The Cancer Training Program
is a critical resource to the National Cancer Institute. It supports a broad
range of training activities in the finest institutions in the country,
individual fellowships and career awards, and education grants. Because
those trained in research today will form the intellectual foundation for
basic, clinical, and population sciences 10 years from now, training activities
sponsored by the NCI must continually anticipate the human resource needs
of cancer research in the future. The quality and progress of the Nation's
cancer research effort tomorrow will depend directly on the quantity and
quality of the individuals who are attracted to careers in cancer research
today, and on the appropriateness of the strategies used to train these
individuals. Rapid advances in our basic understanding of genetic and molecular
changes contributing to the growth and spread of cancer cells provide increasing
opportunities to move this knowledge into patient and population research
settings. In addition, these advances have a direct, more significant impact
on reducing cancer incidence and mortality through new screening, prevention,
diagnostic, and therapeutic interventions. Without adequate training, the
Nation's scientific and health care professionals will be unable to bring
these discoveries to the benefit of the people.
To meet this challenge, NCI is pursuing four interdependent training and
education strategies.
* First, maintaining the critical mass of independent basic scientists studying
cancer at the most fundamental levels of genetics and molecular biology;
basic discoveries will always generate the new knowledge critical for continued
progress in eliminating cancer.
* Second, encouraging a greater proportion of well-trained basic scientists
currently engaged in research on model systems to develop interests in model
systems for human biology and human disease; it is clear that the complex
objectives of cancer research will depend more and more on effective collaborations
between basic scientists and clinical and population scientists.
* Third, attracting more young physicians, other health care professionals,
and public health specialists into cancer research; of particular importance
will be developing and sustaining training programs that will markedly improve
the quality and quantity of physicians trained in the clinical sciences,
as well as continuing programs that will develop a larger contingent of
physicians, other health care professionals and public health specialists
in the biostatistical, epidemiological, behavioral and other prevention,
and control sciences.
* Fourth, using education grants to improve the curricula for health care
and public health students, and improving community education and information
dissemination programs; a critical issue is how to encourage those in the
health care arena and the lay public to maximize the effectiveness of current
information and knowledge.
As part of these strategies, the NCI continues to support extensive training
and career development programs for minority individuals in order to increase
the number of biomedical scientists from under-represented population groups
and to increase the number of research personnel leading us into the next
century. This investment in intellectual resources is expected to pay off
through the expansion of the Nation's ability to identify and respond to
cancer trends among all sectors of the population. The Comprehensive Minority
Biomedical Training Program supports these activities through several mechanisms,
including recently developed minority medical oncology awards intended to
encourage newly trained clinicians to acquire clinical research experience
in oncology. Of particular importance is the emphasis the program places
on issues directly related to the health status of minority populations.
Other NCI training programs support minority students in the pre- and post-doctoral
phase of development, with awards made through the National Research Service
Awards, career development awards, supplements to institutional awards,
and cancer education grants.
Research is a complex enterprise
that only flourishes in the context of a strong, reliable support infrastructure.
Contracts are a primary mechanism that the NCI uses to provide support for
research, information dissemination, and management. About 350 such contracts
are expected to be in force in FY 1996 with funding totaling $279 million.
Generally awarded on a competitive basis for 3 to 5 years depending on the
project, contracts are either completed or the project is recompeted at
the end of the contract period. Contracts support a variety of research
activities, such as components of drug development, cancer control, epidemiology,
surveillance, cancer biology, and information dissemination activities,
including the Cancer Information Service. Contracts principally support
program development activities in which the NCI defines the area of work,
provides guidelines as to how the work will be accomplished, and establishes
specific deliverables. The use of contracts is exemplified in the drug development
program where a range of services is acquired to support drug screening,
synthesis, acquisition, preclinical testing, pharmacology, toxicology, and
drug formulation--all sequential activities necessary to produce a new drug.
The programs that employ contracts are broad and diverse, with a vital role
in supporting laboratory, clinical and population-based research, NCI's
management infrastructure, and information dissemination to both the public
and the scientific community, here and abroad.
Consensus among experts on the
usefulness of new medical knowledge does not guarantee its widespread application.
Cancer control, as supported by the NCI, addresses this challenge through
research on the behavioral, psychosocial, health services, communication,
and cancer surveillance aspects of translating proven technologies and tested
methodologies into routine practice in the community. Among the requirements
may be the removal of barriers to application often found in areas of information
dissemination, access to health care services, or cultural conventions.
These barriers may be present in the home, the community, the environment,
or at the interface with the health care system. They may require behavioral,
social, financial, or political solutions.
The NCI's cancer control activities include a special focus on population
groups who bear excessive risks for cancer or who lack access to state-of-the-art
cancer services. Research efforts have been undertaken with the collaboration
of community and private sector organizations that can be mobilized to assist
these population groups. Research networks of minority investigators and
leadership groups of community representatives have been established to
help accomplish the NCI's cancer control objectives.
Important to the process of technology transfer, the NCI's activities in
information dissemination include programs for both the public and health
care professionals. These programs are based on population needs identified
through epidemiologic studies and market research among specific population
groups. This allows for the design of programs that are relevant and understandable
to each group. Information can be disseminated nationally through the NCI's
patient education program, the leadership initiatives for special populations,
minority research networks, and the Cancer Information Service.
Information dissemination is a central component of the NCI's mission
and mandate. The NCI reaches all segments of our diverse population with
needed cancer information and speeds the assimilation of clinical advances
in cancer into standard medical practice through vital programs including:
The Cancer Information Service (CIS)
The CIS provides accurate, up-to-date cancer information to patients
and their families, the public, and health care professionals in all 50
states through 19 offices located at NCI-funded Cancer Centers and other
health care institutions. By dialing 1-800-4-CANCER, callers are automatically
connected, free of charge, to the office serving their region. Information
on specific cancer types, state-of-the-art care, clinical trials, prevention
and detection, and resources such as support groups or screening and smoking
cessation programs is provided in English or Spanish by information specialists
who respond to more than 600,000 inquiries annually. The CIS regional offices
are also the NCI's focal point for state and local-level cancer education
efforts that particularly target underserved, high-risk, and low-literacy
populations. The CIS offices also catalog local cancer-related services,
catalyze community outreach efforts, and provide print materials and technical
assistance to help local organizations sponsor cancer education programs,
media campaigns, and other community programs.
The International Cancer Information Center (ICIC)
The ICIC, recently designated a government Reinvention Laboratory, provides
an array of cancer information for scientists, health professionals, and
the public. The Physician's Data Query (PDQ) is NCI's comprehensive clinical
cancer database, available on-line and via CD-ROM. Updated monthly, PDQ
contains the most current information on treatment of over 80 types of cancer,
clinical trials open for patient accrual, and cancer prevention, detection,
and supportive care updates. PDQ includes directories of over 21,000 physicians
and 8,000 organizations active in cancer care, including FDA-approved screening
mammography facilities. The CIS uses these directories daily to provide
local referrals to callers. Abstracts from CANCERLIT, NCI's comprehensive
bibliographic database describing cancer research results published over
the past 20 years, are also available through PDQ. Portions of PDQ information,
news bulletins, and other materials are available in Spanish and English
24 hours a day, seven days a week through NCI's CancerFax facsimile system
and CancerNet, an e-mail service. The ICIC also provides easy access to
its information through the World Wide Web (http://wwwicic.nci.nih.gov).
Easily updated, the ICIC's Web page is used to transmit important, late-breaking
news and findings from the NCI and NIH and provides access to some of the
ICIC's information products. Additional links include access to a patient
referral process for cancer clinical trials open at the NIH Clinical Center
and to NCI tissue registries for breast cancer and AIDS malignancies. The
Web page provides extensive information for patients and the general public,
including a site for children, and also has links to other Web sites of
interest worldwide including Cancer Centers, cancer support groups, and
many scientific and government sites.
NEXT SECTION... | PREVIOUS SECTION... | CONTENTS PAGE... |