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Top 25: Medical stories

Human genome mapping ranks No. 1 in health news

Progress and controversy mark the past 25 years in medicine.



What medical development do you think had the greatest impact on the daily lives of Americans?
Low-carb diet
Tobacco regulation
Laser-eye surgery

Top medical stories

1. Human genome mapping
2. Stem cells
3. Cloning
5. Living liver transplant
6. Self-contained artificial heart
7. Prozac
8. Seatbelt laws
9. Overweight America
10. Body mass index
11. Phen-Fen
12. Low-carb diet
13. Cosmetic surgery boom
14. Gene therapy
15. Anthrax attack
16. West Nile/SARS
17. Prescription drug advertising
18. Tobacco settlement
19. Silicone breast implant settlement
20. Reproductive surgery
21. Laser-eye surgery
22. Mad cow
23. ADHD
24. Tylenol tampering
25. Viagra

(CNN) -- Much of the marvel of medicine has to do with discovery. Mapping the human genome, the complete sequence of DNA, gave scientists a blueprint for building a person, making it the No. 1 medical story, according to a distinguished panel CNN gathered to rank the top 25 medical stories of the past quarter-century.

Two men from two separate groups -- Francis Collins of the National Institutes of Health and Craig Venter of Celera Genomics Inc., a pharmaceutical-development company -- worked independently to discover the sequence of the human genome and identify the genes that it contains. This research led to the development of gene-based "designer drugs" that can fight specific diseased or damaged cells.

One such drug is Gleevec, which has proven effective in fighting a form of leukemia. Other drugs that can target various forms of cancer and other diseases could soon be on the way now that scientists know what to look for.

"By 2015, we will see the beginnings of a real transformation in the therapeutics of medicine, which by 2020 will have touched virtually every disorder," Collins said. "And the drugs that we give in 2020 will for the most part be those that were based on the understanding of the genome, and the things that we use today will be relegated to the dust bin."

Continued study on other potential scientific breakthroughs, like disease-curing stem cells (No. 2), cloning (No. 3), gene therapy (No. 14), and reproductive surgery (No. 20) may not move as quickly, as they are hampered by controversy despite signs of success.

From creating new life to preserving existing lives, a revolution in life-saving procedures has included live liver transplants (No. 5), first performed in 1989, and the self-contained artificial heart (No. 6), which debuted in 2001.

The price of perfection

Not all the surgical procedures on the list are life-saving.

Although laser eye surgery (No. 21) aids patients with cataracts, it also has the potential to make glasses and contact lenses obsolete, and cosmetic surgery (No. 13) -- such as tummy tucks, liposuction and breast augmentation -- has never been more popular.

"Everybody is getting on the bandwagon," social historian Lynne Luciano said. "All ages, all income levels, all ethnicities. This started out as a phenomenon of older, well-to-do largely white people and it's spreading to everybody."

But the price of perfection has been high. More than 440,000 women brought claims against the company responsible for making silicone breast implants (No. 19), Dow Corning Corp., charging the implants caused various health problems. The company agreed to a multibillion-dollar settlement in 1999.

Dow Corning wasn't the only company that had to pay. After years of fending off lawsuits, the tobacco industry finally caved to pressure from the public and the Food and Drug Administration and settled for $246 billion (No. 18) with 46 states. Concerns about food and diet were highlighted by mad cow disease (No. 22). More generally, the federal government encouraged people to think about the amount of food they eat through the BMI (No. 10). Short for body mass index, the BMI changed the measurement of obesity.

Prescription plan

In an effort to deal with their weight problems (No. 9), some Americans changed what they ate through low carbohydrate diets (No. 12). Those looking for an easier way tried fen-phen (No. 11), an appetite suppressant whose results were negated by potentially lethal side effects.

The popularity of fen-phen was symbolic of the dramatic proliferation of pharmaceuticals. Some of the most widely used drugs are Prozac (No. 7) intended to help with depression; Viagra (No. 25) which created a profitable market for treating erectile dysfunction; and Ritalin, which is used to treat ADHD (Attention Deficit Hyperactivity Disorder, No. 23).

Americans' ability to acquire prescription drugs got a boost in the late 1990s, when the FDA loosened restrictions on how drug companies can advertise (No. 17). Ads for cheaper medications from Canada suddenly became part of an Internet advertising barrage and drugs could be purchased through the mail.

Several drugs made the list, including: Viagra, Phen-Fen and Prozac.

And those drugs became safer in the wake of the Tylenol tampering (No. 24) case of 1982, which remains unsolved. Seven people died after ingesting cyanide-laced capsules, resulting in the recall of 31 million bottles of the product. The industry responded by introducing caplets and tamper-proof caps.

Twenty years later, more died when anthrax powder was sent through the mail in a brief but frightening bio-terror campaign (No. 15). Again, no one was apprehended: the postal campaign targeted members of Congress and media outlets and left five people dead.

The pharmaceutical industry poured billions of dollars into the quest for an AIDS cure (No. 4). So far to no avail, but for many sufferers a combination of drugs has helped keep it in check.

"With all of these drugs, some more than others, there's the development of resistance," said Dr. Anthony Fauci of the National Institutes of Health. "So it's certainly not a cure, but it was a dramatic turnaround."

Two very different viruses -- the mosquito-spread West Nile virus and SARS (Nos. 16) -- also surfaced. According to the Centers for Disease Control and Prevention, 149 cases of West Nile were reported in its first years in the United States from 1999 through 2001, leading to 18 deaths. SARS, a viral respiratory infection, affected 8,098 people during the 2003 outbreak, mostly in Asia, with 774 dying before the disease was contained.

And one story is as much legal as medical: the passing of seatbelt laws (No. 8).

Stay tuned as CNN continues to celebrate its 25th anniversary by unveiling other top 25 lists through 2005.

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