NCI Annual Plan & Budget Proposal for Fiscal Year 2021

Director’s Message: Building on Success, Maximizing Opportunities

The year 2021 will mark the 50th anniversary of the National Cancer Act of 1971, the landmark legislation that intensified support for cancer research in the United States. The investment sparked a biomedical revolution that has led to extraordinary progress in our understanding of the causes of cancer and its progression, as well as in our ability to prevent, diagnose, and treat the disease.

Douglas R. Lowy
Credit: National Cancer Institute
Douglas R. Lowy, M.D., NCI Acting Director

Over the last 5 decades, mortality rates have declined for most cancers, largely due to improvements in prevention, detection, and treatment. These advances have been fueled by breakthrough studies of complex environmental and genetic interactions that can lead to cancer, the identification of targets that drive cancer, and the development of effective interventions against those targets.

We have been able to make these strides thanks to continuing congressional support for NCI and strong engagement from academic, advocacy, patient, nonprofit, and commercial sectors. And additional funds provided through the Cancer MoonshotSM beginning in fiscal year (FY) 2017 are serving as a catalyst for further progress.

Nonetheless, cancer remains a formidable problem, and too many patients with cancer still face a grim prognosis. Each minute in the United States, more than three people are diagnosed with the disease and approximately one person dies from it. In addition, survivors can face serious cancer-related health issues.

Researchers grapple with many unanswered questions: Why do many cancers initially respond to therapy and later become resistant? How can we reduce serious long-term side effects for survivors of childhood and adult cancers? How can we ensure that high-quality cancer care is available to all who need it?

Meeting these and myriad other challenges requires sustained and robust investment in all areas of cancer research, from exploration of the causes and biological mechanisms of cancer to prevention, detection, treatment, and survivorship.

NCI’s research strategy includes supporting investigator-initiated research and maximizing opportunities in emerging areas of science. The Annual Plan & Budget Proposal for Fiscal Year 2021 focuses on three emerging areas: the immune system and microbiome, artificial intelligence, and implementation science. There are many more areas that need to be addressed as well.

Our investments must not only support cutting-edge research but also strengthen the infrastructure that enables innovation and trains a diverse and talented workforce for the important work ahead.

An unprecedented enthusiasm has permeated the research community. We are buoyed by the explosion of new research ideas, as evidenced by a 50% increase in grant applications to NCI over the past 5 years and the extraordinary number of new cancer drug approvals, which offer more options and hope to patients.

But if our budgets are unable to meet the pace of this growing interest and enthusiasm, we will be confronted with a serious challenge. If discouraged researchers leave the field, we will squander the tremendous momentum and innovation alive in the research community today. There can be no pause button for cancer research.

Today’s investments lay the foundation for tomorrow’s breakthroughs, just as today’s advances were built on earlier discoveries made since the National Cancer Act was signed into law. We must intensify our pursuit of better outcomes for patients and their loved ones. We owe them nothing less. The NCI Annual Plan & Budget Proposal lays out how.

Douglas R. Lowy, M.D.
Acting Director
National Cancer Institute

Increase in NCI R01 Grant Applications Outpacing NCI Budget Graph
This graph shows the NCI budget from fiscal year (FY) 2013 to 2019 being outpaced by a R01 grant applications submitted to NCI during that time. Grant applications increased nearly 50% between FY 2013 and 2018 and are projected to increase another 10% by FY 2021.
Next Section: Budget Proposal