The National Cancer Research Institute (NCRI) is is a UK-wide partnership between the government, charity and industry that promotes co-operation in cancer research. This week it published its 10-year anniversary report [pdf], which outlines how much its 21 member organisations have spent on cancer research in the UK.

We invited the NCRI’s Caroline Magee to write about the report’s main findings, and NCRI’s role in coordinating and promoting cancer research in the UK.

Back in 2002, NCRI members spent £257m on cancer research in the UK. Now, they’re spending almost double on cancer research each year – over £500m.

This is hugely encouraging, and such investment bodes well for the future of people with cancer in the UK and beyond. After all, it’s thanks to research that cancer survival rates have doubled in past 40 years.

But what you might not realise is that the cancer research community is one of the few medical communities that knows exactly what type of research it’s spending its money on, and has been actively using this information to plan cancer research in the UK.

This is thanks to NCRI members – which include Cancer Research UK, several other cancer charities and the Department of Health – working together to help coordinate cancer research across the UK, for the good of cancer patients.

Graphic showing money spent by NCRI partners, by research area

Keeping an eye on how much we spend

One of the NCRI’s first actions when it was created in 2001 was to develop the Cancer Research Database, allowing us to monitor how much our charity and government partners spend on cancer research from 2002, when funding was at £257m. In 2010 – just eight years later – it had nearly doubled to £504m.

Analysis of this bigger picture has helped NCRI partners such as Cancer Research UK to better understand what research others are funding, so that they can plan their work, either individually or together, to reduce unnecessary duplication.

Equally importantly, it has helped funders spot and close gaps in research so that money is pumped into the areas that need it most.

Indeed, the key strength of the NCRI has been to bring together the research funders in this way – previously, cancer research was much more fragmented and less coordinated. When we looked at things in 2002, we were able to categorise funding for the first time and review the types of spending – things like how much is spent on fundamental research applicable to all cancers versus research on specific cancers, and identifying which of the cancer types receive greater or lower levels of funding.

Types of research being funded

The various categories of research are analysed using an internationally recognised system called the Common Scientific Outline (CSO). The major CSO categories are

  • biology (i.e. the basic nuts-and-bolts of our cells, including cancer cells);
  • aetiology (causes of cancer);
  • prevention;
  • early detection, diagnosis and prognosis;
  • treatment;
  • cancer control, survival and outcomes research; and
  • scientific model systems.

Breaking things down in this way gave us a UK-wide picture of which areas of research funding are proportionally higher or lower.

Analysis of the portfolio in 2002 showed that prevention research made up just 2.4 per cent of the total. This startlingly low figure, together with the knowledge that prevention is better than cure, led NCRI partners to join forces with other funders to form the National Prevention Research Initiative (NPRI), which has raised £23m of research funding to date, with an additional £10m being made available this year.

Prevention research has now gone up to 3.4 per cent – this may not sound like a lot, but because the whole of research has doubled, what it means in cash terms is a rise from £6.3m in 2002 to £17.1m in 2010.

Responding to gaps in research – hard-to-treat cancers

As the above example highlights, classifying and tracking cancer research in the UK helps funding organisations like Cancer Research UK to respond to gaps in research. The NCRI was able to show for the first time which cancers receive what proportion of funding:

Spend by cancer type

When the portfolio was first reviewed in 2002 we were shocked to find that funding of lung cancer, one of the most common and hard-to-treat cancers, was so low compared to other cancer sites.

To try to remedy this, NCRI has made a modest investment in palliative care research for lung cancer patients, but more importantly, has sought to raise awareness of the need for lung cancer research.

Perhaps partly as a result of this, we have seen funding for lung cancer research increase from £3.5m in 2002 to over £11m in 2010 – a 3-fold increase and a higher proportional increase than the portfolio as a whole.

There have also been significant increases in support for research in cancers of the pancreas and oesophagus – which overall also have poor survival rates.

So it’s encouraging to see funders taking action in areas that are in need of funding. And it’s also really important to realise that only 40 per cent of the research is specific to an individual type of cancer. That means that more than half of all UK cancer research is potentially relevant to all cancers, and all cancer patients:

A grahpic showing money spent by NCRI partners, by type of cancer

Unpicking the reasons behind different cancer spends

There’s quite a wide variation between funding for research on different types of cancer.

The reasons behind these differences are complex – the difficulty of studying certain cancers is part of the story, but so is the success of several charities in raising money. For example, breast cancer charities have been particularly successful in securing research funding for this cancer which in turn has led to improved survival for breast cancer patients.

This also means more breast cancer survivors raising money for yet more breast cancer research. This is also happening with leukaemia and to some extent with bowel cancer, but not yet very much with other cancers.

What the future may hold

The funding of cancer research is levelling off – not entirely unexpected given the current climate. So NCRI partners are now starting to focus research on key areas, and trying to ensure researchers are aware of and able to access this funding.

Collaboration is going to be crucial over the next 5 to 10 years. Under the auspices of the NCRI, cancer researchers can build on the initiatives started over the first decade and look forward to continued support from our partners. Because our goal is that our combined efforts will enhance cancer research in the UK, for the people who we’re trying to help: cancer patients.

Caroline Magee