture, Man Alive, produced by UPA, creators of Gerald McBoing-Boing and Mr. Magoo, employing clever psychological characterization to stir men from a dangerous apathy concerning the threat of cancer to them. Life magazine, with about 13 million readers, devoted 4 full pages to a highly favorable review of Man Alive, saying "grim but funny." The Saturday Review of Literature, in a roundup of comment on meritorious educational films, said "local and State cancer groups have done remarkably well in having their films brought to the public eye *** Man Alive makes a lively and sensible addition to any kind of adult film program." By the end of the year, the picture was being widely shown in commercial theaters in divisional areas, as well as to many smaller gatherings. Six hundred and thirty 16 mm. prints were in use by the divisions at the year's end. Breast self-examination, the effective 10-minute movie jointly produced by the society and the National Cancer Institute to lead the precision attack against breast cancer, continued to be widely shown in 1952. About 2 million women have seen the picture since its release 2 years ago. But nowhere near enough women have yet seen the film or learned the wholesome health practice it teaches. In radio and television the national society was greatly aided in 1952 in the educational work of the April appeal by a skilled advisory committee for radio and television on which 30 advertising agencies were represented. In result, the usual support of the radio and television networks during April was more generous than ever. The national office produced and distributed through the divisions in 1952 for local radio stations 450 sets of a new series of transcribed dramatic programs on cancer, But Where Today? Well received, also, by local stations was a new series of musical transcriptions, Songs for America, each with a 3-minute cautionary message from the society-715 sets were employed by the divisions. Slides and other visual materials for television were also provided in large numbers. Cancer News, the national society's popular magazine, was given a new format in 1952 and a new appeal for the general reader in illustration and content. It reached with timely articles on developments in the cancer control movement 70,000 readers every quarter. The ACS Bulletin, a fortnightly for operational personnel, continued its aid on "how-to-do-it" for volunteers, division and unit staff people. Circulation is 13,000. Service to divisional educational activities required the production and shipment on order of the divisions of 12,888,390 pamphlets, 168,705 posters, 1,648 films, 6,871 cardboard-display units, 1,326 sets of radio transcriptions, and 169 sets of TV films and slides. The count does not include educational materials prepared by the national office for divisional use in the April appeal-in all, some 40 million additional pieces. An important technical service of the year to the divisions was the completion of a new Handbook for the Public Education Chairman of a Unit of the American Cancer Society. The handbook reflects experience in community educational activities of postwar years. In it, permanent programs are outlined under five main heads-mass media, business and industry, organized groups, schools and colleges, and neighborhood programs. The divisions aided in the preparation of the booklet, indeed it was their hard work which formed it. It should go far to strengthen community educational activities in coming years. Divisional and unit educational programs owe much to local leaders in health and adult education. For this reason, the national society participated in 1952 in national conventions of the American Public Health Association, and the National Association for Adult Education. It joined in meetings of the American Library Association, the National Conference of Social Work, the National Science Teachers Association, the National Conference for Cooperation in Health Education, the Society of Associated Industrial Editors, and for the second year, in a joint conference of the Industrial Medical Association, American Association of Industrial Nurses, and the American Association of Industrial Dentists. It continued its effective liaison with the United States Public Health Service, the Extension Service of the United States Department of Agriculture, the United States Office of Education. Professional education The doctor's office is the key. Will people, in the mass, go to it in time? Will the doctor-and he has seen too much late cancer-be able when people come to him to detect the beginnings of the actual disease? It will be fatal if not treated early. Shall we wait for the sure, quick, cheap test-the certain cure or shail we try it now, the hard way? All the doctor's instincts, and actions of his official associations as represented everywhere in society councils, say try now-the hard way. The society's professional educational program is based on that decision. The effort is idle if the doctor has not made the decision himself. What doctors want, they say in the aggregate, is help for the average practicing physician in his fight with the disease as he must meet it in his office, in his round of calls. The society's professional educational program is designed to give him every help. The program emphasizes earlier detection and diagnosis. It seeks to take to the doctor in all parts of the country tests for cancer such as the effective smear test and to encourage, as routine, better-known procedures such as chest X-rays for lung cancer. It seeks to back up this information with established information on treatment procedures, so that when the diagnosis is made treatment will be positive, prompt, the best available. Once again, in 1952, the national society made wise use of publications in professional education. It continued to publish and distribute through the divisions to 54,240 readers, CA-a Bulletin of Cancer Progress, the society's effective bimonthly digest of cancer information for the general practitioner. It continued its support for Cancer, the distinguished bimonthly for physicians and scientists specializing in the cancer field. It continued in Cancer Current Literature, to issue the only monthly index of world cancer literature, widely consulted and made use of in medical libraries, schools of medicine, research and medical institutions. The national society released during the year the seventh and eighth of the Cancer Monograph Series on early diagnosis for general practitioners. The new titles are "Cancer of the Esophagus and Stomach" by Dr. Owen H. Wangensteen, and the "Value of Early Diagnosis of Malignant Lymphomas and Leukemias” by Dr. Lloyd F. Craver. The monographs were distributed in 1952 to 190,000 practicing doctors, hospital residents, and internes. Late in 1951 the medical teaching film Uterine Cancer; the Problem of Early Diagnosis, was introduced to the profession at the interim session of the American Medical Association at Los Angeles. The fourth in a series jointly sponsored by the society and the National Cancer Institute, the film emphasizes the detection of cancer of the uterine cervix in the noninvasive stage when cure rates of 75 to 100 percent are possible. The precision detection technique of vaginal smears is demonstrated in the picture. In its review the Journal of the American Medical Association said "highly recommended for the general practitioner, the advanced medical student, and hospital staff meetings." Since the start of the professional film series 5 years ago, 922 prints of the four films produced have been distributed: 352 to divisions, 192 to State health departments, 136 to medical schools, 119 to foreign countries, 193 to the Department of State, Armed Forces Medical Services, and other agencies. The national society expanded the services of its professional film library during the year; the 622 requests accommodated nearly doubled those of any previous year. One hundred and eighty-eight sets of the society's kodachrome slide library of 482 slides of lesions of early cancer were in use by medical lecturers in 1952. Several new exhibits were made available for medical meetings during the year. A comprehensive exhibit on cancer of the uterus was first shown at the June convention of the American Medical Association. An exhibit on lung cancer was introduced at the annual meeting of the National Tuberculosis Association in Boston in May. A new exhibit for nurses had its initial showing at the 1952 biennial nursing convention in Atlantic City in June. Clinical fellowships program The national society's fellowship program for younger physicians has become the most comprehensive medical fellowships entrprise undertaken by any organization-voluntary, governmental, or private. Since its beginning in 1948 through June 30, 1952, 202 younger physicians of promise have received advanced training in medical specialties bearing on cancer, such as surgery, radiology, internal medicine, pathology, and gynecology. At the end of the academic year on June 30, 70 physicians were in training in 35 institutions. At the beginning of the new training period on July 1, the number was increased to 75 physicians in 36 institutions. In addition, the society gave financial support in 1952 aiding the training of 43 younger physicians in the 4-year training system of the Memorial Cancer Center in New York. What is more, medical institutions approved for graduate training have been informed the society's fellowship program will be expanded, effective July 1, 1953, to allow the advanced training of 88 physicians in that year. In 1952, additional fellowships in exfoliative cytology were awarded to 8 pathologists, bringing to 38 the number receiving training since 1948 in this vital diagnostic technique. This sustained training activity is saving lives today, in every State through the influence of these specially trained physicians. It is carried as a regular portion of the budget of the national society; $330,840 was devoted to the program in 1952-$900,195 since 1948. National cancer meetings The exchange of knowledge between physicians and research workers is of the highest importance in the fight against a disease so complex, varied, and little understood as cancer. In cooperation with medical and scientific groups, the society supports these meetings in many forms-refresher courses, seminars, teaching days, clinics-national, within the divisions, in cities and counties of the units. At the national level, the society and the National Cancer Institute sponsored the first national cancer conference, held at Memphis in 1949, attended by over 600 doctors and scientists. In 1952, the society joined with the Institute and the American Association for Cancer Research in support of the second national cancer conference, held in Cincinnati in March. At Cincinnati, more than 1,400 physicians and scientists from all parts of the United States and several foreign countries heard 325 presentations summarizing recent clinical and research findings on cancer. Proceedings of the conference are being published by the society. Scientific sessions of the annual meeting of the society in October brought together another group of over 1,000 physicians for a 3-day discussion of radiation versus cancer; a critical evaluation. Published proceedings of the sessions will be made available to the profession in the near future. A smaller meeting of medical leaders sponsored by the national society in 1952 was the lung cancer conference, held at Chocorua, N. H., in September. Six forms of cancer now open to a high measure of control 1. Monthly self-examination of the breasts by women over 35 will uncover more breast cancer in early stage. 2. Semi-annual pelvic examinations of all women will disclose more early uterine cancer. 3. Semi-annual chest x-rays of all men over forty-five will reveal more early lung cancer. Miscellaneous grants 4. Annual digital and proctoscopic examinations can identify most rectal cancer in curable stage. 5. Regular examinations of the oral cavity and larynx will find cancer when highly curable. 6. Examinations of the skin are performed in a few minutes and will detect early skin cancers when most are curable. The grants are made upon recommendation of the medical and sicentific committee to support nonresearch undertakings which further the control program. In 1952, the American College of Surgeons, the World Medical Association, l'Union Internationale Contre le Cancer, the Commission on Chronic Illness, the American Association for Cancer Research, the Committee on Cancer Diagnosis and Therapy (National Research Council), among others, received support. Thirty-eight requests for grants of this character were received during the year, of which 19, totalling $74,120 were acted upon favorably. Service to the cancer patient As service must be extended where patients live, most of it is conducted by the divisions and their community units. Nevertheless, problems of the cancer patient are foremost considerations of the national society. How can this difficult sociomedical problem, often involving whole families in later stages of the disease, best be handled? Seven hundred thousand persons are ill of the disease today. Over 500,000 new cases are diagnosed each year. Their care is a large burden for the Nation. Certainly, the most practical tactic is to increase the number of persons cured of cancer. Public education helps, so also professional education and research. One attack with present knowledge is through cancer diagnostic and treatment clinics in general hospitals which bring to bear on the patient all the knowledge of the hospital staff and the hospital's clinical equipment. The divisions support these clinics with money and many voluntary services. Only 655 clinics had been approved by the American College of Surgeons at the end of 1952. general agreement that many more are needed. There is Notable have been enabling grants, since 1947, to the American College of Surgeons to establish standards for clinic operations believed desirable by the medical profession. Assistance to nursing organizations have been helpful. Useful also have been recommendations and services of the national society in the recordkeeping of clinics-essential in patient management and for evaluation of treatment procedures. Field relations and administration All parts of the society must work together-the national society, the divisions, the units-doctors and lay persons-advisory committees-voluntary workers and staff members. The exchange of information is vital. Many devices are employed by the national society, and encouraged within the divisions. Mention has been made of Cancer News and the ACS Bulletin. But seminars, conferences, training meetings of all kinds, are vigorously employed. During 1952, the divisions reported 2,846 separate meetings, attended by an estimated 77,445 volunteers and staff persons. At the annual meeting of the national society, besides discharge of stated business of the board and the election of directors and officers, there is a refresher activity. Four hundred volunteers and staff people from all parts of the country attended the 1952 meeting in New York in October. Over 1,000 doctors attended the medical and scientific sessions. An innovation of the 1952 meeting was a special seminar for selected divisional and national board members. At the 1952 annual dinner a number of individuals were honored by the society for signal contributions to the control of cancer. Upon this occasion Dr. George N. Papanicolaou and Dr. Herbert F. Traut were awarded the society's medal for their outstanding development of the cytologic method of cancer examination. Also honored with other society's citations were Senator Dennis Chavez, of New Mexico, and Representative John E. Fogarty, of Rhode Island, for their leadership in enactments by Congress of cancer control legislation. A distinguished service award was made to the Columbia Broadcasting System television feature, See It Now, produced by Edward R. Murrow and Fred W. Friendly, for a national telecast of the cancer Thanksgiving service to patients. It is used as a source book on celebration, held at Cedar Rapids, Iowa, in April. Visits to divisions of national office field representatives are valuable aids to the interchange of information. Under direction of the department field relations, these trained members of the national staff consult with the divisions on a wide range of problems-education, service to the patient, training, management, finance, the April campaign. In 1952, several technical studies of administrative problems were completed upon divisional request. A total of 868 mandays were employed in 54 divisions in these activities. Members of the medical and scientific department staff are also frequently in the field to address professional meetings. In 1952, the staff of the statistical research section traveled to many States for training and supervisory actions on the smoking study and other duties. So also, representatives of the public relations department and the comptroller's office made visits to the divisions for problems in their areas. A total of 1,897 man-days in 58 divisions was employed by the national staff in this basic activity in 1952. Relations with the National Cancer Institute As has been noted the Director of the National Cancer Institute is a member of the national board. Correspondingly, James S. Adams, chairman of the research committee of the board, is a member of the National Advisory Council of the Institute and Dr. Frank Adair, former president of the society and board member, and Dr. Charles S. Cameron, medical and scientific director and vice president, are respectively chairman and member of the Control Grants Section Committee of the Institute. In 1952, so as to strengthen the liaison between the society and cancer control programs of the Federal Government, a Washington representative was appointed by the society. In February, Mr. Adams, Dr. Cameron, and a group of distinguished research scientists and physicians-Dr. C. P. Rhoads, of New York; Dr. Sidney Farber, of Boston; Dr. Leon O. Jacobson, of Chicago-presented testimony before House and Senate committees in support of more adequate appropriations for the work of the Institute. Congress increased by more than $2 million the funds which will be available to the Institute in 1953-$17,887,000 as against a proposed appropriation of $15,371,000. These funds will be expended for research and medical education, and in official control projects within the States, thus helping in the expansion of many phases of the society's attack on cancer. Finance fiscal control The national society leadership responsibility is exemplified by budget procedures established in recent years to control expenditures and in the financial accounting of the National Society and its 61 divisions. The society follows latest developments in accounting practices so that its affairs will be administered on a basis comparable to an efficiently conducted major business. Expenditures from the 15 percent of contributions accruing to the national society are controlled by a budget processed well in advance of the start of the fiscal year. Departmental budgets are prepared, coordinated into an overall budget, further reviewed by the finance committee of the board before board approval. When approved, the budget becomes a guide and control for expenditures. In practice, in the 1952 fiscal year, the cost of the national society's program was $2,309,000-95.8 percent of the announced budget of $2,410,000. Expenditures from the 25 percent of gross annual contributions allocated to the national research program are controlled with similar care. Applications for research assistance are studied by the research committee of the board or the committee on growth before grants are made by the board. Grantees are required to submit detailed budgets outlining proposed expenditures. They must furnish periodic reports of expenditures and adhere to the society's regulations on grants. Further controls provide for visits by national office auditors to check reports of expenditures with the institutions' records. The national society works with the divisions in the establishment of similar practices with respect ot the 60 percent of total contributions employed in their programs. Charters of the divisions include standards providing for the submission of budgets aproved by divisional boards and adequate narrative explanation. Divisions also furnish the national society with audited annual financial reports prepared by independent public accountants. From these reports, a combined budget and combined financial statement are prepared and published each year by the national society. The society takes pride in having been the first national voluntary health agency with geographical divisions throughout the country to present such a report to the public. For the 1952 fiscal year, the society's total combined program budget was announced as $15,891,000, whereas the actual cost was $15,325,000--96.4 percent of the forecast. Below is a graph of the society's 1952-53 combined budget-for details. |