Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis

Our plain-English summary of Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis, by M. Maruthappu, M.G. Head, C.D. Zhou, et al (BMJ Open, 2017).

The study

• Authors: M. Maruthappu, M.G. Head, C.D. Zhou, B.J. Gilbert, M.A. El-Harasis, R. Raine, J.R. Fitchett, R. Atun
• Journal: BMJ Open
• Published: 2017;7(4):e013936
• Cited by: 20 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objectives: To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000-2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs).

Design: Systematic analysis of all open-access data.

Setting And Participants: Public and philanthropic funding to all UK cancer research institutions, 2000-2013.

Main Outcome Measures: Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs.

Results: We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded-the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs.

Conclusions: Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies. Funding agencies and industry should openly document their research investments to improve better targeting of research investment.

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In plain English

This was a systematic analysis of cancer research funding, not a study of asbestos exposure or health effects. The authors compared public and philanthropic research awards made to UK institutions from 2000 to 2013 with global cancer burden (deaths, disability-adjusted life years and years lived with disability) from the Global Burden of Disease Study. Cancer Research UK did not provide award-level amounts and was left out of the main analysis. The authors identified 4299 funded studies worth almost £2.4 billion. Mesothelioma received 30 awards totalling £4 476 088, or 0.2% of all funding, and was among the five sites with the least total funding. Relative to its global disease burden, however, mesothelioma ranked among the five best-funded of 16 cancer sites, along with prostate, ovarian, breast and testicular cancer. Liver, thyroid, lung, upper gastrointestinal and bladder cancers were the least funded relative to burden. The authors concluded that cancer research funding is not allocated according to relative disease burden. They suggested funding decisions may be influenced by exceptional need, as may be the case in mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Systematic analysis of openly available research funding data compared with global disease burden estimates
• Who was studied: 4299 cancer research awards made by public and philanthropic funders to UK institutions, 2000 to 2013. Cancer Research UK and private sector funding were excluded from the main analysis. A further 3284 Cancer Research UK grants were analysed without award amounts. Global burden data came from the Global Burden of Disease Study.
• Exposure: Not applicable. The study examined research funding by cancer site, not an exposure. Asbestos and fiber types are not discussed. Mesothelioma is one of 16 cancer sites analysed.
• Main results:
  • Across all included funders: 4299 funded studies representing almost £2.4 billion of research investment.
  • Mesothelioma: 30 awards (0.7% of awards) totalling £4 476 088 (0.2% of funding). It was among the bottom five sites by total funding, alongside testicular, thyroid, bladder and cholangiocarcinoma.
  • Relative to 2013 global disease burden, the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer. Mesothelioma's mean ranking was 4.0, with ranks printed as 6 (mortality), 1 (years lived with disability) and 5 (DALYs).
  • The least well-funded sites relative to disease burden were liver, thyroid, lung, upper gastrointestinal and bladder cancers. Together these account for 47.9%, 44.3% and 20.4% of global cancer mortality, DALYs and YLDs respectively.
  • Research classed as occupational health received 18 awards (0.4%) totalling £2 576 841 (0.1% of funding).
  • Preclinical science accounted for 66.2% of awards and 62.2% of funding. The Medical Research Council was the largest individual funder, with 35.1% of all funding.
• The authors' conclusion: The authors concluded that cancer research funding is not allocated according to relative disease burden.
• Limitations the authors state:
  • The results depend on the accuracy of the original investment data supplied by funding bodies.
  • Private sector funding data and award-level Cancer Research UK data could not be obtained.
  • Years of life lost were not included, which may underrepresent the burden of cancers that affect younger people.
  • Disease burden measures are estimates and may be biased.
  • Funding gaps cannot be fully equated with neglect without considering other factors. The authors noted that decisions may reflect exceptional need, as may be the case in mesothelioma.

Topics

Medical terms in this study, explained in our Lexicon: Ovarian Cancer, Mesothelioma.

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