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- PREFACE The National Cancer Institute (NCI), as part of the National Institutes of Health (NIH), has contributed greatly to the research advances that are . revolutionizing our understanding of cellular and molecular processes and the causes of cancer. These advances are improving our capacity to treat and even prevent cancers. They are reducing the incidence and mortality rates for many types of cancers. However, the full implications of the ongoing biological revolution for increasing our ability to prevent or cure cancer remain to be explored. Examples of promising research areas are mentioned in this report. ~ - NCI uses a number of mechanisms for supporting cancer research, including research project grants, cooperative agreements, core grants to centers, contracts, and an intramural program. NCI's primary mechanism has always been the research project grant to individuals and groups pursuing promising scientific leads. NCI also recognized early the value of establishing and maintaining cancer centers at places conducting substantial amounts of NCI-funded research. Cancer centers are able to attract able researchers to cancer research, promote scientific interactions that transcend departmental and disciplinary lines, and translate basic research advances into better clinical practices and prevention efforts. NCI, facing severe budget constraints, is not planning to increase funding for the cancer centers core grant program this year or next. This wall result in fewer centers overall after ongoing centers are given inflationary increases. It was, therefore, an opportune time to-Iook at the program. The committee became convinced that the program is especially valuable at this time, because cancer centers provide an excellent environment for exploring the expanding opportunities to apply cancer research advances. The committee makes specific recommendations for maintaining the program during the next year while -NCT conducts a thorough review to determine the appropriate scope and size of the program as part of the nation's overall cancer program. The committee also recommends organizational and management improvements in the program, although the details are left for the director of NC] to determine. The committee would like to thank a number of individuals and organizations for their assistance in carrying out the study. Ron Getter, our project officer in the office of the director of NTH, was very supportive and especially helpful in mobilizing the assistance of various NTH offices with · V11
useful information. Robert E. Moore and staff at NTH's Division of Research Grants provided many helpful data tables from NTH's administrative data base. The study would not have been possible if NC! had not cooperated fully in providing information about the program. Judith M. Whalen, our liaison with NCT, was very helpful in graciously answering numerous committee and staff questions and arranging access to officials and files at NCI. Also at NCT, John P. Hart~nger, chief of the financial management branch, Mary C. Cushing, chief of the extramural financial data branch, and Stephen Hughes, data processing supervisor at the extramural financial] data branch, provided extensive budget and program data--usually on short notice. Lucius F. Sinks, chief of NCI's cancer centers branch ~nr1 hit Off M~ra~re.t Holmes ~ . . %, . _ , _ _ ~ , ~ O~ _ ~ ~ ~~_v~ Raymond A. Morrison, and Regina Berthold, shared their knowledge and program files. The committee Olin henefite.~1 from intPrvie~v~ with . ~ C7 ~ ~^ ~ ~ ~ ~ ^~ _^ ~ ^_ ~ ~ v ~ ~ ~ ·~A ~4 _ _% . . - . ~ ~ ~ ~ Drover, Erector ot NUT, and Vincent all. DeVita. former NC:T director ~nr1 ~ ~ A ~ ~ ~ ~ ~ ~ ~ ~ 7 from presenianons Dy. Alan a. Hanson, then-acting director of NCI, and Peter Greenwald' director of NCI's division of cancer Prevention and control John ~ _` . . . ~ ~ . tCe Arrant, chairman ot the subcommittee on cancer centers of the National Cancer Advisory Board, shared his knowledge and views of the program. O. Ross McIntyre, director of the Norris Cotton Cancer Center at Dartmouth, and Edwin A. Mirand, associate director of the Roswell Park Memorial Institute, who are president and secreta~-treasurer, respectively, of the Association of American Cancer Institutes, presented the views and concerns of the cancer centers and provided information about the centers and their activities. John E. Ultmann, director of the University of Chicago Cancer Research Center, presented the views of the National Coalition for Cancer Research. The committee also thanks the directors and staffs of cancer centers visited by the committee's staff, including the Jonsson Comprehensive Cancer Center at UCLA, the University of Southern California Comprehensive Cancer Center, and the Fred Hutchinson Cancer Research Center in Seattle. who in_ 1 ~ ~ ~ _ _ ~ , ~ ~ ~ explamea now core grants actually work in practice. The committee is grateful for the support of the staff of the Institute of Medicine, including president Samuel O. Thier, executive officers Charles Miller and Queta Bond, and director of the division of health care services, Karl D. Yordy. The committee deeply appreciates the hard and capable work of Michael McGraw, the study director, and his staff and consultants. · · V111 .
Carlotta Molitor, Robert Walkington, and Linda Lipson gathered and analyzed an enormous amount of information about the cancer centers program. Deborah Fulcher prepared the tables, charts, and text for publication. Finally, as chairman, ~ would like to thank the other committee members for their willingness to devote considerable time, on short notice, to the study and for their contributions to this report. CHARLES C. SPRAGUE, Chairman Committee to Study the Cancer Centers Program of the National Cancer Institute IX