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In 2001, the National Cancer Institute (NCI) issued to the nationwide cancer community a Challenge Goal: Eliminate the suffering and death due to cancer by 2015.
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Never before have so many scientific tools and technologies and so much biomedical knowledge been assembled to power our ability to reach our Challenge Goal. The cancer community is currently experiencing exponential growth in its knowledge of cancer as a disease process, growth that has been fueled by historically high levels of funding, scientific expertise, infrastructure, and enabling technologies. With a sharp focus on our goal and continued budgetary support, we will be able to assemble the necessary pieces and achieve the type of progress needed to remove the ring of fear from the word "cancer" for future generations.
NCI will concentrate its research investments on preempting the process of cancer by preventing its initiation; detecting it early; and slowing, stopping, or reversing the cancer process so that it cannot progress to a lethal phenotype. We will also work to ensure that emerging knowledge is used immediately to develop, test, and deliver new interventions for public health programs, medical practice, and policy making. Our success will depend on our ability to seamlessly integrate activities both within NCI and with our partners, remove major barriers to progress, and ensure that all new activities are informed by lessons learned along the way.
This focus is in keeping with the new NIH bench-to-bedside "Roadmap" announced on September 30, 2003, as a framework for the strategic investments by which NIH proposes to optimize its entire research portfolio. Building on the tremendous progress in medical research achieved in part through the recent doubling of the NIH budget, the NIH Director set forth an ambitious vision for a more efficient and productive system of medical research. The Roadmap focuses on the most compelling opportunities for "new pathways to discovery," "research teams of the future," and the "re-engineering of the clinical research enterprise."
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As the leader of the National Cancer Program, NCI provides vision and leadership to the nationwide community of researchers, public health workers, healthcare providers, patients, advocates, and policymakers working to defeat cancer. We strive to facilitate a seamless process for integrating discovery activities, accelerating the development of new interventions, and ensuring the delivery of new evidence-based interventions for all cancers and all people in need. We must:
- Ensure that results of research are continuously evaluated for their potential for practical application and quickly moved into arenas of developmental research.
- Have an eye toward the delivery of validated interventions to clinical practice and public health settings throughout all of our efforts in discovery and development.
- Continue to study their impact on individual and public health to inform future research and development as interventions are taken to the people.
- Ensure that movement in each of our priority areas along the discovery-development-delivery research continuum is smooth and unencumbered by traditional infrastructure boundaries and linear ways of thinking.
NCI's Action Plan for Fiscal Year 2005 outlines our next steps in achieving our Challenge Goal to eliminate the suffering and death due to cancer. It includes continued work in broad research areas and optimal use of existing and new knowledge for the development and application of evidence-based interventions, all of which will have implications for many types
of cancer.
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To advance toward our goal to eliminate the suffering and death due to cancer, we must continue to improve our understanding of:
- The genetic, environmental, and lifestyle factors and their interactions that define cancer risk.
- The interaction between cancer cells and their microenvironment.
- How body weight, physical activity, and diet interact with genetic and environmental factors to influence the cancer process.
- The causes of tobacco use, addiction, and tobacco-related cancers.
- The biological, physical, psychological, and social mechanisms, and their interactions that affect a cancer patient's response to disease, treatment, and recovery.
- The scientific basis for quality cancer care.
- The fundamental causes of cancer health disparities.
- Imaging methods, molecular biosensors, and imaging-guided interventions.
- Molecular targets for treatment and prevention.
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. . . then use that information to develop highly effective evidence-based interventions including:
- Strategies to address the clinical, behavioral, and societal issues associated with cancer susceptibility.
- Validated molecular targets for treatment and prevention.
- New drugs and reagents that target cells in the microenvironment.
- Novel combinations of drugs and modalities that can preempt or arrest malignancy.
- Imaging and molecular biosensors for use in early detection, diagnosis, treatment, and prediction.
- New approaches to the prevention and treatment of tobacco use, nicotine addiction, and tobacco-related cancers.
- Tools to improve physical fitness, diet, and weight control.
- Process and outcome measures for assessing the quality of cancer care.
- Incorporation of symptom management and palliative care into quality care improvement.
- Specific approaches to reducing cancer-related health disparities.
- Strategies for reducing cancer-related chronic or late morbidity and mortality.
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. . . and ensure that these new interventions are used to:
- Make novel and effective prevention, early detection, and prediction measures available to all who need them.
- Deliver targeted and effective therapeutic interventions to all cancer patients.
- Eliminate cancer-causing behaviors such as tobacco use, unhealthy diet, and sedentary lifestyle.
- Eliminate disparities in cancer incidence, mortality, and access to quality cancer care.
- Eliminate the adverse effects of cancer diagnosis and treatment on cancer survivors.
- Capture the experience and knowledge gained from application to inform further discovery in cancer biology, molecular epidemiology, and the behavioral sciences.
To meet these objectives for research discovery, development, and delivery, we must optimize our research platforms and enable investigators to work at peak efficiency. Our success in achieving these objectives will depend on our ability to:
- Accelerate innovation in investigator-initiated research by expanding access to resources and new technologies.
- Integrate infrastructures and collaborations through Cancer Centers, networks, and consortia to address large problems in human cancer.
- Ensure that our national clinical trials program addresses the most important research questions quickly and effectively.
- Promote networks, partnerships, and coalitions to translate results of research into clinical practice and public health benefit.
- Create and use bioinformatics and analytical tools to redefine how cancer research is conducted; care is provided; and patients, physicians, and researchers interact.
- Understand, apply, and disseminate communication approaches that maximize access to and appropriate use of cancer information by all who need it.
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(dollars in thousands) |
Core Scientific Areas |
| We will be able to accelerate our understanding of the causes of cancer through large-scale studies in Genes and the Environment. | $73,150 |
| We will further explain the biological mechanisms that influence the development and progression of cancer through studies on the Signatures of the Cancer Cell and Its Microenvironment. | $35,300 |
| As we more fully understand the causes, development, and progression of cancer, we will be able to accelerate the validation of Molecular Targets of Prevention, Diagnosis, and Treatment. | $47,650 |
| And we will continue to expand the discovery and development of Imaging tools, accelerate the development of image-guided interventions, and stimulate research on in vivo Molecular Sensing. | $44,750 |
Areas of Public Health Emphasis |
| We will continue to investigate the pervasiveness and causes of Tobacco Use and Tobacco-Related Cancers and apply this knowledge to prevention and treatment. | $75,000 |
| Studies in Optimizing Energy Balance will help us better understand the interactions among weight, physical activity, diet, and cancer and apply this knowledge to cancer prevention and control. | $57,800 |
| We will strengthen the scientific basis for public and private decision making to Improve the Quality of Cancer Care on behalf of millions of people who do not receive adequate cancer care. | $36,300 |
| We will work to Reduce Cancer-Related Health Disparities for the untold numbers of people who suffer because of social or economic status, cultural or language barriers, or geographic location. | $71,300 |
| We will work to better understand Cancer Survivorship and develop interventions that will optimize health and quality of life after cancer. | $30,250 |
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| Investigator-Initiated Research builds on the synergism at institutions across the country to ask the critical questions, explore research options, and develop and test innovative technologies. | $123,501 |
| Centers, Networks, and Consortia allow investigators to work in teams, collaborate for progress, and ensure that results advance from discovery to intervention development and delivery. | $96,800 |
| NCI's National Clinical Trials Program provides the infrastructure to move new cancer interventions from the laboratory to studies in people and then to the healthcare setting. | $334,900 |
| We will harness Bioinformatics tools to integrate data, capture and share research outcomes, and provide tools for patients to interact more directly with cancer researchers. | $40,800 |
| As we better understand, apply, and disseminate effective Communication approaches, we will be able to maximize access to and appropriate use of cancer information by all who need it. | $43,500 |
| Total Increase Request for Fiscal Year 2005 Priority Areas | $1,111,001 |
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