By Richard L. Schilsky, MD, FASCO, Chief Medical Officer of ASCO

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ASCO’s recently issued report on Clinical Cancer Advances for 2013 highlights dozens of research breakthroughs reported this year that will improve the lives of people living with cancer and set the stage for the next generation of discoveries that will emerge in the coming years. But despite these advances, the sober reality is that 1.6 million Americans will be diagnosed with cancer this year and the number of new cancer cases will increase by nearly 40% by 2030, due largely to the aging of our population. One of every four deaths in the U. S. is caused by cancer, which this year will claim the lives of nearly 580,000 Americans, making it the second leading cause of death in the country. But the progress reported this year in Clinical Cancer Advances is cause for hope and optimism that the hundreds of diseases we call cancer are coming under control.

Due largely to our nation’s investment in cancer research over the last four decades, people diagnosed with cancer are living longer and better than ever before and more are being cured. Cancer-related deaths continue to decline in the U.S., by 1.5% per year over the last decade, and a person diagnosed with cancer today has a better than two-thirds chance of being alive five years from now. Scientific breakthroughs in cancer are occurring at a breathtaking pace and are being translated into new drugs and devices that benefit patients more quickly than ever before. Yet this progress against cancer is in real jeopardy of being stalled just when the opportunities and need are greatest.

The NIH budget has been flat for more than a decade and, when adjusted for inflation and the additional cuts imposed by sequestration, is 23% lower today than in 2003. As a result, the number of new grants NIH is able to fund is at its lowest level since 1998. As a result of sequester cuts, the budget of funded grants was cut by 10%, and more than 600 viable research projects went unfunded this year. Who knows which of these might have led to the next breakthrough in cancer prevention or treatment? These budget cuts are far more damaging and their effects far more long-lasting than their immediate impact on funded researchers. Young people are giving up on research careers, those with funding are curtailing projects and laying off staff, promising clinical trials are being put on hold. The nation’s research infrastructure is beginning to crumble while other countries are investing heavily in biomedical research and attracting our brightest young minds overseas.

A recent ASCO survey revealed that many ASCO members are spending less time in research, reducing the scope of funded projects and downsizing their research programs. Enrollment on NCI-supported clinical trials is approaching the lowest level in decades as NCI has had to impose a cap on enrollment at about 65% of previous highs, and fewer definitive phase III randomized trials are being mounted. This trend is particularly troubling as NCI-funded trials typically address important areas of research that are of little interest to the pharmaceutical industry but important to patients, such as research in cancer screening and prevention, studies of quality of life and symptom control, research to reduce disparities in cancer care, comparative trials of similar agents, and studies combining different modalities of treatment.

Meanwhile, other regions of the world are forging ahead of the U.S. in investing in research. Many pivotal clinical trials are now conducted overseas, and China, Russia, and Europe are all investing heavily in basic science. As the Washington Post recently editorialized, “The research NIH funds is precisely what we should demand from government. It is critical to our future as a healthy society and world leader in science, and it’s not something the private sector will do in the government’s stead.” NIH Director Dr. Francis Collins has been equally vocal stating that with continuing budget cuts “deep and long term damage” to U.S. biomedical research is at stake.

ASCO, along with our many partners in the cancer community, is calling for a renewed commitment to Federal funding of cancer research. The need is simply too great, the opportunities too tangible, the potential for clinically meaningful outcomes too near to continue down the path we are on. That’s why ASCO has been calling on Congress to provide an NIH budget of at least $32 billion for the next fiscal year to begin to reverse the decade-long decline in NIH spending power. We are pleased that for the first time in several years, the Federal government will have an appropriated budget to bring more stability to the biomedical research enterprise. The recently passed budget lays a foundation to begin rebuilding our future in biomedical research by rolling back the sequester cuts, but the glimmer of hope for better funding contained in the FY ’14 budget must be kindled to substantial and meaningful investment in cancer research in the years ahead. Our patients deserve nothing less.

Richard L. Schilsky, MD, FASCO, is the Chief Medical Officer (CMO) of ASCO. He assumed this newly created position with the Society in February of 2013. Formerly, Chief of Hematology/Oncology in the Department of Medicine and Deputy Director of the University of Chicago Comprehensive Cancer Center, he is a highly respected leader in the field of clinical oncology, who specializes in new drug development and treatment of gastrointestinal cancers. Dr. Schilsky is a Past President of ASCO, having served in the role during 2008-2009, and also a Past Chair of one of the National Cancer Institute’s Cooperative Groups, Cancer and Leukemia Group B (CALGB).

Sources for the Infographic:

1. American Cancer Society. Cancer Facts & Figures 2013. Atlanta: American Cancer Society; 2013.
2. American Institute for Cancer Research. Number of US Cancer Cases Expected to Rise 55 Percent Higher by 2030 [Press Release]. Published February 1, 2012.
3. One Voice Against Cancer. Impact of Sequestration Cancer Research [Fact Sheet]. Published June 2013.
4. NIH Director: Impending NIH Budget Cut Would Be ‘Devastating’ [ASCO in Action News Brief]. Published March 27, 2012.
5. Comis R: Implementing a National Cancer Clinical Trials System for the 21st Century: Workshop #2. Presented at the National Cancer Policy Forum Workshop, Washington, DC, February 11, 2013.
6. American Society of Clinical Oncology. Impact Survey: Federal Funding Cuts to Cancer Research [Press Release]. Published September 16, 2013.
7. Families USA’s Global Health Initiative. In Your Own Backyard: How NIH Funding Help’s Your State’s Economy. Published June 2008.