The roots of INCA go back to the 1930’s, as there was a shift in the national health policy due to the increase in mortality from chronic and degenerative diseases, including cancer. On January 13, 1937, President Getúlio Vargas signed the decree creating the Oncology Center as part of the Health Care Department of the Federal District, in Rio de Janeiro. As director, he appointed Dr. Mário Kröeff, one of the pioneers in cancer research and treatment in Brazil. The facilities of the Centre were inaugurated just over a year later, on May 14, 1938, with 40 beds, a surgical ward, one x-ray machine and one radiotherapy equipment.

Seeking to develop a national policy for cancer control, the National Cancer Service - SNC was established in 1941, and three years later the Oncology Centre was transformed into the Cancer Institute, an executive support body of that Service. At the beginning, SNC had to overcome serious obstacles, as it had to operate in inadequate facilities until it was transferred in 1946 to the Gaffrée e Guinle Hospital. A final acquisition of its own headquarters, allowing the establishment of a large hospital-institute, became the target of institutional goals. Nineteen forty six also saw the transfer to the federal government of two vacant areas and a building under construction, located at Praça Cruz Vermelha No. 23, in Rio’s downtown, where the new Cancer Institute would be built. This new building was inaugurated 11 years later, in 1957, by President Juscelino Kubitschek.

In 1961 a new regiment was approved for the Institute, recognizing it officially as the National Cancer Institute with new tasks and responsibilities in cancer care delivery, research and education. A golden age for the institution was marked by training programs for specialized personnel nationwide and by the expansion of its facilities at Praça Cruz Vermelha.

Reorientation of economic and health policies, starting in the 1960’s, led to changes that, on the one hand favored preventive medicine, but on the other dramatically reduced the budget of the Ministry of Health. INCA has suffered many structural and functional modifications. In 1967 the National Campaign to Fight Cancer - CNCC was created, with the aim of facilitating, financially and administratively, the control of cancer in Brazil. In 1969, in spite of the protest of many, the Institute was separated from the Ministry of Health and placed under the administration of the Rio de Janeiro School of Medicine and Surgery, an entity linked to the recently created Foundation of Isolated Federal Schools of the State of Guanabara — FEFIEG. This situation, however, did not last long, as in 1972, thanks to internal and external pressure, INCA was reintegrated with the Ministry of Health. The Institute was separated from its former financial management organ, the National Cancer Division (the new name to the former SNC), and became directly subordinated to the Minister of Health.

The early years of the 1980’s were a period of growth and recovery to INCA. It became the care agency in the cancer control policy of Brazil. In 1980 the Institute began to receive funds through the CNCC, as a result of a co-management administration agreed on by the Health and Welfare Ministries. This allowed INCA, in just two years, to double its medical services. Under the administration of Dr. Ary Frauzino, many renovations and new programs were carried out, as well as technical-scientific agreements, giving a broader scope to INCA as a specialized treatment and teaching centre.

Starting in 1982, INCA and CNCC sought to reorient their efforts for cancer control, via an Integrated System for Cancer Control - SICC, whose technical-administrative structure was named Pro-Onco. In 1983, this was consolidated with the transfer to INCA/CNCC of the activities performed until then by the National Department of Chronic-Degenerative Diseases - DNDCD (to which the National Cancer Department had also been incorporated), under the Special Secretariat for Health Programs - SNEPS of the Ministry of Health.

Since then, action has been continuous at nationwide level, including various types of cancer control programs which are being carried out until now in many areas such as information (cancer registries); tobacco control; prevention; oncology education in medical schools; and dissemination of technical-scientific knowledge

Under the hospital care perspective, INCA has established a Bone Marrow Transplant Centre, and Pro-Onco, in partnership with the Hospital de Oncologia, has created an Oncology Therapeutic Support Service. Both of these have become very important in the technical-scientific structure of INCA.

In the 1990’s, under the direction of Dr. Marcos Moraes, INCA has consolidated its leadership in the fight against cancer in Brazil, working in many directions. The expansion of existing programs; the creation of new national programs for detection; the set up of a Steering Committee with members from Brazilian cancer societies and institutions and the incorporation of the Hospital de Oncologia, Luíza Gomes de Lemos Gynaecological Centre and Pro-Onco were some of the main institutional achievements. Moreover, INCA has been submitted to audits by national and international institutions; it has started a Total Quality Management Program; it established CONTAPP to coordinate efforts to reduce smoking and prevent other cancer-risk factors; it fosters the domestic and international ties and it is well acknowledged. To provide technical and financial support, INCA has created the Ary Frauzino Foundation for Cancer Research and Control — FAF, which has been greatly assisting the Institute to maintain its numerous activities.

The year 1997 saw one more honor for INCA - the blessing of Pope John Paul II during his visit to Rio de Janeiro, as a symbol of all sick people and health institutions in Brazil.