Study Points to Significant Disparities in Federal Cancer Research Funding

Sylvester researchers discover areas that are in need of immediate support to help mitigate cancer burden among populations.

A photo of Shria Kumar, M.D.
Shria Kumar, M.D.

A new study led by researchers at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, has identified significant disparities in federal cancer research funding.

“Some cancers with high mortality rates in minority populations received relatively lower research funding,” said Shria Kumar, M.D., a colorectal cancer researcher at Sylvester, South Florida’s only National Cancer Institute (NCI)-designated cancer center. “Our study highlights the need for federal research funds to be equitably distributed, especially given the discrepancies in cancer incidence rates and outcomes for minorities, particularly in the more underfunded cancers.”

Dr. Kumar was the senior author of the study, “Urgent Need to Mitigate Disparities in Federal Funding for Cancer Research,” which was recently published in the Journal of the National Cancer Institute. Co-authors were Shida Haghighat, M.D., M.P.H., fellow; Chunsu Jiang, M.D., fellow; Wael El-Rifai, M.D., associate director for basic science and co-leader of Sylvester’s Tumor Biology Program, the John and Judy Schulte Senior Chair in Cancer Research and associate vice chair of surgery; Alexander Zaika, Ph.D., professor of surgery; and David S. Goldberg, M.D., M.S.C.E., associate professor of clinical hepatology.

The Analysis

In the study, the Sylvester researchers evaluated NCI funding distribution to the most common cancers, using data from NCI’s Surveillance, Epidemiology and End Results, United States Cancer Statistics database, and funding statistics between 2014 and 2018. For each year, the researchers identified the incidence rate and mortality rate per 100,000 persons for the 19 most common cancer sites, as well as NCI funding for each cancer. The incidence and mortality rates were also analyzed by race and ethnicity.

To determine the overall public health burden of different cancers, the Sylvester researchers used a validated measure — funding-to-lethality (FTL) scores, NCI funding divided by lethality. Breast and prostate cancer had the first and second highest FTL scores, while esophagus and stomach cancer ranked 18th and 19th. Dr. Kumar noted that breast cancer research received approximately 50 times more funding than stomach cancer in 2018, even though estimated breast cancer deaths were only four times those of stomach cancer deaths.

“We also evaluated FTL and cancer incidence and mortality rates within individual racial and ethnic groups,” said Dr. Kumar. “We found that NCI funding correlated highly with cancers afflicting a higher proportion of non-Hispanic whites, such as breast cancer, leukemia and lymphoma, compared with stomach, uterine and liver cancers, which have high incidence rates in minority populations.” For example, Black Americans, Hispanics, and Asians/Pacific Islanders are two to three times more likely to die from stomach cancer than non-Hispanic whites. As for uterine cancer, white and Black women are diagnosed at similar rates, but Black women are twice as likely to die from it.

The Findings

Dr. Kumar noted the Sylvester team’s finding was supported by a 2022 study, which demonstrated that NCI and nonprofit funding increased proportionately as incidence increased for white patients, while cancers with higher incidence in the ethnic minority populations were relatively underfunded. Although there was a slight increase in overall NCI funding during the study period, the disparities across the cancers included in the analysis were unchanged over time, she said.

“In my gastroenterology research and clinical practice, disparities in cancer are an unfortunate but well-known reality,” said Dr. Kumar. “This is an issue of utmost importance, as shown by the White House’s Cancer Moonshot initiative, which focuses on mitigating cancer disparities. This study is important because NCI funding is the driver of research that can help unlock answers in our quest to improve outcomes for our entire population.”

Looking ahead, Dr. Kumar said the study findings can be applied immediately by sources of research funding.

“Agencies can evaluate their own recent funding distributions, perhaps using cancer lethality as a measure for funding allocations,” she said. “For upcoming cycles, they can prioritize funding for cancers that disproportionately impact minorities in order to mitigate disparities and reduce cancer burden.”

Tags: cancer care disparities, Cancer Moonshot, Dr. Shria Kumar, Journal of the National Cancer Institute, Sylvester Comprehensive Cancer Center, USNWR Gastro