NCI Fiscal Year 2026 Professional Judgment Budget Proposal
This Fiscal Year 2026 (FY26) Professional Judgment Budget Proposal presents NCI’s assessment of the optimal funding needed to support the National Cancer Program and ultimately help all people live longer, healthier lives. While FY24 and FY25 were subject to statutory budget caps, FY26 presents an opportunity for Congress to fully fund cancer research. This includes new funding to increase investments in research grants, train the next-generation cancer workforce, modernize and expand clinical studies infrastructure, and develop new ways to prevent or intercept cancer.
NCI is the largest funder of cancer research in the world, providing foundational support that fuels novel discovery, technical innovation, economic growth, and hope. NCI funding is distributed across the United States in both academic and community settings. Meaningful progress against cancer requires sustained funding increases to act upon existing and emerging opportunities and to build on discoveries made from previous investments, including those made through the 21st Century Cures Act funding for the Cancer Moonshot℠. Support for these opportunities will increase our understanding of cancer biology and spark the discovery of better ways to prevent, detect, diagnose, and treat cancer.
Strengthening the future cancer workforce
NCI is committed to fostering a highly skilled and diverse cancer research workforce that catalyzes future progress against cancer. Strong support for training of the future workforce will ensure that progress against cancer continues and thrives by constantly infusing cancer research with innovative ideas to prevent more cancers, further reduce mortality, and improve outcomes for all.
Even with a constrained budget, NCI is prioritizing support for early-stage investigators (ESIs) by funding a higher percentile of peer-reviewed R01 applications from ESIs than established investigators. In FY24, the ESI payline—the percentile cutoff point that NCI intends to fund in a given fiscal year—was maintained at the 17th percentile. However, the payline for established investigators fell to the 10th percentile, and decisions were made to reduce the budgets for existing grants and other programs.
This proposed budget for FY26 would allow NCI to grow its training portfolio beginning with the highly competitive K99/R00 Pathway to Independence Award. The program has succeeded in transitioning early-career mentored scientists to independent researchers. More funding would allow NCI to grow the program beyond the current capacity of about 40 awards per year. Additionally, NCI could increase support for programs for trainees at all career stages, including for students as young as middle school through NCI’s Youth Enjoy Sciences program.
As NCI seeks to attract talented individuals with a diversity of opinions, backgrounds, and interests to the cancer workforce, we also need to diversify our training portfolio. This requires steadfast support for diversity-focused career development and training programs that cultivate a sustainable pathway toward independence. NCI also needs new programs to prepare a workforce skilled in data science, public health, and other fields that support cancer research to sustain progress against cancer.
Modernizing cancer clinical studies to deliver breakthroughs
The pace of discovery is faster than ever before, aided by the return on decades of investment in basic research and technology development that are yielding advances for people with cancer and those at risk for the disease. Clinical research must keep pace with the speed of discovery to bring benefits to all people.
Clinical studies are a key step on the path to making progress against cancer. However, they can take years to design, launch, and complete. This proposed budget would enable NCI to further modernize clinical studies and expand clinical research networks and associated infrastructure into community oncology practices, where most people receive their cancer care.
In 2024, NCI launched a pilot Virtual Clinical Trials Office providing remote staff to help sites with patient screening, enrollment, and data collection. Innovative approaches like this can increase efficiency and make trials accessible to more people by enabling institutions with fewer resources to participate in more studies. NCI is also convening experts in community engagement and related fields to develop a plan to increase capacity to conduct cancer research in all communities, including rural areas and other underserved populations.
Sustained funding increases will allow NCI to transform the way we approach clinical studies, making them more accessible, nimble, and inclusive. This transformation will ensure equity in access to clinical studies designed to rapidly answer the most pressing questions and help deliver high-quality cancer care for all people.
Preventing and intercepting cancer
Effective cancer prevention and control with proven, cost-effective strategies will have a powerful effect on the goal of cutting cancer death rates in half by 2047. To develop better preventive measures and screening methods, we must increase our knowledge about the causes and trajectories of many cancers. This requires investing resources in foundational research and promising new drugs, vaccines, and other interventions to reduce the risks of cancer and to intercept cancer at the earliest possible stages.
Research has shown that multi-cancer detection tests can find precancer or cancer before it is symptomatic. These tests could change how we screen for cancer and potentially improve outcomes by detecting cancer at its earliest stages. Using a single blood draw, these tests may be able to detect the presence of multiple cancer types—including ones without established screening methods. However, it is not known whether multi-cancer detection tests will save lives or cause substantial harms by overdiagnosing conditions that do not require invasive diagnostic measures or even treatment.
To answer these and other questions, NCI launched the Cancer Screening Research Network. This network will conduct large, rigorous studies on multi-cancer detection tests in asymptomatic people. Initial funding provides resources for seven sites; additional funding is needed to expand the network and support the goal of enrolling over 200,000 people from diverse populations into randomized controlled trials that evaluate these tests.
This budget request will enable NCI to fully leverage the scientific opportunities before us to prevent, detect, and treat cancer, while growing and diversifying the cancer research workforce. The return on this investment will be a stronger cancer research enterprise that maximizes research advances to empower progress against cancer for all people.