The three foundations of the National Cancer Program are basic research, clinical trials (in prevention and treatment), and cancer centers. These foundations have supported a great deal of progress against cancer over the past 20 years. Nevertheless, a number of challenges remain, and continued progress will depend on the speed with which research advances can be translated into practical realities. Poverty is a risk factor for cancer incidence and mortality. Thus, a lack of access to the technologies generated by the National Cancer Program can be a force for bringing about differential burdens of cancer in underserved populations.