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~nr~c i : e Arn.erican Canc er Soriety, Lx><c. ilTationallleadquaricers and Chartered Divisions Support from the Public by Divisions as of August 31, 1976 and 1975 DDivisions 1976 1975 Divtsiona 1976 1975 Alabama $ 854,619 $ 795,766 New York State 5,408,739 4,351,768 Alaska 224,322 174,667 Queens 645,562 436,135 Arizona 953,569 1,341,374 Westchester 603,258 642,670 Arkansas 552,565 498,465 (Total) 18,199,706 11,389,373 California 14,681,829 17,230,398 _ North Carolina 1,635,741 1,409,588 Colorado 1,226,031 1,092,944 North Dakota 431,187 302,749 Connecticut 3,063,314 2,609,930 Ohio 6,896,482 5,923,763 Delaware 464,342 409,737 Oklahoma 837,689 761,055 District of Columbia 1,116,540 1,250,928 Oregon 1,224,189 1,200,318 Florida 5,428,648 5,748,089 Pennsylvania: Georgia 2,836,659 2,435,246 Philadelphia = 1,562,560 1,351,336 Hawaii 1,110,780 1,020,647 Pennsylvania 4,799,396 4,212,321 Idaho 295,210 298,419 Illinois 6,894,008 7,494,553 (Total) 6,361,956 5,563,657 Indiana 2,100,300 1,798,362 Puerto Rico 151,385 171,880 Iowa 1,811,692 1,820,337 Rhode Island 438,801 353,838 Kansas 1,388,454 1,292,320 South Carolina 1,015,873 926,659 Kentucky 1,003,921 1,011,540 South Dakota 289,193 264,371 Louisiana 672,821 635,704 Tennessee 1,824,497 1,272,372 Maine 555,896 499,581 Texas 5,331,358 4,535,792 Maryland 2,082,224 2,136,141 Utah 433,036, 374,523 Massachusetts 2,923,464 3,865,341 Vermont 293,501 353,202 Michigan 4,361,068 3,523,199 Virginia 2,276,733 2,051,764 Minnesota 1,805,617 1,463,351 Washington 1,496,204 1,632,534 Mississippi 616,921 538,566 West Virginia 613,074 549,965 ~ Missouri 2,370,729 2,648,398 Wisconsin: ~ Montana 273,138 317,304 Milwaukee 472,278 473,673 Nebraska 684,632 619,098 Wisconsin 1,448,247 1,318,238 Nevada 253,493 162,929 (Total) 1,920,525 1,791,911 New Hampshire 416,597 403,723 Wyoming 172,457 145,204 New Jersey 3,641,512 3,437,699 826 847 Sub Total: $118 $109,844,419 New Mexico 318,345 266,318 Canal Zone , , 23 669 28,827 New York State: , Long Island 1,804,311 1,363,276 850 516 Grand Total: $118 $109 844,419 New York City 9,737,836 4,596,524 , , , The accompanying notes to combined financial statements are an integral part of this exhibit. 27

r Report from the Presiderkt and C1 iCa1A"man Thomas P. Ulmer Dr. R. Lee Clark Public interest in cancer this past year surged in response to new developments in diagnosis, treat- ment and rehabilitation. The American Cancer Society again contributed substantially to the cancer control effort by awarding more than 500 research grants in 1976, as part of a total research expenditure of over $32 mil•lion. Moreover the Society, recognizing that real progress increases by confronting controversy and examining alternatives, acted decisively to initiate bold new programs in 1976. Among them are the following: Smoking and Health-The ACS, long a pioneer in the field of smoking and health, launched an aggressive, five-year campaign in 1976 to reduce sharply the hazards of this deep-seated habit. Breast Cancer-The Society acted promptly to counter misinterpretation of guidelines issued on the use of mammography. ACS leaders emphasized that while periodic mammograms are not recommended for every woman, they are vital for those over the age of 50, and, indeed, for younger women at high risk to breast cancer. Unproven Methods-For years the Society has main- tained one of the world's largest files on unproven 2 and fraudulent cancer remedies. In the face of accelerated activity by irresponsible and misguided practitioners, ACS Divisions launched a counter- offensive to combat these remedies that deceive cancer pat ients and delay them from getting effective trcatment. Childhood Cancer-ACS-sponsored research has helped to bring about dramatic gains in controlling childhood cancer. In 1976 the Society began estab- lishing committees across the country to deal with thc need for specialized treatment and psychological support unique to this area of cancer control. Blood Donatlon-The proliferating need for blood and blood components in cancer therapy is both a sign of progress in the development of new treatment techniques, and a challenge to meet a crucial need. The Society has initiated a nationwide blood donor effort that both reinforces and seeks to improve existing blood bank programs. We, as physician and businessman, as we11 as American Cancer Society volunteers, know from personal experience the lifesaving role the Society plays in communicating new developments in cancer control to the medical and lay communities. A new telephone information service of the National Cancer Institute is strongly supported by ACS efforts, especially through the use of volunteers to answer telephone!Pand relay vital cancer informa- tion. This service facilitates broader exchange of information between major medical centers and community medical facilities, as well as between physicians and the public. The mass media-newspapers, magazines, radio and television-contributed to the cancer communi- cations effort in 1976 more fully than ever before. The ACS reaches physicians and other medical specialists through professional conferences. In 1976, these dealt with the use of radiation techniques in cancer diagnosis and treatment, and the broad spectrum of cancer research and clinical investigation. In 1977, the Society not only plans medical seminars on topics related to the nursing profession and advances in leukemia therapy, but also a`second major conference on human values and cancer. We at the ACS are deeply committed to the concept that cancer control should benefit the whole person-not only save lives and extend survival, 'but help cancer patients and their families to cope with all aspects of the disease and return to normal, active lives. 11 DR. R. LEE CLARK THOMAS P. ULMER ~ ~ President Chairman m : 0 -4 fi

0 Chamlelil'g DoUars Into the.PXS A ratio of 900 volunteers to 1 paid staff person makes it possible for the ACS to channel its dollars into Program Activity. This then keeps our Fund Raising expenses at very low levels, as they have been for more than 25 years. Our Management and General Expenses have also been kept under strict control. PERCENT OF FUND RAISING AND MANAGEMENT & GENERAL EXPENSES 100% r~ ~ ~y FUND RAI$IIJG MANAGEMENT & GF.NERAL , , 9M - 80% 7 0% 60% tid96 - 40% 30% 2096 10% V`-i PF9 h`: .~ V .~ i 1950 1955 1960 1965 1970 1975 1976 Except for gifts restricted by donors for specific purposes, contributions received in the Annual Cancer Crusade are divided so that 60% is retained by the Divisions for their programs of Public and Professional Education, Service and Rehabilitation for the cancer patient, and for supporting services of Fund Raising, Management and General. A minimum of 25% (actually 28.5% of 1976 expenditures by National and Divisions was for research) is used for the Society's nationally- administered research program; 3% is for a national program of medical grants and fellowships; 12% is for National Office programs including technical and advisory help to Divisions in program planning and support service activities. . Funds bequeathed to the Society, which the testators do not restrict for specific program purposes, are also divided so that 60°/o supports Division programs and 40°'o is for National Headquarters' use, principally, in support of the research program. A1VERICAN CANCER SOCIETY, INC. COMBINED BUDGET 1976-1977 Program Services: Research $ 37,987,000 30.2% Public Education 20,973,000 16.7 Professional Education 13,370,000 10.6 Patient Services 15,615,000 12.4 Community Services 11,130,000 8.8 $ 99,075,000 78.7% Supporting Services: MarPagement and General $ 12,282,000 9.8% Fund Raising 14,411,000 11.5 $ 26,693,000 21.3 % GRAND TOTAL $125,768,000 100.0% BUDGETS In addition to the amounts reflected at right, which have been approved for programs during the coming year, budgets for special projects aggregat- ing $9,879,000 have been approved for program develop- ment during 1977-1979. In February 1977, the National Board budgeted an additional $5,000,000 for grants under a Special Research Development program through fiscal year 1978. 20

Young canccr patient (below) at Children's 1lospiW, Philadc6 phia, has wcit;lrt and height checked. Leukcniic boy's sister (left) visits clinic as part o( effort to involve entire fa?n- ilies in the care of children with cancer. sivc information and rrfcrral sc•rv icc for farnilies of children with cancer. It also provides soine financial support for transhortation, living expenses during out-of-town therapy,and limited funds for drugs and other treatment. The new ACS volunteer blood donor effort (de- scribed elsewhere in this report ) is particularly beneficial to children. Thcircanccr thcrapy frcqucntly calls for large amounts of blood components such as red cells, white cells and platelets. Comprehensive Cancer Centers, funded by the National Cancer Institute and in many cases sup- ported with ACS services, have become specialty facilities for children with cancer. Childhood cancer is neither worse than in the past, nor are more children getting it. The activity in the field stems from the solid progress that has taken place over the last several years. For the first time, long-term control of childhood cancer is a real possibility. Progress is accompanied by problems, and the ACS tries to remedy them directly or through referral. Among the problem areas are the following: • Childhood cancer involves the entire family of the young patient, and ad justment difficulties call for counseling of many kinds. • Therapy depends heavily on drugs, combination treatments and unusually large amounts of blood and blood components. • Hospitals need to gear themselves more to children with cancer-to group young patients by age and provide them.vith recreational equipment rang- ing from rattles to record players.

least 50 percent, or 4.5 milIion smokers. 3. To reducee the toxic elements in cigarette smoke by at least 50 percent. The campaign is being waged on many f ronts simultaneously, and includes the following efforts: DEF' Physicians are being asked to urge their smok- ing patients to stop, and to provide assistance as needed. $+r An "Early Start to Good Health" program is being directed at children in kindergarten through third grade to encourage them to adopt good health habits and avoid hazardous ones such as smoking. UCF- A broad radio and television campaign on smoking and health will include a series of programs produced for the Public Broadcasting System on helping people to quit smoking. C3F- A National Commission on Smoking and Public Policy, composed of national leaders in health, education and other fields will hold public forums throughout the country to develop a public mandate for social action against smoking. 00- The Society is.vorking with legistlative forces and other health organizations for the phasing out of ~60 million worth of government tobacco subsidies each year. During 1976, ACS Divisions conducted more than 1,500 Quit Smoking Clinics and nearly 200,000 Public Education programs on lung cancer, involving films, speakers and discussions. A new international magazine,World Smoking and Health, made its debut in the fall. It is designed to keep open the channels of communication be- tween the quadrennial World Conferences on Smok- ing and Health. Supporting all this activity were several new ACS studies which contributed valuable data to the grow- ing indictment against cigarette smoking as a serious health menace. A survey done for the Society by Yankelovich, Skelly and White, Inc. showed that 27 percent of teen-age girls are smokers-5 percent more than in 1969. Perhaps more significantly, the number of these girls who smoke a pack or more a day had increased fourfold to 39 percent. The smoking habits of teen-age boys have not changed much, but they hold a slight numerical edge over the girls. Part of the reason for heavy smoking by young people was judged to be an all-pervasive smoking environment: Parents who tolerate or even approve of their children smoking, teachers who smoke, schools that provide special smoking rooms for students and teachers, and peer pressure. Among adults, cigarette smoking has declined somewhat over the past decade, according to a report of the Nat ional Clcaringhouse for Smokinfi and I le,ilth. Yet smoking by women has dropped less than that of men, and in some agc brackets women's smoking even increased. A 12-ycar survey released in September provided the first dcfinit ive evidence that smoking low tar and nicotine cigarettes results in lower death rates from lung cancer. The survey was part of the resumption of the Society's huge Cancer Prevention Study. Although ACS researchers recognize that sonie cigarettes may be less hazardous than others, they stress that no cigarette is safe. A study conducted for the Society by The Gallup Organization, Inc. in December indicated that 71 percent of those who smoke a pack or more a day would stop if their doctor urged them to do so. In addition, nearly half of the ex-smokers queried said they would be willing to help others break the habit. Although 53 million Americans still smoke ciga- rettes, 30 million have stopped since the anti-smoking campaign began. The average cigarette today has 60 percent less tar and nicotine than it had 20years ago. Most importantly, there is a definite sign that public attitudes are turning against the habit. Twenty years ago the popular question was: "Aren't you smoking?" Today, it is: "Are you still smoking?" 13

Legacies and Planned Gifts Planned giving is arranged between a donor and the American Cancer Society so that a gift of money or property is irrevocably specified for use by the American Cancer Society. Though the right to use the gift may be deferred, there can be immediate and future tax benefits to the donor. In addition to gifts of cash, a variety of methods for planned giving exists including life insurance, outright or in trust, and appreciated property, such as securities or real estate. An Attorney can advise on how to modernize estate plans and can present ways in which planned giving to the American Cancer Society not only.vill support its work but will also help the donor improve income, lessen taxes and reduce cost of probate. Legacies and bequests are among the most freque-nt-ly used methods of &up--- porting the activities of the American Cancer Society. The simple and direct gift of money or property should state: "I give to the American Cancer Society, Inc., the sum of dollars to be used for the general purposes of the Society." For those interested, a brochure and further information can be had from ACS Divisions. • Memorial Gifts People who have lost close relatives or friends to cancer often wish to make a contribution to the American Cancer Society as a living memorial. Such a gift greatly assists the Society's programs of Research, Edu- cation and Service to cancer patients. Each conxribution is deductible for tax purposes. Each is acknowledged. An appropriate memorial card is sent to the family of the deceased, the amount of the gift not being indicated. Inquiries The AMERICAN CANCER SOCIETY, INC. invites inquiries and will be pleased to respond to requests for information on its progr m activities or finances. The audited ~inancial state- ments-of the Society's Nationai Omce for the year ended August 31, 1976, are also available on request. , . 0 NATIONAL HEADQUARTERS: Y AMERICAN CANCER SOCIETY, INC. 777 Third Avenue - New York. N.Y. 10017 ~ 0 0 0 m oi lu,

CoNMOTS 2 Report from the President and Chairman 3 Executive Vice President's Report 4 Cancer Highlights 5 Research 6 Cancer in Children 8 Blood Donor Program 9 Unproven Methods: A Campaign Against Quackery 10 Mammography: Detecting Breast Cancer Early 11 Cancer Information Network 12 Worldwide Fight Against Cancer 12 Smoking and Health 15 Volunteers for Public Education 16 Cancer Crusade 18 Working with Media 20 Channeling Dollars 21 Treasurer's Report 22 Financial Statements 28 National Officers, House of Delegates 29 Councils and Committees 32 Divisions 33 Legacies, Memorial Gifts, Inquiries i

Cancer Information • Network Acruss the country ACS voluntccrs arc picking up telephones to answer questions about cancer. "I think I have a lump in my breast. What do I do?" "We've just moved into the area and my little boy has leukemia. Wherewill hee get the best treat- ment?" "What is this chemotherapy I've been hear- ing about?" Dealing with such questions is not new for the Society-people have been calling Units and Divisions for years. But now this kind of help is being expanded and improved. The Society, together with the National Cancer Institute and its Comprehensive Cancer Centers, has been building more links over the past year between the public and authoritative sources of cancer information. In some cases, space for "hot-line" telephone centers is donated by ACS Units and Divisions. ACS volunteers answer phones, and toll-free lines are supplied wherever possible. The hotlinc staffs have more complete, up-to-date information at their fingertips than ever before. This effort is part of the Comprehensive Cancer Centers' program of reaching out to community hospitals, medical professionals and the public directly. And it is one of the ways in which the Society and the NCI are cooperating effectively in various parts of the country. These pilot programs will be evaluated to see if they should be more widely developed. In Minnesota, a toll-free WATS line is run by the Minnesota Cancer Council, a newly-formed, non- profit organization initiated by the Minnesota ACS Division and involving nine state medical groups. This information service, housed in the Minnesota Division headquarters in Minneapolis, is manned from 8: 30 a.m. to 4: 30 p.m. five days a week. At other times callers have the option of leaving a message on a telephone answering machine or calling the 24-hour information service of the National Cancer Institute in Bethesda, Md. Complex questions are passed on to cancer specialists and then the volunteer phones the callers back with answers. 5000P U0P3

Honorary Crusade Chairman John Wayne plays a role in the Society's advertising campaign (top left). Former First Lady Betty Ford receives a special Media Award (bottom left). With her are ACS Executive Vice President Lane W. Adams and television's Barbara Walters. Baseball great Hank Aaron , (immediate left) is inter- viewed for an ACS radio spot at Nex, York's Yankee Stadium. 19

r Cancer in Chaldre n The accelerated action against childhood cancer is one of the most promising new areas of ACS work. Cancer strikes many more adults than children. Yet it is the number one disease killer between the ages of 3 and 14. Childhood cancers-affecting such areas as the blood, brain, bones, kidneys and nervous system-have had a poor record of responding to treatment. Now, however, advances in chemotherapy and radiation therapy have sharply altered this dismal picture. More and more children are living longer and in a number of cases are being cured. The Society has been in the forefront of this progress and is striving for further gains. In 1976 it awarded 140 research grants totaling $8.6 million to scientists studying childhood cancer. There is now a National Advisory Committee on Childhood Cancer which is helping Divisions form their own committees and programs. A National Conference on Care of the Child with Cancer is being planned. Some Divisions already have well-established programs. Florida, for example, maintains an exten- Followiug successful bone surgery, Sigrid Gelber has plenty of energy for riding and her pre-ined studies.