In the past, the final NCI Cancer Bulletin issue of the year has been used to reflect on some of the important research news from the past 12 months. And, indeed, the news this year has been encouraging. Most recently, the annual Report to the Nation ¹ documented that, for the first time since the report was initially produced a decade ago, both incidence and death rates from cancer are declining.

Although the decline in incidence must be interpreted with caution, the continued downturn in mortality demonstrates that translating the research of cancer prevention, early detection, and treatment into clinical practice pays significant dividends. Our progress toward more individualized prevention and treatment will undoubtedly build on this promise.

In today's global economic climate, however, it's difficult not to ponder how the current financial tumult will affect future gains against cancer. Flat budgets over the past 5 years have already dramatically reduced NCI's purchasing power. We've had to make difficult funding choices, and there are continued concerns about the impact on the pipeline of young cancer investigators.

If some of the economic stimulus proposals that have been discussed in Congress are any indication, including one proposal that would increase the NIH budget by $1 billion, there could be reason for optimism. And although we tend to think of an investment in biomedical research in purely clinical terms, there is evidence that such an investment can provide a boost to the economy.

According to leading economists, in an "underemployed economy" - that is, an economy where skilled workers, such as basic scientists and lab technicians, are not engaged in jobs that maximize their skill sets - there can be a two- to threefold return for every dollar spent by the federal government that puts such people back to work.

At its most rudimentary level, that government investment in research ends up, for instance, as a grant to a researcher. The largest part of that grant ends up as salaries and some funds are used to purchase materials to conduct research. But the investigator and laboratory staff receiving this government grant support use those salary dollars to purchase a new vehicle or a home or goods and services. All of that is money going directly back into the economy again, multiplying well beyond the initial investment.

But this type of government stimulatory effect is even more complex than what can transpire through tax breaks or direct spending on infrastructure projects, such as roads and bridges. While it is difficult to measure the payoff in terms of individual research projects, in the aggregate, a significant investment in biomedical research is the type of government spending most likely to produce long-term gains for society - such as the unexpected innovations that create new markets for economic growth, the increased productivity of the populace whose health is improved and who are thus able to be more productive citizens, and the opportunity through science to decrease health care costs.

When you look just at NCI, let alone the 26 other NIH institutes, you get a sense of the potential of this type of investment. NCI has a budget of approximately $5 billion. It supports approximately 5,700 researchers who are focused on efforts to improve the outcomes of a disease that, according to a recent NCI analysis, will have an economic burden in the United States of $1.8 trillion by 2017.

Many around the country are dealing with the fallout from the current economic difficulties. Both policymakers and homemakers are faced day after day with tough decisions about how to spend their available resources wisely. But even in these difficult times, I see a groundswell of support at all levels, from local communities to the highest sectors of government, to do what it takes to overcome the cancer burden.

It's for that reason that I'm hopeful we'll see the type of investment in cancer research we know can pay dividends for people's health and well being, and that very well could produce the type of financial gains that can help our struggling economy recover.

In closing this, the 200th issue of the NCI Cancer Bulletin, the NCI staff and I would like to extend our best wishes for a joyful and safe holiday season.