1990s

After increasing steadily for decades, overall cancer death rates in the United States stabilized in the early 1990s and began to decrease in 1994, a trend that continues today.

The transition from film-based radiology to digital computer-assisted medical imaging begins.

The multi-step nature of carcinogenesis is proven. That is, more than one gene mutation is required for a cell to become cancerous.

The fluorescence in situ hybridization (FISH) technique, allowing researchers to study gene copy number and chromosomal location inside cells, is developed.

Several common genetic variants are linked to the risk of lung and other cancers.

1990   Results from the first chemoprevention trial to show efficacy (vitamin A analogue against mouth and throat tumors) are reported.

1991   The first human gene therapy for cancer (melanoma) is attempted.

Post-operative (adjuvant) radiation therapy and chemotherapy are found to improve survival in rectal cancer.

Two white blood cell colony-stimulating factors (G-CSF and GM-CSF) are approved to fight the neutropenia caused by cancer treatment.

1992   The Mammography Quality Standards Act is passed.

Paclitaxel (Taxol) is approved by the Food and Drug Administration (FDA). Found in the bark of the Pacific yew tree, Taxus brevifolia, this drug acts to stabilize fiber-like structures called microtubules that play a key role in the cell division cycle.

1993   The first gene associated with hereditary nonpolyposis colon cancer (HNPCC) is cloned (hMSH2). People with HNPCC are at increased risk of developing colon cancer.

The prevalence of U.S. adult smoking is 25 percent.

NCI-sponsored studies in China show the importance of nutrition in preventing cancer.

Annual guaiac fecal occult blood testing (FOBT) is shown to reduce colorectal cancer deaths by one-third.

The largest early detection study ever conducted, the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, begins recruiting 148,000 volunteers.

1994   BRCA1 is the first breast cancer-associated gene cloned.

The Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study finds no benefit from the use of beta-carotene supplements in smokers and a possible increased risk of lung cancer.

Human herpesvirus 8 (HHV-8), a causative agent for Kaposi's sarcoma, is identified. HHV-8, also known as Kaposi's sarcoma-associated herpesvirus, is later linked to primary effusion lymphoma and multicentric Castleman disease.

1995   The BRCA2 gene is cloned.

The FDA approves tretinoin, a differentiating agent related to vitamin A, for use in the treatment of acute promyelocytic leukemia. Tretinoin is also known as all-trans retinoic acid (ATRA).

Porfimer sodium, a light-sensitive drug that can be absorbed by tumors, is approved by the FDA, permitting photodynamic therapy of some types of cancer.

Information in NCI's Physician Data Query (PDQ) database becomes available on the World Wide Web via the NCI Web site CancerNet.

1996   Topotecan (Hycamptin), the first of a class of drugs that interferes with the enzyme topoisomerase I, is approved by the FDA for the treatment of metastatic ovarian cancer. Topoisomerases uncoil DNA during DNA replication, and altering the work of this enzyme leads to tumor cell death. Topotecan is derived from the bark of a Chinese tree known as Camptotheca acuminata.

The FDA approves another topoisomerase 1 inhibitor - irinotecan (Camptosar) - for the treatment of metastatic colorectal cancer.

Two major studies of beta carotene supplements (The Physicians' Health Study and the Beta-Carotene Retinol Efficacy Trial) show no cancer prevention benefit.

1997   The Cancer Genome Anatomy Project (CGAP), a multi-year project to assemble the first index of genes involved in cancer, is launched.

The first biotechnology product approved by the FDA to treat patients with cancer - a monoclonal antibody called rituximab (Rituxan) - is used to treat a type of lymphoma.

NCI and Chinese scientists find that occupational exposure to benzene is associated with increased risks of developing acute non-lymphocytic leukemia and related myelodysplastic syndromes and non-Hodgkin's lymphoma.

The National Cancer Advisory Board recommends that NCI should advise all women age 40 years and older to receive screening mammograms every one to two years.

1998   Results from the Breast Cancer Prevention Trial show that the incidence of breast cancer among women who are at increased risk of the disease can be reduced by 50 percent with the drug tamoxifen. The FDA subsequently approves tamoxifen for the prevention of breast cancer.

Trastuzumab (Herceptin), a monoclonal antibody that targets cancer cells that overproduce the protein HER2, is approved by the FDA for the treatment of metastatic breast cancer. HER2 is overproduced in the tumors of approximately 25 percent to 30 percent of women with advanced disease.

The prevalence of U.S. adult smoking is 24.1 percent.

1999   The Hybrid Capture II human papillomavirus (HPV) DNA test is approved by the FDA as a test that can be used in conjunction with the Pap smear in screening for cervical cancer.

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