The Problem: Low Federal Funding of Pediatric Cancer Research
About 60% of biomedical research funding in the United States comes from industry. For childhood cancer, only a fraction of a percent of funding is actually supported this way. The federal government is essentially the sole funder of pediatric research, yet funding for pediatric cancer research at the NCI is relatively low, comprising just 4% of total funding, with very few programmatic initiatives (e.g. SPORE grants) focused on children’s tumors.
National Cancer Institute’s Budget for Cancer Research
One reason federal funding for pediatric cancer research is low is the structural impairments in peer review process, the process by which research proposals are evaluated. Unexamined biases, and lack of accommodations for the inherent limitations of pediatric cancer research has resulted in chronic underfunding of pediatric cancer researchers.
The Solution: The Establishment of a Pediatric Cancer Study Section
There are a number of areas in which the National Institute of Health could improve the quality and quantity of pediatric cancer research through the establishment of a Pediatric Cancer Study Section. Study section scoring undervalues important and unique aspects of childhood cancer research such as years of life lost with the death of each child, poor quality of life for childhood cancer survivors, and the value our society places on protecting children. Study section scoring guidelines that narrowly define public health impact disfavors important knowledge that can be gained from childhood cancer research and instead focuses on next-step innovations in the best-studied cancers affecting adult patients. Study section scoring guidelines also underestimate the impact of pediatric cancer research by failing to take into consideration the opportunity the study of pediatric cancers present as a result of the absence of genetic “noise” associated with older age. Few pediatric cancer researchers serve on study sections.
The establishment of a Pediatric Cancer Study Section meets the goals of the NIH’s own peer review evaluation process. A Pediatric Cancer Study Section would attract the best pediatric cancer reviewers, improve the quality of the review of childhood cancer research and ensure balanced and fair reviews. A Pediatric Cancer Study Section would be not disease specific, but would focus on an area of cancer with its own specific treatment paradigm and unique long run survival implications. In addition, it would follow precedents of other NIH age specific and pediatric specific study sections within the Center for Scientific Review.