Meeting News

Gynecologic cancer research disproportionately underfunded

Ryan J. Spencer

NCI funding for research of gynecologic cancers appeared significantly lower than for other cancer sites, according to study results presented at the Society of Gynecologic Oncology Annual Meeting on Women’s Cancer.

Additionally, this disparity persisted over time.

“Our initial interest came about after seeing that gynecologic cancers tend to have a lower number of high-level evidence-based guidelines for diagnosis, treatment and surveillance,” Ryan J. Spencer, MD, assistant professor in the gynecologic oncology program at University of Wisconsin School of Medicine and Public Health and the associate director of the gynecologic oncology fellowship training program, told HemOnc Today. “Because of this, we wanted to investigate potential causative factors. One that we deemed important to explore was the funding awards for cancer sites from NCI-sponsored research.”

Spencer and colleagues used data from the NCI SEER database, Cancer Trends Progress Report and funding statistics to assess funding received across 13 cancer types from 2007 to 2014.

Researchers calculated a score for each cancer site for the funding received per years of life lost from 100 incident cases, called funding-to-lethality scores.

Scores would be the same across cancer types if funding was equitably allocated based on considerations of incidence and mortality.

However, funding for three gynecologic cancers appeared significantly lower than for the cancers ranked first through eighth in funding-to-lethality scores (P < .05 for all comparisons).

Prostate cancer had the most funding with an 8-year average of $1.81 million received per years of life lost from 100 incident cases (funding-to-lethality score, 1.81). Breast cancer followed closely with a score of 1.8.

Of the 13 cancers analyzed, funding for ovarian cancer research ranked ninth, with a score of 0.097, followed by cervix cancer with a score of 0.087. Uterine cancer ranked next to last with a score of 0.057.

Breast and prostate cancer scores were nearly 32 times higher than uterine cancer, 21 times higher than cervix cancer and 19 times higher than ovarian cancer (P < .00001 for all comparisons).

“When using a metric that accounts for mortality, incidence and years of life lost, certain cancer sites have received disproportionate levels of funding awards from the NCI over the most recent 8 years of funding data available” Spencer said. “Although some cancer sites have trended toward less funding and some toward more, some cancer sites have consistently received lower amounts of funding and those include the ovarian, uterine and cervical cancers. This is not a call to detract from the great efforts being made for other cancer sites, but a notice that all cancer sites deserve the same consideration and funding levels to benefit patients.”

Gynecologic cancers also had greater decreases in funding compared with other cancer sites. From peak levels during the 8-year study period, funding in 2014 decreased 18.5% for ovarian cancer research and 18.8% for uterine cancer research compared with a 9.9% decrease for breast cancer, a 7.1% decrease for testicular cancer, a 6.3% decrease for leukemia and a 5.7% decrease for kidney/renal pelvis cancer. Funding for pancreatic cancer increased by 67%.

If disparities in research funding do not improve, gynecologic cancers risk lagging behind other cancers in prevention, survival and development of targeted therapies, according to the researchers.

“As with any important cause, we need constant effort to make both administration and lay persons aware of the inequalities,” Spencer said. “It is critical to recruit people to champion the case that gynecologic cancers deserve more funding to keep pace with the transformative discoveries that we are seeing for other cancers.”

It is especially concerning that these data may reveal an area of gender inequality within the health care system, Spender added.  

“This particular inequality harms not only women with gynecologic cancers, but society as a whole suffers when these types of inequalities go undiscovered or uncorrected,” he said.

“We want this to be a call to action,” he added. “Complete results of this project should be published soon and we are engaging in ongoing research to understand how to best highlight this concern and develop suggestions and systems to correct the problem. We are always looking for partners and collaborators for both the research and advocacy to further the cause for women's cancers.” – by Cassie Homer

Reference:

Spencer R, et al. Abstract 3. Presented at: Society of Gynecologic Oncology Annual Meeting on Women’s Cancer; Mar. 24-27, 2018; New Orleans.

Disclosure: HemOnc Today could not confirm the authors’ relevant financial disclosures at the time of reporting.

Ryan J. Spencer

NCI funding for research of gynecologic cancers appeared significantly lower than for other cancer sites, according to study results presented at the Society of Gynecologic Oncology Annual Meeting on Women’s Cancer.

Additionally, this disparity persisted over time.

“Our initial interest came about after seeing that gynecologic cancers tend to have a lower number of high-level evidence-based guidelines for diagnosis, treatment and surveillance,” Ryan J. Spencer, MD, assistant professor in the gynecologic oncology program at University of Wisconsin School of Medicine and Public Health and the associate director of the gynecologic oncology fellowship training program, told HemOnc Today. “Because of this, we wanted to investigate potential causative factors. One that we deemed important to explore was the funding awards for cancer sites from NCI-sponsored research.”

Spencer and colleagues used data from the NCI SEER database, Cancer Trends Progress Report and funding statistics to assess funding received across 13 cancer types from 2007 to 2014.

Researchers calculated a score for each cancer site for the funding received per years of life lost from 100 incident cases, called funding-to-lethality scores.

Scores would be the same across cancer types if funding was equitably allocated based on considerations of incidence and mortality.

However, funding for three gynecologic cancers appeared significantly lower than for the cancers ranked first through eighth in funding-to-lethality scores (P < .05 for all comparisons).

Prostate cancer had the most funding with an 8-year average of $1.81 million received per years of life lost from 100 incident cases (funding-to-lethality score, 1.81). Breast cancer followed closely with a score of 1.8.

Of the 13 cancers analyzed, funding for ovarian cancer research ranked ninth, with a score of 0.097, followed by cervix cancer with a score of 0.087. Uterine cancer ranked next to last with a score of 0.057.

Breast and prostate cancer scores were nearly 32 times higher than uterine cancer, 21 times higher than cervix cancer and 19 times higher than ovarian cancer (P < .00001 for all comparisons).

“When using a metric that accounts for mortality, incidence and years of life lost, certain cancer sites have received disproportionate levels of funding awards from the NCI over the most recent 8 years of funding data available” Spencer said. “Although some cancer sites have trended toward less funding and some toward more, some cancer sites have consistently received lower amounts of funding and those include the ovarian, uterine and cervical cancers. This is not a call to detract from the great efforts being made for other cancer sites, but a notice that all cancer sites deserve the same consideration and funding levels to benefit patients.”

Gynecologic cancers also had greater decreases in funding compared with other cancer sites. From peak levels during the 8-year study period, funding in 2014 decreased 18.5% for ovarian cancer research and 18.8% for uterine cancer research compared with a 9.9% decrease for breast cancer, a 7.1% decrease for testicular cancer, a 6.3% decrease for leukemia and a 5.7% decrease for kidney/renal pelvis cancer. Funding for pancreatic cancer increased by 67%.

If disparities in research funding do not improve, gynecologic cancers risk lagging behind other cancers in prevention, survival and development of targeted therapies, according to the researchers.

“As with any important cause, we need constant effort to make both administration and lay persons aware of the inequalities,” Spencer said. “It is critical to recruit people to champion the case that gynecologic cancers deserve more funding to keep pace with the transformative discoveries that we are seeing for other cancers.”

It is especially concerning that these data may reveal an area of gender inequality within the health care system, Spender added.  

“This particular inequality harms not only women with gynecologic cancers, but society as a whole suffers when these types of inequalities go undiscovered or uncorrected,” he said.

“We want this to be a call to action,” he added. “Complete results of this project should be published soon and we are engaging in ongoing research to understand how to best highlight this concern and develop suggestions and systems to correct the problem. We are always looking for partners and collaborators for both the research and advocacy to further the cause for women's cancers.” – by Cassie Homer

Reference:

Spencer R, et al. Abstract 3. Presented at: Society of Gynecologic Oncology Annual Meeting on Women’s Cancer; Mar. 24-27, 2018; New Orleans.

Disclosure: HemOnc Today could not confirm the authors’ relevant financial disclosures at the time of reporting.