Cancers with high incidence among racial/ethnic minorities receive less research funding
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Key takeaways:
- Breast and prostate cancers appeared to have the highest funding-to-lethality scores.
- Esophageal and stomach cancers had the lowest scores.
Federal research funding appeared to be allocated more toward cancer types with higher incidence among white people than members of other racial and ethnic groups, according to a study published in Journal of the National Cancer Institute.
Addressing these inequities could have a positive effect on cancer research disparities within a short period of time, researchers concluded.
Rationale and methodology
“As gastroenterologists and researchers, we often see cancer disparities firsthand,” Shria Kumar, MD, MSCE, gastroenterologist and researcher at Sylvester Comprehensive Cancer Center at University of Miami Miller School of Medicine, told Healio.
“This is an area I am particularly committed to improving,” she said. “On a larger scale, mitigating disparities is an area of priority as it is a focus of the White House’s Cancer Moonshot initiative.”
Researchers examined federal funding data from the SEER database between 2014 and 2018 to determine associations between funding directed to cancer incidence and funding aimed at cancer mortality for the 19 most common cancer types. They used a validated measure, funding-to-lethality (FTL) score, that incorporated disease incidence and mortality rates, and person-years of life lost.
Findings
Results showed the highest FTL scores for breast cancer (179.65) and prostate cancer (128.9). Conversely, esophageal (2.12) and stomach cancers (1.78) had the lowest scores.
Researchers additionally found that in 2018, nearly 50 times more federal funding was allocated to breast cancer research compared with stomach cancer research. Moreover, federal funding across cancer sites did not appear concordant with lethality, and cancers with high incidence among racial and ethnic minorities received lower funding, according to Kumar.
“There was also a stronger association between FTL scores and race- and ethnicity-specific cancer incidence vs. mortality,” she said. “We observed a strong correlation between a cancer’s incidence among white people and FTL score, but this was not the case for other racial and ethnic groups, where we found a weak to moderate correlation. There was also a moderate to strong correlation between a cancer’s mortality among white people and FTL score, but only a weak correlation for all other racial and ethnic groups. NCI funding correlated highly with cancers afflicting a higher proportion of white people, such as breast cancer, leukemia and lymphoma, compared with stomach, uterine and liver cancers, which have high incidence rates among minority populations.”
Implications
“The findings encourage us to continue to critically examine disparities in funding and allocate resources to mitigate these disparities, especially where underrepresented groups are disproportionately impacted,” Kumar told Healio.
“Funding is complex and multifaceted, but part of mitigating disparities is ensuring we adequately study cancers in an equitable way,” she said. “We are hopeful that agencies will use this to evaluate their own recent funding distributions, and prioritize funding for cancers that disproportionately impact minorities to mitigate disparities and reduce cancer burden.”
References:
- Haghighat S, et al. J Natl Cancer Inst. 2023;doi:10.1093/jnci/djad097.
- Sylvester study identifies ‘marked disparities’ in federal cancer research funding (press release). Available at: https://physician-news.umiamihealth.org/study-points-to-significant-disparities-in-federal-cancer-research-funding/. Published June 8, 2023. Accessed July 3, 2023.
For more information:
Shria Kumar, MD, MSCE, can be reached at shriakumar@med.miami.edu.
Perspective
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Suneel Kamath, MD
The foundation of all advances in cancer care is research funding, and it is alarming that federal funding from the NCI under-supports the deadliest cancers and cancers that affect racial and ethnic minorities the most.The study by Kumar and colleagues demonstrates that gastric, esophageal, liver, pancreatic, ovarian and brain cancers — diseases that remain highly lethal and which we’ve made little progress in over the last few decades — are significantly underfunded by the NCI.
The fact that the funding-to-lethality score for breast cancer was more than 10 times higher than for 12 other cancers and 100-fold higher than for gastric cancer truly is staggering.
The study also showed that cancers with higher incidence and mortality rates among racial and ethnic minorities are underfunded. These funding disparities are an important contributing factor to the downstream health disparities these communities continue to face. For example, a previous study that showed similar funding disparities demonstrated that underfunding strongly correlated with fewer clinical trials in underfunded cancers.
These data indicate that there is a dire need for more emphasis on equity across different cancers in determining NCI funding allocations. An important role of the federal government is to fulfill the needs of its citizens that are not met by private entities. Market forces may push pharmaceutical companies, private donors and nonprofit groups to direct funds and invest in less lethal cancers due to higher chances of success. The NCI must counterbalance that to ensure the most lethal cancers receive proportionately more funding. A strong, sustained effort to increase funding for the deadliest cancers is the only way we will improve outcomes in these diseases.
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