Planning for Prostate Cancer Research
Expanding the Scientific Framework & Professional Judgement Estimates
Harold E. Varmus, M.D., Director National Institutes of Health Submitted June 1999

Section 2 of 13

Executive Summary

Prostate cancer is the single most common form of cancer in men in the United States. According to the American Cancer Society's Cancer Facts and Figures - 1999 and as shown in the reports of the National Cancer Institute's Surveillance, Epidemiolgy and End Results Program, in 1999 alone, an estimated 179,300 men will be diagnosed with prostate cancer, and some 37,000 men will die of their disease. Prostate cancer exacts a particularly devastating toll on African American men; incidence rates are substantially higher among African Americans, and mortality rates in African American men remain more than twice as high as rates in white men.

The Congress has expressed a keen interest in monitoring and advancing a national response to this serious health problem. In appropriating 1999 funding for the National Institutes of Health (NIH), Congress asked for several actions regarding prostate cancer research: In response, NIH, with the leadership of the National Cancer Institute (NCI), has aggressively sought participation from researchers, advocates, and patients in reviewing the prostate cancer research portfolio and charting a plan for a vigorous expansion of the prostate cancer research program.

The initial evaluation of the research program and a broad outline of future directions were completed in August 1998 and are described in part I of this report to Congress, "Planning for Prostate Cancer Research: Expanding the Scientific Framework." The NIH efforts in coordinating a research plan for prostate cancer have focussed on continuing development of a widely disseminated research program coordinated and supported by the NIH and accompanied by continuing involvement of researchers, advocacy groups and patients. The report of the NCI-convened Prostate Cancer Progress Review Group described a nationwide program involving a significant investment in infrastructure across the nation. It is recognized that each of the 35 NCI Comprehensive Cancer Centers, geographically dispersed throughout the nation, devote significant effort to education, training, treatment and research on prostate cancer and cover the full spectrum of prevention, early diagnosis and treatment.

Part II of this document, "Planning for Prostate Cancer Research: Five Year Professional Judgment Estimates," describes prostate cancer research opportunities from 1999 through 2003. This plan estimates that $420 million of potential research opportunities could be supported in 2003. NIH has increased prostate cancer research funding significantly from a 1998 level of $114 million to a current projection of $180 million in 1999. This plan includes many efforts already initiated in 1999. In fact, we are pleased to report that the original 1999 estimate of $168 million for prostate cancer research has been increased by $12 million as additional funding opportunities have been identified, primarily by the NCI. Two institutes not previously focussed on prostate research are now newly included in the NIH prostate efforts. It must be noted that this estimate is based on our assessment of scientific opportunities over the next five years, without consideration of economic constraints or other competing priorities of the Federal government. This level of support must be integrated with other research efforts of the NIH.

There is a notable program of multifaceted research within the NIH. Nine institutes have important intersecting interests that contribute to the NIH prostate cancer research effort and have been consulted in the development of this plan. The Institutes and Centers, in order of funding opportunities estimated for prostate research, are:

Five Year Professional Judgment Estimate

(in thousands) 1998 (baseline) 1999 Estimate 2000 Estimate 2001 Estimate 2002 Estimate 2003 Estimate 98-03 Change
NCI $86,907 $141,500 $211,000 $267,000 $307,500 $340,000 $253,093
NIDDK 16,223 26,100 31,300 37,900 46,200 56,900 40,677
NHGRI 4,343 4,769 5,893 6,326 6,803 7,327 2,984
NCRR 2,086 2,532 4,000 4,500 5,000 5,500 3,414
NIEHS 1,261 2,300 3,110 3,610 4,210 4,910 3,649
NIA 1,402 1,540 3,000 3,000 3,000 3,000 1,598
NlNR 625 690 800 900 1,000 1,100 475
NIMH 415 478 615 715 815 915 500
NIDCD 349 394 458 458 458 458 109
Total NIH 113,611 180,303 260,176 324,409 374,986 420,110 306,499

We look forward to achieving the goals of this ambitious plan and we are pleased to provide this analysis of programs and professional judgment of research opportunities and their potential costs.


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