What determines the overall number of Cancer Centers funded by NCI?
The original intent of Congress was to have a center within 200 miles of every U.S. resident, enhancing the application of cancer discoveries to patients and people at risk. As a consequence, NCI has never set limits on their number. An applicant must achieve a meritorious priority score in peer review to be funded. Obviously, the NCI budget also has some effect, but we've always supported the funding of outstanding new centers, even in times of budget constraints.
Can any institution that conducts cancer research become an NCI-designated Cancer Center?
In theory, yes, but the requirements are steep: a large cancer-relevant grant funding base; substantial institutional commitment in the form of space, resources, and authorities provided to the Center director; organization of transdisciplinary research across all scientific areas of the institution to "make the whole greater than the sum of its parts;" and, specifically for comprehensive centers, community outreach, education, and training activities. The average NCI grant base for existing centers is somewhere around $11 million, so that gives you an idea of the critical mass of research required.
What impact do the guidelines issued last year have on Cancer Centers?
The new guidelines were partly a response to recommendations made to NCI by the P30/P50 Ad Hoc Working Group Report, but we also introduced formatting changes and some templates to standardize data submissions. The guidelines just went into effect on February 1 and it'll take several application cycles before we can assess their impact.
How would you summarize the contribution that Cancer Centers make to the overall cancer community? While the NCI designation is based solely on an evaluation of the science, centers are also chief deliverers of medical advances to patients and their families, providing state-of-the-art care and access to clinical trials. They serve as the major training ground for new clinicians and researchers and have the strong links with national, state, and local agencies and advocacy groups needed to address the problems in their communities.
When you combine NCI awards with the number of grants received from other NIH institutes and sponsors, centers have significant resources to leverage against the cancer problem. They also have an environment that fosters basic discovery and its translation into cancer treatment, prevention, and control activities; and the ability to network both within their community and with each other, so there's extraordinary research power.
Over time, they've been variously described as the "jewels in the NCI crown," and the "ships of the line" and these descriptions are very fitting. Their contributions have been enormous and we see them continuing to escalate in the future.