Updated funding to lethality measures for National Cancer Institute funding allocation (2007-2017)

Objectives: To advocate for National Cancer Institute (NCI) funding more effectively, we quantified funding to lethality (F:L) ratios, tracked changes in those ratios over time, and compared F:L to other measures of funding allocation, including funding to incidence (F:I), funding to mortality (F:M) and funding to years of life lost (F:YLL) across 19 cancer sites. Methods: We used the NCI research portfolio database to assess funding allocated to 19 different cancer sites from the years 2007-2017. We collected incidence rates (I), mortality rates (M), and years of life lost (YLL) from the Surveillance, Epidemiology and End Results (SEER) database over the same 11 years. We defined lethality (L) by the formula (M/I x (YLLx100)). We calculated median yearly funding ratios and ranked them by cancer site. The correlations between funding ratios were accessed using Pearson correlation test. For each ratio, we calculated rate of change over time by cancer site using linear regression with year as the independent variable. To compare rates of change of each ratio by cancer site, we performed multivariable linear regression incorporating year, cancer site and their interaction as covariates, after applying a log10 transformation on the ratio to achieve linearity. The reference groups for comparison were the gynecologic cancer sites uterus, ovary and cervix. All analyses were completed in R, version 4.0.2. Results: The three cancer sites with the highest F:L ratio were breast, prostate and melanoma despite these being the 12th, 17th and 16th in terms of lethality. Ovary, uterus and cervix ranked 12th, 15th and 13th in F:L ratios, but were 5th, 13th and 6th in terms of lethality. The top three F:I were brain, leukemia, cervix; F:M were melanoma, Hodgkin's lymphoma, brain; and F:YLL were breast, prostate, lung. All three gynecologic cancer sites experienced negative rate of change of F:L over the 11 years. Ovary, cervix and uterus also experienced negative rate of change for F:I, F:M, and F:YLL with the only exception being ovary with positive change in F:M. F:L rates of change were significantly different for ovary, cervix and uterus compared to breast, melanoma, and prostate. F:L ratio was strongly positively correlated to F/YLL with Pearson correlation coefficient of 0.86 (p Conclusions: F:L ratios correlate with other funding allocation measures, and highlight inadequate NCI funding to gynecologic cancers. Trends of the last 5 years (2013-2017) are consistent with trends of the last 11 years. This data should be used for advocacy to improve the disparities in funding to GYN cancers that affect laboratory science discoveries, clinical trial availability and survival outcomes. Download : Download high-res image (296KB) Download : Download full-size image