Director Tells How NCI Will Spend Budget Increases

WASHINGTON—President Clinton’s proposed budget for fiscal year 2001 includes $3.505 billion for the National Cancer Institute (NCI), a 5.8% increase over the current fiscal year. The President also asked Congress to appropriate $18.813 billion for the National Institutes of Health, a 5.6% increase over its present budget.

The proposed NCI spending includes $3.25 billion for cancer research, an increase of $183 million (6%) over its current funding, and another $255 million for AIDS research, which represents a $10 million (4.1%) increase. In fiscal year (FY) 2000, which ends Sept. 30, NCI will have a total budget of nearly $3.312 billion, an increase of 14.5% above its budget authority in FY 1999. The actual increase in spending available for use by NCI in the current fiscal year is $420 million

In testimony on Capitol Hill and in material provided to the National Cancer Advisory Board, NCI director Richard D. Klausner, MD, outlined some of the key areas in which NCI will spend its increased funding during this fiscal year and the next one.

Racial Disparities

In an address to the House subcommittee that oversees the NCI budget, Dr. Klausner said that one general area in which NCI will devote additional dollars is that of the uneven distribution of cancer among racial and ethnic groups.

“We are in the midst of a number of expansions in our programs aimed at the ability to assess, explain, and affect the unequal burden of cancer,” he said in his statement to the subcommittee.

NCI’s Surveillance Epidemiology and End Results (SEER) program is currently being revised to enhance coverage of rural whites and blacks, non-Mexican Hispanics, and Native Americans.

The Institute is also formalizing its collaboration with the Centers for Disease Control and Prevention (CDC) and the integration of its surveillance programs with CDC’s National Program of Cancer Registries.

This year, NCI will begin creating what it calls special population networks (SPNs) to develop cancer control and research programs within various un-derserved communities. The Institute envisions establishing 14 SPNs and spending $50 to $60 million on the program over the next 5 years.

“These SPNs, we hope, will provide the basis for a new national platform for cancer research to address the distinct cancer burdens of special populations,” Dr. Klausner said. And the Institute this year will also fund five research partnerships between NCI-designated cancer centers and minority institutions.

Following up on findings in its Atlas of Cancer Mortality in the United States, 1950-1994, released in December [see ONI February 2000, page 9], NCI will solicit research proposals for two types of studies.

The Institute will seek epidemiologic studies to decipher the geographic and temporal cancer patterns revealed in the 367-page publication, and methodologic proposals for developing geographic information systems for evaluating environmental associations with cancer.

Early Detection Research Network

Dr. Klausner said that NCI has created an Early Detection Research Network, “a novel and complex research structure established to discover, develop, and validate markers for the early detection of cancer.”

In this program, researchers from multiple institutions will collaborate to assess potential markers and develop them into reliable and standardized assays. In its first year, the program is focusing on markers for breast, prostate, ovarian, lung, and gastrointestinal cancers.

NCI is also funding a series of studies intended to advance the imaging of cancers, including a series of clinical trials now being planned.

These studies include a comparison of magnetic resonance imaging (MRI) and computed tomography (CT) in gynecologic malignancies, the use of positron emission tomography (PET) to track responses to chemotherapy, the value of spiral CT in lung cancer screening, and comparative studies of real vs virtual colonoscopy and standard vs digital mammography.

In addition, NCI will fund a series of In Vivo Cell and Molecular Imaging Centers, starting with two or three this year. The intent of the centers is to strengthen and develop the emerging field of functional imaging, in which the presence of a tumor, its molecular characteristics, and its behavior are all identified.

The Institute also expects this year to increase the number of consortia, now six, in its Unconventional Innovations Program, which is aimed at developing novel detection and imaging systems by exploiting new technologies such as molecular sensing, nanoscale devices, and microexplorers.

NCI will continuing the 3-year-old effort to restructure its drug discovery program to focus on ways to attack precise molecular targets involved in the development of cancer and in the behavior and survival of tumors.

“We have funded four new centers to develop new libraries of chemical diversity and to screen for promising molecular targets,” Dr. Klausner said. “This year, we will fund new Centers of Excellence for drug development, each of which will focus on specific cancer pathways to speed the discovery of useful targets.”