In 1989, Congress mandated that the National Institute for Occupational Safety and Health (NIOSH) develop an agricultural health initiative that would include goals similar to the Healthy People 2000 Initiative led by the National Cancer Institute (NCI). The agricultural health initiative was to serve the overall goal of reducing disease morbidity and mortality in the United States by the year 2000. Specifically, the NIOSH agricultural health initiative would focus on improving the occupational health and safety of farm families and farm workers. Drs. Paul A. Schulte, Lawrence J. Fine, and colleagues took the lead in the conceptualization and the development of the initiative. Today the Cancer Control Demonstration Projects for Farming Populations have been in operation for nearly six years. One facet of this initiative, according to the congressional mandate, is the development of cancer screening programs targeting farmers in the upper Midwest. This mandate was, in part, predicated on the fact that although, overall, farmers experience lower cancer rates than the U.S. population, they are nevertheless at increased risk for certain site-specific cancers, such as brain, stomach, lymphatic and hematopoietic, lip, prostate, and skin cancer. In addition, compared to urban populations, rural cancer patients are more likely to be diagnosed at later stages of disease; are more likely to not be assigned a specific degree of severity, called staging at diagnosis; and are at a more advanced stage of illness when referred to home health care agencies. In an effort to more fully address the health needs of farmers and their families, NIOSH developed the Cancer Control Demonstration Projects for Farming Populations.