How big is the US Cancer Research Funding? A Comparison of Research Output from Surgical Cancer Centers and Specialist Cancer Centres in 2018-2019
The impact of such investment has been variable. Significant improvements in some adult blood-cancer outcomes have been made, but changes in survival for stage 4 solid adult cancers have been modest and even more so. The rate of improvements in outcomes for cancers of the pancreas and upper gastrointestinal tract has been glacial.
There are technical expansions in surgery, radiotherapy, and artificial intelligence. The introduction of more advanced minimally-invasive surgery, as well as other improvements, has greatly changed the way surgical cancer is treated. These new technologies come with a host of real-world implementation issues, just like cancer medicines. Although minimally invasive surgery has helped some cancer types in low- and middle- income countries, there is still a lot of work to be done. There is also good evidence that in surgical oncology, robotics have created market forces that favour affluent patients at the expense of more equitable service delivery. The state of global radiotherapy research reflects similar inequalities, with most of the research focused on high-income settings and technical innovation, and less than 2% of global R&D focused on implementation.
Every year a bunch of cancer drugs are approved for market but they do not deliver clinically meaningful benefit. Of the 161 approvals for solid adult cancer therapies by the US Food and Drug Administration since 2017, only 35% were graded as delivering substantial clinically meaningful benefit on the European Society for Medical Oncology Scale, a standardized tool for assessing new anticancer therapies.
Cancer research represents a large slice of overall research output in the Nature Index for many institutions, although this does not always translate to a high Share in this field. The Share is plotted against the Nature Index output for the leading 200 institutions in the topic.
With 10,280 grants worth a total of US$13.1 billion awarded in 2018–22, the US National Cancer Institute (NCI) dwarfs all other major North American funders of cancer research. The federal government allocated a budget of $7.3 billion for the National Institute of Health, up $400 million from last year.
Some outliers are highlighted in the chart below. Specialist cancer centres unsurprisingly have a high proportion of Nature Index output related to cancer research. But two in the United States, the Memorial Sloan Kettering Cancer Center in New York City and University of Texas MD Anderson Cancer Center in Houston, Texas, are clear of other specialist institutions on Share.