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STATEMENT OF M. R. RUNYON, EXECUTIVE VICE PRESIDENT, AMERICAN CANCER

SOCIETY

25

The American Cancer Society is a voluntary health agency incorporated under the laws of the State of New York as a membership corporation.

It has 60 divisions chartered to carry out its program of cancer control in every one of the 48 States, the District of Columbia, and Alaska, and affiliations with organizations in Puerto Rico, Hawaii, and the Canal Zone.

The 60 divisions have organized local units in substantially all of the 3,000 counties of the United States, so that its program is actually nationwide.

Funds which are collected from the annual drive are initially allocated three ways:

Percent National research program. Divisions' program of education and service, with some local research support--

60 National office for its share of the integrated program of education and service

15 This allocation of funds and division of effort has resulted in a coordinated nationwide program with little or no overlapping. Those things which can best be done nationally, such as laying out and supporting a nationwide program of research ; producing educational films for nationwide use; handling publicity for national media such as radio networks, wire services, magazines, etc., are done by the national society. Those parts of the program which can best be accomplished on a State level are done by the State division organization, and those parts of the education and service programs which can best be carried out locally are the responsibilities of the local county units of the State divisions.

Since 1948 the national society has published an annual report in which the total receipts and expenditures of the society are accounted for under the appropriate headings of education, research, and service, with the necessary administration and fund raising. This financial accounting is based upon audited reports and includes all county units, State divisions, and the national society.

The attached tables show total funds collected during the annual drive by the American Cancer Society since 1938; the purposes for which these funds have been expended since 1948; and a copy of the latest annual report of the society describing in great detail its attack on cancer at the national, State, and local level.

Money to fight cancer- -How increasing public awareness has swelled voluntary American Cancer Society, Inc.-National headquarters and chartered divisions

and tax funds to combat cancer

National Can.
cer Institute,

U. S. Public
Health Service,
appropriations,

American Can

cer Society
campaign

receipts,
year ended

Aug. 31

Year

National Can. cer Institute,

U.S. Public Health Service, appropriations,

American Can-
cer Society
campaign

receipts,
year ended

Aug. 31

Year

year ended

year ended

June 30

June 30

1938.
1939.
1940.
1941
1942
1943.
1944.
1945.
1946
1947

$133, 487.52
171,020.76
210, 165. 78
377, 388.07
285, 467.89
372, 057. 17

832, 862.00
4, 292, 491. 56
10, 106, 766.92
12, 126, 875.30

$400,000
400,000
570, 000
570,000
565, 000
534, 870
530, 000
561, 000

548, 700
1,772, 000

1948.
1949
1950.
1951.
1952.
1953..
1954.

$13, 221, 068. 76
13, 596, 661.54
13, 933, 638. 15
14, 974, 513. 69
16, 438, 184.65
319,800,000.00

1 $14, 500,000

14,000,000 2 18, 900, 000 3 20, 086, 000 4 19, 500,000

17,887, 000 20, 237, 000

Total.

120, 872, 649. 76

131, 561, 570

1 Includes construction cash of $2,303,000.
2 Includes $4,175,000 to liquidate construction contract authority.
3 Includes $5,000,000 to liquidate construction contract authority.
4 Includes $4,825,000 to liquidate construction contract authority.
Latest year estimate.

general and research fund expenditures actual Sept. 1, 1948, to Aug. 31, 1952, and budgeted Sept. 1, 1952, to Aug. 31, 1953

[blocks in formation]

1 Includes $1,584,750 approved for grants and fellowships for the 1953–54 research program.

1952 ANNUAL REPORT AMERICAN CANCER SOCIETY

FOREWORD

It can be said at the end of 1952 that we have come measurably closer to our goal—the control of cancer. We have made heartening progress in tooling up to save the tens of thousands of lives which can be saved today with present knowledge and for the research attack which will someday bring us freedom from cancer.

There is now strong promise of better weather ahead—but just how far ahead no one can say. Cancer is still an all-pervading biological problem of bafiling complexity. It is still a task of unusual and rather surprising difficulty to persuade men and women to take the simple steps necessary for their own protection. Cancer remains a scientific and social problem second to none we face today.

While the advance is necessarily slow, we can look back to the position of the control movement in 1945 and see the radical change which has occurred. In public knowledge of the disease, in the knowledge of our doctors and facilities at our hospitals, and in the determination, equipment, and vast increase in numbers of research investigators who devote their lives to cancer, notable advances have taken place. Perhaps we can say the great achievement of the years since 1945 has been defeating the spirit of despair and raising the spirit of hope. This new spirit can become contagious; once Americans are convinced they can win, they always do.

But here we must be careful. A long look forward is also needed. We must face the fact that the struggle may continue for years. Our victory will be hard bought. We cannot rest while we watch thousands die of this disease when they could be saved with present medical knowledge. Nor can we fail to nourish generously the widely developed and quickening research effort that has been brought into being in recent years.

These accomplishments are due in a large part to the volunteers, and the spirit of devotion which they have brought to the society. Most of the volunteers are impelled by their own personal tragic experience. In 1952, one of the most valiant of this army was claimed by the disease. In the death from cancer of Albert D. Lasker the society and the Nation suffered an irreparable loss.

No one gave more of himself because no one knew better the need for sustaining our effort with always greater strength, resourcefulness, and courage.

Because of the continuing vision and devotion of our volunteers we can face the future with confidence.

WILLIAM J. DONOVAN, Chairman, Board of Directors, 1952.

PROGRESS UP TO NOW

As 1952 draws to a close we ask ourselves of our progress in bringing under the control of mankind the centuries-old scourge of cancer. Daily, all of us face the grim facts: A wife, a mother, a husband, a cherished brother or sister, a father, a child, a gallant friend and coworker, a great and honored statesman,

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a famed actress, a wise philanthropist, dies of cancer. Approximately 1 in 7 still must go this way—many, far too soon, leaving tasks unfinished.

Certainly, no body of people can be more conscious of the painfully slow progress we appear to be making in the control of cancer than the hundreds of thousands—doctors, scientists, and lay persons together--who give their time or money to the work of the American Cancer Society. For they, most of them, know cancer at first hand and all of them have accepted the challenge which this disease lays down to the human spirit and to their energies. There is meaning, therefore, in the fact that such people today, in some measure are heartened.

It is proper, therefore, in these opening pages of the society's annual report for 1952 to state the facts which give courage to so many. As progress is slow, measured year by year, perspective is needed for the true picture. The society is today in its 39th year, but its present national program, including the now widespread program of research into the basic nature of cancer, dates only from 1945. Progress there was and no lack of determination before that time, but the full will of Americans to strike back at cancer required the historical opportunity which came, in due course, with a revival of concern for health problems at home and the reorganization of the society upon a wide national basis at the close of the World War period. Before 1945, our powers of attack had not been summoned in full strength. That so much has been done in so short a time, when it is known the struggle must be long, promises well for the future.

The collective “we” of the statement is employed unreservedly, for the accomplishment speaks for all and not those alone who are most concerned, as donors or workers, with the society's progress. We have good reason, all of us, to be encouraged by these achievements:

A powerful volunteer striking force: We have created under voluntary auspices in the American Cancer Society an instrument of the determination of the American people to strike back at cancer. It combines the knowledge of the physician, the scientist, the health educator, the social scientist, and the publichealth official, with the active concern of the private citizen. A program of action has been developed which each year becomes stronger, sharper, more accurately directed to the ultimate defeat of the disease. More people than ever before engaged in educational and service activities of the society in 1952. More people than ever before contributed to the financial support of the society in 1952-enabling the society for the second year in succession to exceed its announced goal and to maintain its attack with undiminished vigor.

A national research attack: The attack includes in its scope, and has included in the past 7 years, the major scientific institutions of the country, the accredited schools of medicine and research hospitals, and many hundreds of individual research scientists, physicians, and research technicians. A primary focus on cancer as a disease entity has been created from studies which in the past were dispersed-a concentration of effort which is resulting in a slowly but surely growing body of specific information on the nature of cancer in man. The society bears a large share of the responsibility for the aroused spirit of scientific inquiry concerning cancer which exists today.

Increased interest by physicians: With the warm cooperation of medical societies of all kinds and schools of medicine and nursing, we have encouraged members of the medical profession in all parts of the country to take a greater interest in cancer as a curable disease. Through the society we have supplied and are continuing to supply doctors with the latest and best information on approved treatment procedures, including diagnostic and detection techniques not commonly available a few years ago. The cancer patient today in many parts of the country has a far better chance of receiving adequate and prompt treatment for his disease than in past years.

Cancer can be discussed now: Strongly supported by educators of all kinds, by the press, radio, television, and other means for communication with great numbers of people, we have lifted-largely through the work of the society, cancer from a position of blind and unreasoning dread in the minds of many people to the point, at last, where the disease can be openly faced, accurately reported, and boldly examined for all its consequences-economic, medical, and social-to the American public.

Health habits formed without unreasoning fear: Through continued stress on the curability of many forms of early cancer, and wide dissemination to the public of the bodily signs which may mean early cancer, we have made it possible for a very large number of people to adopt without unreasoning fear the sensible health habit of regular physical examinations by a physician. Undoubtedly, many lives have been saved from cancer by this practice, strongly encouraged

by the society in the past 7 years. Cancer is properly feared—it is unreasoning fear that is dangerous. In the same process, we have diminished the hold of the cancer "quack” on those who fear but lack real knowledge of cancer.

Service program begun: We have laid the foundations for service to persons suffering from cancer and to members of their families. Primary emphasis is given to early detection of the disease and prompt and more positive treatment, but aid is also extended to patients in need in later stages of the disease in areas where that activity seems necessary and desirable. In acceptance of the fact that cancer in later stages often means financial disaster for the patient and his family, the society has encouraged more effective measures in public assistance.

Treatment facilities established: We have made possible the establishment of formally organized cancer diagnostic and treatment clinics within many general hospitals. Here physicians can bring to bear on a particular cancer case the force of their collective medical experiences and medical skills. Patients in many parts of the country, formerly without such services, receive the highest medical consideration available to their communities. The society has given much attention, many voluntary services, and large sums of money to the establishment and support of these clinics. There is a need for many more of them.

Manpower has been trained: We have encouraged, with fellowships and scholarships in leading scientific institutions, many hundreds of younger scientists and physicians of promise to make life careers of the study and treatment of cancer. This has added weight to the contemporary attack upon the disease and at the same time has begun to provide for the scientific and medical manpower which will be needed to sustain the attack in future years. By such means, consistently employed by the society and the National Cancer Institute of the United States Public Health Service, the number of talented younger men and women who are devoting their lives to the defeat of cancer grows larger year by year.

Plant equipment: Through the construction program of the National Cancer Institute and by substantial private philanthropies, plant equipment has been increased significantly for the research attack upon cancer. Under the Institute's building program, new laboratories and other facilities exclusively devoted to cancer studies have been added to the equipment of 49 medical and scientific institutions in 27 States. Since the war

15 major cancer hospital and research institutions have received large private gifts for building purposes. Fellowships and studies financed by the society are today often housed in these new research facilities.

Cancer registries and records: We have improved our recordkeeping of the prevalence and mortality of cancer in many States, local communities, and individual hospitals to the point where we begin to see more clearly the true dimensions of the formidable enemy we face. Cancer registries keep patients during and after treatment in closer touch with their doctors and provide the medical profession as a whole with more accurate and more complete information on the value, as proved in time, of treatment procedures. The society has had an active role in this useful epidemiological development.

An integrated national cancer control program: Besides the educational, research, and service programs of the society, the national attack includes complementary control and research activities by the Federal and State Governments. The society consistently supports and participates in these programs and has played a significant part in testimonies to congressional committees and other activities in obtaining for the National Cancer Institute of the United States Public Healh Service annual appropriations of reasonable adequacy for the task at hand.

The American Cancer Society strives to be hopeful but realistic, conservative but open-minded, constantly self-critical, ready for change when change will lead on to better things. It holds to the classic American belief that responsibility for one's self and one's fellow citizens may never in entirety be delegated to others, and that in the case of cancer, in particular, this doctrine must hold especially true because the individual is at all times personally and directly threatened by the disease. Oneself--you and I-must take the early symptom to a doctor.

For this reason-of a personal responsibility in the control of cancer—the society believes it can serve the American public most effectively through combining its educational efforts with its own fund-raising activities. We learn through the educational effects of giving to care for ourselves, our neighbors, and what must be done perhaps for many years to come, to defeat cancer. In most cases the sharpness of the educational effect is diminished where the cancer crusade is combined with other appeals, no matter how worthy-lives may be unnecessarily sacrificed.

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Though the society thus strongly supports the voluntary spirit in all its affairs, it believes this admirable readiness to serve, and to learn, must be strengthened and guided everywhere by the best technical advice. It is needed, for one thing, to engage the full interest of the intelligent voluntary worker. For such reasons, the society makes wide use of expert technical advisory committees—in education, in the social services, in medicine, and the basic sciences—and it insists upon the employment of persons in salaried staff positions of the highest professional competence for their daily tasks. The Committee on Growth of the Na. tional Research Council is a notable example of the expert voluntary advisory services made use of by the society in its program.

The following three sections of the report discuss the activities of the society during 1952 under headings representing its principal structural parts—the National Society, the State, Territorial, and metropolitan divisions, and the community units. Other sections are devoted to research, fund-raising, and finances of the society.

The reader should bear in mind the need for perspective in considering cancer. The road has been and will be, probably for many years to come, a hard one. The gains are measured in inches, not miles. The great achievement of the present is the mobilization of the attack—the organized willingness to striveeverywhere evident in 1952 activities. Nevertheless, time, work, thought, training, organization, money, are still basic requirements of ultimate success. Bear in mind also

Every day over 600 Americans die of cancer.
Out of every 7 deaths last year, 1 was caused by cancer.
Cancer strikes 1 in every 2 families.
About 220,000 Americans died of cancer in 1952.

About 15 million Americans will die of cancer in the next 50 years if present trends continue.

In 1953 there will be about 525,000 new cancer cases in the United States.

In 1953 about 700,000 persons will be under treatment for cancer in the United States.

In 1952 about 70,000 Americans were saved from dying of cancer.

The number of cancer patients saved in 1952 could have been doubled if every cancer case had been treated early and by the most effective methods.

We still do not have a readily applied test for cancer or a means for cure effective at any stage of the disease.

THE NATIONAL SOCIETY FIGHTS CANCER

The war against cancer has been only fairly begun. Though the end of the beginning may be in sight, the beginning of the end is still far distant. The enemy is still implacable, still deeply entrenched in the pits of our ignorance, its threat still growing through the growth in our population and in the numbers of older people who make it up. Cancer strikes the older person far more often than the young.

It is one of the purposes of the national organization of the society to hold the gains which have been made. That in itself is no small task. But an even more important purpose is leadership in the attack-through direct action in public and professional education, service to the patient, and research into the nature of cancer; and through indirect actions, designed to enlist in the national undertaking other national agencies, official and private, which can be helpfully employed in the struggle. There are but few agencies which may not be so employed.

A duty of the national society, moreover, is to provide guidance and assistance to the combat troops of the society—the divisions in the carrying out of programs within each of the 61 divisional areas in every State, the Territories of Alaska and Puerto Rico, the District of Columbia and 10 metropolitan areas. The leadership role

The world cancer picture is today in a state of great change, much of it due to knowledge of the disease and of means for its control gained in postwar years—much of it resulting from the society's work. Some of the advance in our knowledge is medical and scientific in its nature; some can be called "social," as betokening advances in other health and welfare activities; some is educational, involving newer methods for influencing the actions of people; some is administrative, in the sense that experience with any problem increases the

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