cancer program. The IOM committee, a mixture of scientists with and without cancer center affiliations, conceded that it lacked hard evidence of the effects of cancer centers on the nature or quality of the research conducted in them and as a result relied on its collective judgment, based on expertise in biomedical research and study of existing information on cancer centers and their achievements (IOM, 1989). The report noted that scientists at the 59 centers with NCI core grants received nearly half the competitive research project grants awarded by NCI and substantial amounts of peer-reviewed funding from other NIH institutes, the National Science Foundation, and other research sponsors, and as a result, they had been involved in many of the important advances in cancer research over the preceding 20 years. They also noted that the centers were the sites for more than half the research traineeships funded by NCI and they participated extensively in the cooperative oncology groups that conducted NCI-supported clinical trials and other aspects of NCI’s national cancer program. They concluded that, as a group, the centers were a valuable resource for NCI because of their interdisciplinary focus and their ability to translate research discoveries into better methods of prevention, early detection, diagnosis, and treatment.
The report’s first recommendation was that the NCI director halt the slow erosion of center funding that had characterized the previous eight years. A second recommendation called for NCI to develop a systematic program plan that would ensure adequate resources, coordination with related programs, and effective scientific oversight. The committee commented in passing that, taken as a whole, the centers were involved in every aspect of the national cancer research program, but that additional incentives should be provided to encourage individual centers to broaden their research agendas. They also pointed out the disparity between NCI’s support of cancer centers as research institutions and the broader role of centers intended by Congress and expected by the public. Despite the National Cancer Act of 1971’s mandate for comprehensive centers that conducted not only research and research training but demonstrations of better models of care delivery, education of health care providers, public information, and community outreach programs, the cancer center core grants focused solely on support of research, and grant funds could not be used for those other purposes (IOM, 1989).
The authors of this report to the NCI director reviewed data on the history, budget, and operations of the Cancer Centers Program; heard testimony from a variety of NCI personnel and cancer center directors; and