The Objectives of the Cancer Control Program and the National Cancer Institute's Administration of Program Contracts

The origin of the National Cancer Institute's (NCI) cancer control progam can be traced to the National Cancer Institute Act of 1937, which gave NCI responsibility for conducting research to prevent, diagnose, treat, and control cancer in humans. However, not until Congress enacted the National Cancer Act of 1971 was a separate cancer control program established. Originally, NCI administered the cancer control program from the NCI Director's Office, but in September 1974, NCI formed the Division of Cancer Control and Rehabilitation (DCCR), which is now responsible for program administration. DCCR administers the program through grants, contracts, and interagency agreements awarded to State and local health agencies, medical centers, and others. In the past 5 fiscal years, about 72 percent of the funds allocated for the cancer control program was obligated for contracts. GAO reviewed five NCI contracts to determine whether the cancer control program's objectives were being met, whether NCI was effectively administering the cancer control projects, whether funding and staffing levels were adequate, and whether advice provided by cancer control advisory groups was being implemented.

GAO found that: (1) NCI did not award the contracts in accordance with Department of Health, Education, and Welfare contracting procedures or sound management practices; (2) DCCR has never done a study to determine the number of demonstration projects that are continued by localities and does not know the extent to which demonstration projects are continued by localities after federal funding stops; (3) NCI did not effectively manage four of the five contracts; (4) contractors did not perform tasks specified in the contracts, and project officers failed to bring problems to the attention of contracting officers so that corrective actions could be taken; (5) a lack of cooperation existed between DCCR project officers and NCI contracting officers; and (6) DCCR has had difficulty in obtaining staff for the program.