NCI Annual Plan & Budget Proposal For Fiscal Year 2020

Each year, NCI prepares its Annual Plan and Budget Proposal for the President and Congress, which represents our best professional judgement on the optimum funding needed to make the most rapid progress against cancer. In it, we highlight the impact of NCI-funded research and discuss promising opportunities to better prevent, diagnose, and treat cancer and help cancer survivors.

Norman E. Sharpless
Credit: National Cancer Institute
Norman E. Sharpless, M.D., with former patient Mike, whom he treated for acute leukemia in 2016.

Director’s Message: A Time of Great Hope and Great Challenge

As director of the National Cancer Institute (NCI), I am pleased to share our Annual Plan and Budget Proposal for Fiscal Year 2020. Having been sworn in to my position a little less than a year ago, this marks my first opportunity to present, in this form, the promising results of our country’s investments in biomedical research. This plan directs attention to areas where additional support has unique potential to improve cancer prevention, detection, and treatment.

To place the plan’s focus squarely on those most likely to benefit from NCI research, we have included stories of patients. While each story is unique, they are not that different from that of Mike, a patient I treated for acute leukemia.

Mike started feeling poorly in 2016, and a bone marrow biopsy revealed acute myeloid leukemia (AML). I began his initial treatment with aggressive chemotherapy, which caused difficult side effects and required him to spend more than a month in the hospital. After further therapy, Mike fully recovered, and he has been in remission for more than 2 years.

Mike, and patients like him, are our true partners in cancer research. They are the reason we do what we do.

We are in the midst of a historic moment in cancer research. Groundbreaking discoveries from multiple disciplines—epidemiology, pathology, molecular biology, medicinal chemistry, structural biology, data science, and others—have converged into remarkable advances and clinical benefits. These insights have triggered unprecedented industry investment, philanthropic support, and patient advocacy for cancer research. In addition, NCI has benefited from concerted, sustained, and bipartisan support from Congress and the White House.

As a result, patients today have better options for more effective and less toxic therapies than ever before. It is not a coincidence that death rates for most cancers are on a steady decline. And it’s not by chance that the age-adjusted rate of new cancer cases is steadily decreasing.

Yet as we celebrate new successes, we face new and existing challenges. There are still too many cancers for which we lack effective screening and prevention, and others for which we lack effective therapies. Some new treatments are so expensive that they are inaccessible to many patients. Some cancer treatments have side effects that may be considered worse than cancer. The dissemination and implementation of effective treatments to the community setting can be slow and inconsistent.

We are tackling these issues head on.

As we prepare to overcome these obstacles, I have identified key areas of focus that leverage the scale and reach of NCI. These areas of focus, which permeate all sections of this Annual Plan and Budget Proposal, are to:

  • Develop the workforce of cancer investigators
  • Reaffirm our commitment to basic science to drive novel approaches and technologies
  • Innovate the design, administration, and analyses of clinical trials
  • Increase data aggregation and interpretation to speed work across the cancer enterprise

The pages that follow reveal a promising future for cancer research. These are times of great hope and great challenge. This Annual Plan and Budget Proposal lays out a vision to achieve our goals at an even faster rate. With this plan, we become ever closer to fulfilling NCI’s mission to help all people live longer, healthier lives.

Norman E. Sharpless, M.D.
National Cancer Institute

Key Focus Areas

NCI is responsible for the full scope of cancer research—from conducting basic science on the biological mechanisms of cancer to developing prevention, early detection, and treatment approaches to improving public health and the lives of cancer survivors. Focusing on the following areas will catalyze additional progress in cancer research and take advantage of the opportunities described in this plan.

Basic Science

Reaffirm our commitment to basic science to drive novel approaches and technologies

Basic science discoveries fuel new approaches to cancer prevention, detection, and treatment across cancer types and populations.

Workforce Development

Support the cancer research enterprise by focusing on the workforce of cancer investigators

A diverse and talented workforce of cancer researchers will make the discoveries needed to better prevent, detect, and treat cancer.

Big Data

Increase data aggregation and interpretation to speed our work across the cancer enterprise

Harnessing the power of large and diverse scientific and clinical datasets holds incredible promise to accelerate research and improve patient care.

Clinical Trials

Fully realize the power of clinical trials through innovative design, administration, and analyses

Clinical trials are a fundamental means for making progress in cancer care. Enhancing cancer clinical trials will mean that the success of new cancer interventions can be determined more rapidly.

Next Section: Progress Against Cancer