Disparities in Government and Nonprofit Funding Affect Cancers with High Mortality Rates

Underfunding could impact clinical trial development

Many cancers with higher mortality rates and high incidence are underfunded, according to an analysis of government and nonprofit organization funding for cancer research presented at the American Society of Clinical Oncology 2021 annual meeting.

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“Funding from government organizations like the National Cancer Institute (NCI) and nonprofit organizations (NPO) are absolutely critical for advancing cancer research,” says Suneel Kamath, MD, author of the abstract and staff in the Department of Hematology and Medical Oncology at Cleveland Clinic Cancer Center. “But we suspected some cancers are less well funded than others are. Our study sought to understand if disparities in research funding exist among different cancers and to investigate potential impact on clinical trial development.”

Evaluating funding

Researchers used publicly available financial reports to evaluate funding from the NCI and any NPOs with over $5 million in annual revenue in the following cancers: endometrial, cervical, ovarian, hepatobiliary, prostate, colorectal, pancreatic, breast, lung, melanoma, lymphoma and leukemia. Then, they compared each cancer’s median incidence and mortality from 2015-2018 with funding amounts and analyzed for correlation with clinical trial numbers using descriptive statistics and Pearson correlation coefficients.

“We found that breast, leukemia and lung cancer had the most funding, while endometrial, cervical and hepatobiliary cancers received the least,” says Dr. Kamath. “Funding tracked well with incidence, but not necessarily with mortality.”

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Disease-specific funding from all sources correlated well with incidence but less so with mortality (Pearson correlation coefficients: 0.74 and 0.30, respectively). Funding from NPOs correlated with incidence but not with mortality (Pearson correlation coefficients 0.52 and 0.11, respectively).

Underfunded cancers

Results showed that colorectal, lung, hepatobiliary and uterine cancers were consistently underfunded when factoring in incidence and mortality. Breast cancer, lymphoma and leukemia, on the other hand, were consistently funded well.

 

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“When you look at colorectal cancer, the third most common and second leading cause of cancer death in the United States, or the rising rates of uterine cancer, there are clear opportunities to improve support for these and other underfunded cancers,” says Dr. Kamath. “Our data suggest that more dollars will lead to more clinical trials and in turn, to better outcomes.”

The researchers found that NCI funding, NPO funding and combined funding for each cancer correlated significantly with the number of clinical trials listed on clinicaltrials.gov for that disease (Pearson correlation coefficients: 0.88, 0.87, 0.91, respectively). “We linked underfunding directly to fewer clinical trials, and our worry is that this will slow the pace of advancement in treating these diseases,” says Dr. Kamath.

Dr. Kamath’s previous research highlights other disparities in cancer care, including a study of over 1 million patients that showed that Black patients with young-onset colorectal cancer were more likely to present with late-stage disease and have worse outcomes regardless of insurance type, income or education level. “The more we are able to demonstrate the causes of various disparities in funding or cancer care, the better we can pinpoint actionable targets and make impactful changes for our patients,” concludes Dr. Kamath.