The federal government has spent more than $46 billion on cancer research since President Nixon declared a War on Cancer and Congress passed the National Cancer Act in 1971. In addition, states, private companies, and foundations invest billions of dollars in research and the development of new therapies. This investment recently produced the first evidence of reduced mortality from cancer. Cancer deaths declined 6 percent between 1990 and 1999 after two decades of increase between 1970 and 1990. The benefits have not been uniformly shared among all patient groups or cancer types. Against the big cancer killers, such as lung cancer, there has been little progress.