Federal funding lacking for cancers with highest mortality rates
Key takeaways:
- Federal research funding lags for many cancers with high mortality rates.
- More equitable funding policies are needed to support research for the most lethal malignancies.
CHICAGO — Cancers with higher mortality rates receive a disproportionately low amount of federal cancer research funding, according to study results presented at ASCO Annual Meeting.
Underfunding “strongly correlates” with fewer clinical trials, which limits research advances for malignancies that already have poorer outcomes, according to Suneel Kamath, MD, a gastrointestinal oncologist at Cleveland Clinic.
“We continue to fund the outcome we already get, and we continue to neglect diseases for which we’re not getting the results we need,” Kamath told Healio. “We will never make progress in the tumor types that have high mortality rates — where we desperately need more effective therapies — until we start putting dollars toward those cancers.”
Funding from NIH and other federal sources is crucial for cancer research and advocacy.
Kamath aimed to evaluate the extent to which funding is distributed equitably across cancer types.
Kamath reviewed NIH and Congressionally Directed Medical Research Programs (CDMRP) funding distributed from 2013 to 2022 to support breast, cervical, colorectal, endometrial, hepatobiliary, lung, ovarian, pancreatic and prostate cancers, as well as leukemia, lymphoma and multiple myeloma.
He looked for funding disparities based on cancer incidence and mortality, as well as impact on racial groups. He also examined whether underfunding correlated with a reduced number of clinical trials.
Results showed the largest combined NIH and CDMRP funding for breast cancer ($8.36 billion), lung cancer ($3.83 billion) and prostate cancer ($3.61 billion).
The lowest funding amounts went to uterine cancer ($435 million), cervical cancer ($1.12 billion) and hepatobiliary cancer ($1.13 billion).
Cancer-specific funding correlated well with incidence (Pearson correlation coefficient, 0.85); however, it did not align well with mortality (Pearson correlation coefficient, 0.36).
Several cancer types — including breast, cervical and ovarian cancers, as well as leukemia and lymphoma — appeared consistently well funded based on incidence and mortality rates, Kamath said. Other malignancies — such as colorectal, liver, lung and uterine cancers — appeared consistently underfunded.
“I knew the [breast cancer funding total] would be big, but I didn’t expect it to be almost a billion dollars every year,” Kamath said. “I didn’t expect the next-closest cancer type would be so much further down. I also was surprised to see how many very common and highly lethal diseases — like colorectal cancer, pancreatic cancer, liver tumors and uterine cancer — get very little funding.”
Results showed disproportionate underfunding of cancers with higher incidence among Black individuals.
Overall, the findings highlight the need for more equitable research funding policies to better support research into the most lethal cancers, Kamath said.
“Right now, we have a lobbying- and advocacy-based way of choosing where federal dollars go. It’s about who came to Capitol Hill, how often they come, or how much they bother their senators or members of Congress,” Kamath said. “That’s not a rational way to choose where our funding allocations go. Now that the pool of money is dwindling, we need to be smarter about where those dollars go.”
One potential strategy is to develop a score, algorithm or other criteria that takes factors such as incidence, mortality, costs and impact on specific populations — such as younger individuals — to guide funding decisions.
“I don’t care about any particular tumor type, and nobody else should,” Kamath said. “It should be about which ones affect the most people and cause the most deaths. The funding cuts we’re facing now, for better or worse, are designed to improve efficiency. They’re not really achieving that but, if we had a score of some type, we actually could do more with less dollars because they’d be going to the right places.”
Kamath’s analysis also revealed that funding for specific malignancies correlated strongly with the number of clinical trials available for that cancer type (Pearson correlation coefficient, 0.76).
Kamath characterized that finding as “a little surprising” given federal money typically funds a greater proportion of basic science research.
“A lot of the pathways that are identified and become drug targets for [industry-supported trials] later on are found in federally funded labs and universities,” Kamath said. “The targets that drug companies will get us in 2040 and 2050 really will come from federally funded research that happens in labs today. If we don’t have that pipeline, we’re not going to get those results.”
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Kamath, S. Abstract 11025. Presented at: ASCO Annual Meeting; May 30-June 3, 2025; Chicago.