Last week it was announced that the absolute number of annual cancer deaths has fallen for the first time in seven decades. The death rates from cancer have been declining since 1993, but now the actual number of cancer-related mortalities are yielding to our efforts. To my mind, that's momentous news. It proves that our antismoking messages, technologies that allow for earlier detection of disease, and improved treatments are having an impact. It also proves that our expectation of continued progress against cancer is well founded.

This news takes on special importance when considered in the context of our current budgetary situation. At last week's National Cancer Advisory Board (NCAB) meeting, in fact, the president's 2007 budget proposal for NCI was presented, and it sparked a critically important conversation about priorities.

When we announced the 2015 Challenge Goal 4 years ago, there was an expectation of increasing resources. But that expectation has changed. The government's discretionary spending now is increasingly restrained, placing greater focus on our strategic decisions about programs and research to be funded. As Dr. Niederhuber and I reinforced to the NCAB, those decisions are primarily driven by two factors.

First and foremost, funding decisions are based on the quality of the science. I cannot emphasize this enough. Whether it relates to R01s, P01s, NCI-designated Cancer Centers, or Specialized Programs of Research Excellence - scientific excellence is the principal consideration in the decision making process.

There is a second consideration that goes hand in hand with the scientific excellence of a program or a research proposal, and that is, does the science match our strategic priorities and contribute to our balanced portfolio? The programs and research projects that will help us achieve the 2015 goal must be in step with the scientific avenues identified by NCI leadership, our advisory boards, and the cancer community.

Over the past 15 months, each of NCI's divisions and centers worked to come up with almost 200 possible strategic goals, from which the NCI executive committee eventually agreed on 8 strategic priorities. It's these priorities that comprise the soon-to-be-released 2015 strategic plan, which will be instrumental in guiding our funding choices.

That said, clearly other considerations will influence the process.

There is, for example, a unanimous agreement among NCI leadership and advisory boards that we continue to strongly support young investigators. This is an imperative investment in our intellectual capital pipeline, and will create the generation of researchers who will build upon and refine the molecular oncology movement.

Also, leadership has carefully reviewed our research portfolio in an effort to limit duplication of effort and identify programs that should continue to be grown and nurtured, as well as those that have achieved all they can. Both will allow us to redeploy funds so we can quickly respond to promising opportunities or accelerate existing programs.

We also are committed to leveraging our investments by engaging in collaborations and partnerships with other NIH institutes and federal agencies, as well as with other groups in the public and private sector. The NIH Trans-Institute Angiogenesis Research Program, or TARP, which involves NCI and four other NIH institutes, is an excellent example of how we can leverage the portfolios of multiple NIH institutes to answer important biomedical questions.

The budgetary landscape has changed. We are adapting to these changes and making difficult choices. But I'm confident that the planning we have done will allow us to make the best decisions - those that will ensure we continue on a path of exponential progress and where death from cancer is the exception, not the expectation. The data now confirm we are on the course to eliminating the suffering and death due to cancer, a course we must - and will - continue.

Dr. Andrew C. von Eschenbach
Director, National Cancer Institute