Does the global cancer research funding by public and philanthropic investments address important research gaps?

Abstract

e23032 Background: Public and philanthropic funding are vital to all domains of cancer research, yet little is known about how the funding landscape has evolved over the years and whether the public investments in cancer research are aligned with disease burden and research priorities. Methods: We conducted a cross-sectional analysis of cancer research grants recorded in the International Cancer Research Partnership database and European Commission programs from 2007 to 2022. Awards were converted to 2022 US dollars, adjusted for inflation, and classified by cancer site and the six Common Scientific Outline (CSO) categories- biology, etiology, prevention, early detection and diagnosis, treatment, and survivorship and outcomes research. Funding trends were assessed using joinpoint and linear regression. GLOBOCAN 2022 data for incidence, mortality, and mortality-to-incidence ratio (MIR) were extracted to assess alignment of funding amount with cancer burden. Results: Combined public and philanthropic cancer research funding increased from US$7.00 billion in 2007 to US$10.90 billion in 2022 (APC 2.46%). Observed investment in 2022 exceeded the inflation-adjusted projection of 2007 funding (US$9.87 billion). In 2022, funding was highest for treatment (US$3.31 billion), followed by biology (US$2.53 billion). Funding for treatment research constituted the highest proportion and funding for early detection, diagnosis, and prognosis (US$1.85 billion) and prevention (US$0.97 billion) represented a small portion of the total portfolio. Survivorship and outcomes research accounted for US$1.15 billion in 2022 and showed sustained growth over time (APC 2.51%). All categories had significant increases in funding amount per year except for the category of etiology. In 2022, breast cancer accounted for 6.9% of total cancer deaths but received 19.5% of total research funding, whereas upper gastrointestinal cancers represented 13.4% of deaths and received only 3.0% of funding. Funding distribution showed a moderate correlation with incidence (R² 0.41; R 0.64), a weak correlation with mortality (R² 0.10; R 0.32) and no correlation with MIR (R² 0.01; r −0.11). Conclusions: Public and philanthropic investments in cancer research increased from 2007 to 2022 at an annual rate of 2.46%. However, the funding distribution showed disproportionately low funding for the categories of cancer etiology, prevention, and survivorship. Certain tumor types were also likely to be disproportionately less funded relative to their public health burden. Our study highlights the underfunded categories and tumor types to be considered for increased and perhaps, targeted funding as part of future funding decisions.