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2. Rettig, Richard A., Cancer Crusade: The Story of the National Cancer Act of 1971 (Princeton, NJ, 1977)Google Scholar; Patterson, James T., The Dread Disease: Cancer and Modem American Culture (Cambridge, Mass., 1987)Google Scholar; and Proctor, Robert, Cancer Wars: How Politics Shapes What We Know and Don't Know About Cancer (New York, 1995)Google Scholar. For a broader look, see Strickland, Stephen P., Politics, Science, and Dread Disease: A Short History of United States Medical Research Policy (Cambridge, Mass., 1972)CrossRefGoogle Scholar; and Harden, Victoria A., Inventing the NIH: Federal Biomedical Policy, 1887–1937 (Baltimore, 1986).Google Scholar

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4. The Boston Women's Health Book Collective, The New Our Bodies, Ourselves: A Book By and For Women (New York, 1984)Google Scholar; and Gallagher, Dana M. and Richwald, Gary A., “Feminism and Regulation Collide: The Food and Drug Administration's Approval of the Cervical Cap,” Women and Health 15.2 (1989): 87–97Google Scholar. See also Beckwith, Barbara, “Boston Women's Health Book Collective: Women Empowering Women,” Women and Health 10 (Spring 1985): 1–7.CrossRefGoogle ScholarPubMed

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8. “Is There Still Too Much Extrapolation From Data on Middle-aged White Men?” See also Cotton, Paul, “Example Abound of Gaps in Medical Knowledge Because of Groups Excluded From Scientific Study,” JAMA 263, no. 8, February 23, 1990: 1051–1052CrossRefGoogle Scholar; and Angell, Marcia, “Caring for Women's Health—What is the Problem?” The New England Journal of Medicine 329, no. 4; July 22, 1993: 271–272.CrossRefGoogle ScholarPubMed

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11. Ibid.

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22. Elliott, Stuart, “Advertising,” New York Times, December 1, 1994: C11Google Scholar. ironically, another slogan, “If a murderer kills you, it's homicide … If the FDA kills you, it's just being cautious,” came from the opposite end of the political spectrum, an advertisement placed by a conservative anti-regulation foundation. Leon Jaroff, “The Commish Under Fire,” Time, January 8,1996: 60. While AIDS activists attacked the FDA's purported slowness in approval from the perspective of dying patients, business groups and conservatives led by House Speaker Newt Gingrich charged the FDA with committing bureaucratic evil through the complexity of its regulatory requirements. Hilts, Philip J., “FDA Becomes Target of Empowered Groups,” New York Times, February 12, 1995; 1:12Google Scholar; and Mack, Connie, “Lift the FDA Roadblock on Experimental Drugs,” New York Times, February 19, 1995, 4:12.Google Scholar

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27. Similarly, in 1995, NCI acquired a new director, Richard Klausner, with an explicit mission, apparently endorsed by NIH, to cut through bureaucracy and so revitalize the agency. Kolata, Gina, “New Administrator is ‘Not an Administrator,’” New York Times, December 12, 1995: B5, B9.Google Scholar

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29. “Snipping Away at the Red Tape on Drugs;” and Philip J. Hilts, “FDA Approves a New Drug to Attack the AIDS Virus.” In 1996, however, the FDA faced new challenge with Senate and House moves to force further acceleration in agency procedure. Proposed bills spoke about requiring a four-month deadline for action on drugs to fight life-threatening disease and six months for all other applications; FDA failure to meet such time limits would give an automatic go-ahead to the medicine in question for the United States as long as European or British authority had already approved it. The drive for such legislation drew heavily on pharmaceutical business interests; in hearings, Senator Dan Coats accused the FDA of bearing an “approval bias against companies.” Denying such prejudice, Kessler warned that such strict deadlines would lead to a drastic Thalidomide-style mistake one day; but House interests talked about going further, allowing some privatization of the drug review process. ABC Nightly News, February 27, 1996.

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34. In 1994, over 182,000 American women faced diagnosis of breast cancer, while about 46,000 die from breast cancer per year. The figure “one in nine” was used most commonly in popular discussions, though some breast cancer observers talked about “one in eight” or “one in ten.”

35. February, 1996 fundraising letter from the National Breast Cancer Coalition.

36. Complicating the efforts to establish the importance of regular mammograms firmly in women's minds, however, medical organizations and doctors disagreed about the best age to start testing. Wallis, Claudia, “A Puzzling Plague,” Time, January 14, 1991: 48–52.Google Scholar

37. Hilts, Philip J., “U.S. Breast Cancer Deaths Fell Nearly 5 Percent in Three Years,” New York Times, January 13, 1995: A17Google Scholar. Screening also complicated scientific questions, since new microscopic and molecular diagnostic techniques permitted researchers to find tiny cancer cell clusters, which some researchers suggested might carry a different meaning than full cancer, proving fundamentally harmless. Autopsies done on females age forty to fifty detected tiny breast tumors in 39 percent, “so quiescent [that]… had they been detected while the woman was alive, they would have been labeled as breast cancer” though not fitting the popular image of cancer as a rapidly spreading mass. Researchers expressed concern that as ability to detect smaller tumors increased, practitioners would face the challenge of deciding how aggressively to treat spots which might or might not turn deadly. Kolata, Gina, “New Ability to Find Earliest Cancers: A Mixed Blessing,” New York Times, November 8, 1994: B5, B8.Google Scholar

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39. Brody, Jane, “Personal Health,” The New York Times, March 8, 1995: B6.Google Scholar

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46. Guttman, Monika, “Chasing Breast Cancer,” USA Weekend, January 13–15, 1995: 24Google Scholar; and Gina Kolata, “Weighing Spending on Breast Cancer.” Similarly, regarding AIDS, two Ohio State University doctors wrote The New England Journal of Medicine in 1988 to “question the wisdom of allowing its dramatic nature and the public outcry it generates to dictate public policy in health care funding….” Noting that annual American suicides exceeded the 1988 total of people with AIDS, they called it “unreasonable” for the* Alcohol, Drug Abuse, and Mental Health Administration to devote 22 percent of total funds to AIDS-related investigations. Such an emphasis, they worried, might draw researchers away from other vital areas of study or induce some to alter projects to include AIDS patients to win grants. Dilsaver, Steven C. and Coffman, Jeffrey A., “Effect of Generous Funding for AIDS Research on General Biomedical Research,” The New England journal of Medicme 318. no. 16, April 21, 1988: 1071–1072.Google ScholarPubMed

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48. Burd, Stephen, “NIH Issues Rules Requiring Women and Minorities in Clinical Trials,” The Chronicle of Higher Education, April 6, 1994: A50Google Scholar; and Kolata, Gina, “FDA Debate on Speedy Access to AIDS Drugs is Reopening,” New York Times, September 12, 1994: A13.Google Scholar

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54. Barbara J. Culliton, “NIH Push for Women's Health.”

55. Susan Rennie, “Breast Cancer Prevention: Diet Vs. Drugs,” Ms., May/June, 1993: 39–40, 42; Liane Clorfene-Casten, “The Environmental Link to Breast Cancer,” Ms., May/June, 1993: 54; and Liane Clorfene-Casten, “Inside The Cancer Establishment,” Ms., May/ June, 1993: 57.

56. Susan Ferraro, “The Anguished Politics of Breast Cancer,” 62; and Liane Clorfene-Casten, “The Environmental Link to Breast Cancer,” 52–56.

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63. Wachter, Robert M., “AIDS, Activism, and the Politics of Health,” The New England Journal of Medicine 326, no. 2, January 9, 1992: 129.CrossRefGoogle ScholarPubMed