External factors that affect research funding

Less common cancers and especially rare cancers face several known research challenges, often relating to the smaller numbers of people affected. In research studies, particularly randomised controlled trials, larger participant numbers generally make findings more robust. Therefore, with fewer people diagnosed with rare and less common cancers, it follows that there is a smaller pool to recruit study participants from. It has been suggested that grant funding agencies and reviewers, if unexperienced in rare cancers, may not be able to effectively judge the quality of study proposals and navigate towards funding research on the more common cancer types.1
 

Funding of cancer types in relation to impact

Several studies have analysed the funding of cancers compared to societal burden in terms of costs to treat, mortality and other established population health metrics. Maruthappu et al. (2016) reviewed the cancer sites in 4299 funded studies in the UK and compared them to cancer sites of the highest disease burden.2 Disease burden was determined by a compound metric combining mortality, disability adjusted life years (DALYs) and years lived with disability (YLDs). The researchers found that the least well-funded sites in the context of disease burden were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. They argue that research funding for cancer is not allocated according to relative disease burden and that funding agencies and industry should work to improve better targeting of research investment.
 

Cancer mortality in the UK

Of new cancer cases each year in the UK, 53% are one of the top four common cancers – breast, prostate, lung and bowel cancers, meaning 47% are rare and less common cancers. Yet rare and less common cancers account for 55% of cancer mortality.
 

The graph below shows the top ten rare and less common cancers by mortality (indicated by grey dots), compared to research spend on individual cancer type (shown as bars).3 The notable exception is CUP (Cancer of Unknown Primary), which is not an individual cancer type but is when secondary cancer has been found and it is unknown where the primary tumour started.4