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The Future of Cancer Research: ACCELERATING SCIENTIFIC INNOVATION

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The Future of Cancer Research: ACCELERATING SCIENTIFIC INNOVATION The Future Of Cancer Research: ACCELERATING SCIENTIFIC INNOVATION President’s Cancer Panel Annual Report 2010-2011 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute The President’s Cancer Panel LaSalle D. Leffall, Jr., M.D., F.A.C.S., Chair (through 12/31/11) Charles R. Drew Professor of Surgery Howard University College of Medicine Washington, DC 20059 Margaret L. Kripke, Ph.D. (through 12/31/11) Vivian L. Smith Chair and This report is submitted to the President of the United States Professor Emerita in fulfillment of the obligations of the President’s Cancer Panel The University of Texas to appraise the National Cancer Program as established in MD Anderson Cancer Center accordance with the National Cancer Act of 1971 (P.L. 92-218), Houston, TX 77030 the Health Research Extension Act of 1987 (P.L. 99-158), the National Institutes of Health Revitalization Act of 1993 (P.L. 103-43), and Title V, Part A, Public Health Service Act (42 U.S.C. 281 et seq.). Printed November 2012 For further information on the President’s Cancer Panel or additional copies of this report, please contact: Abby B. Sandler, Ph.D. Executive Secretary President’s Cancer Panel 9000 Rockville Pike Bld. 31/Rm B2B37 MSC 2590 Bethesda, MD 20892 301-451-9399 [email protected] http://pcp.cancer.gov The Future Of Cancer Research:: ACCELERATING SCIENTIFIC INNOVATION President’s Cancer Panel Annual Report 2010-2011 Suzanne H. Reuben Erin L. Milliken Lisa J. Paradis for The President’s Cancer Panel November 2012 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute The President The White House Washington, DC 20500 Dear Mr. President: Passage of the National Cancer Act more than 40 years ago marked the start of our nation’s war on cancer. In the decades since, important strides in preventing, detecting, and treating cancer have been made possible by our national investment in cancer research. Major contributors to this progress include the sharp overall decline in tobacco use among Americans, better cancer screening and early detection methods, and improved and targeted cancer therapies. As a result, more Americans are surviving longer following a cancer diagnosis than ever before. Moreover, mortality from some cancers has decreased markedly. Despite these achievements, the incidence of some cancers is increasing for unknown reasons and the decline in the nation’s overall cancer death rate has been slower than anticipated. Of additional concern, the number of cancer diagnoses is expected to increase sharply over the coming years as the U.S. population ages, overwhelming much of the progress that has been made. Indeed, cancer is projected to become the nation’s leading cause of death over the next decade, surpassing heart disease. Cancer is the disease most feared by Americans, and a majority of the population believes that accelerating research to improve health is a top or high priority. Yet the impediments resulting from fluctuations in funding and the current focus, priorities, and processes of cancer research have inhibited widespread reductions in incidence and mortality and limited quality of life improvements for cancer survivors. These elements of the National Cancer Program need to be examined, reimagined, and reorganized to better support innovative research with the potential to transform cancer prevention and care. With these concerns in mind, the President’s Cancer Panel (the Panel) devoted its activities in 2010- 2011 to exploring opportunities to significantly improve cancer patient outcomes by fostering innovative research approaches and intensifying cancer prevention research efforts. The attached report provides the Panel’s recommendations for policies and related actions to accelerate scientific innovation and achieve the transformative advances needed to dramatically decrease cancer deaths. Mr. President, your administration has amply demonstrated its commitment to health care reform and the goal of a healthier nation. Similarly, the Panel believes that your administration now has an opportunity to lead the nation into the next era of cancer research—one that holds more potential than at any time in history for improving our understanding of cancer and learning to prevent it, find it early when it does occur, and treat all forms of the disease effectively without harmful side effects. Without your crucial support for a refocused vision for cancer research, progress toward the goal of preventing, controlling, and curing cancer will continue to proceed incrementally instead of accelerating to meet the needs of the American people. Sincerely, LaSalle D. Leffall, Jr., M.D., F.A.C.S. Margaret L. Kripke, Ph.D. Past Chairman Past Member Table of Contents Executive Summary and Recommendations ................................................................................i Preface Acknowledgements PART I THE NATIONAL CANCER PROGRAM: OVERVIEW .......................................................................1 Chapter 1: Scope and Leadership of the National Cancer Program A Brief History of the National Cancer Act .......................................................................................... 3 Participants in the National Cancer Program ...................................................................................... 5 Perceptions of Cancer Risk, Cancer Research, and the National Cancer Program ......................... 5 Chapter 2: Our National Cancer Burden Incidence ..................................................................................................................................................10 Mortality ...................................................................................................................................................12 Survival .....................................................................................................................................................12 Continuing Disparities ...........................................................................................................................13 Chapter 3: Highlights of Cancer Research Progress Basic Research ..........................................................................................................................................15 Translational Research ............................................................................................................................16 Clinical Research .....................................................................................................................................18 Surveillance, Epidemiology, and Population Research ......................................................................19 Screening and Early Detection Research ............................................................................................ 21 • Breast Cancer Screening ................................................................................................................ 21 • Cervical Cancer Screening ............................................................................................................ 23 • Colorectal Cancer Screening ........................................................................................................ 24 • Prostate Cancer Screening ............................................................................................................ 25 • Lung Cancer Screening .................................................................................................................. 27 Prevention Research ............................................................................................................................... 28 • Preventing Cancer through Modifiable Lifestyle Behaviors ..................................................... 28 • Chemopreventive Interventions ................................................................................................... 28 • Addressing Cancer-Linked Infections ......................................................................................... 29 PART II MOVING FROM INCREMENTAL ADVANCES TO TRANSFORMATIVE INNOVATION ................... 33 Chapter 4: Modifying the Focus and Priorities of the National Cancer Program to Accelerate Innovation and Progress Cancer Research Funding Trends ........................................................................................................ 35 • Federal Government ....................................................................................................................... 35 • Voluntary Sector.............................................................................................................................. 38 • Industry ........................................................................................................................................... 39 Variations in Research Emphases of Federal, Voluntary, and Private Sector Funders .................. 39 • Federal Government ...................................................................................................................... 39 • Voluntary Sector ............................................................................................................................ 40 • Industry ........................................................................................................................................... 41 Research Areas with Limited Emphasis .............................................................................................
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