Armor of patience: The National Cancer Institute and the development of medical research policy in the United States, 1937-197

President Franklin D. Roosevelt signed Public Law 75-244 on August 5, 1937, thereby creating the National Cancer Institute (NCI) and committed the resources of the federal government to the conquest of a chronic and dread disease. This is an historical study focusing on one aspect of the development of federal health policy--medical research. The establishment of the NCI and the implementation of its grant-in-aid program represents an historical turning point that marks the enduring expansion of the federal government into the field of medical research on a chronic disease. This became the model for funding medical research in the United States because it combined public funding with private control and allocation of funds. This cooperation between the public and private sectors stimulated and expanded cancer research and obtained increased funding to attack the disease. How the research community viewed the nature of medical research impacted the federal response to disease and affected the implementation of research policy.;The time period of this study is from 1937, the establishment of the NCI, to 1971, the passage of the National Cancer Act and the inauguration of the second war on cancer. This study focuses on the role of the National Advisory Cancer Council (NACC) as the policy making body legislatively charged with reviewing and recommending extramural grants for funding. Sources for this study include the proceedings and minutes of the National Advisory Cancer Council, annual reports of the NCI, administrative records and reports, oral histories of some of the key participants, and Congressional reports and hearings. The papers of Thomas Parran, Surgeon General of the Public Health Service (1936-1948), place the development of medical research policy within the overall context of federal health policy. The reports of the Committee on Growth of the National Research Council, as well as annual reports and published histories of the American Cancer Society show the role of the principle voluntary health agency interested in cancer in supporting research.;Federal medical research policy, development, and implementation were an interplay between the public and private sectors. Cooperation between the public and private sectors provided a rational line of attack against cancer and increased overall funding for cancer research in both sectors. The grant-in-aid policy of the NCI, as developed by the National Advisory Cancer Council, legitimized a role for the federal government in health care because it combined public funds with private control, via peer review, to address a serious health problem of the American people.