National Cancer Institute (NCI)
The National Cancer Institute (NCI) is a key agency under the National Institutes of Health (NIH) in the United States, primarily focused on cancer research and training. Established in 1937, the NCI's mission is to eliminate cancer and improve treatments for those diagnosed with the disease. It achieves these goals through extensive research initiatives, educational programs, and by fostering collaboration among various stakeholders, including academic institutions, hospitals, and private organizations both domestically and internationally.
The NCI operates nearly thirty specialized offices and divisions that focus on different aspects of cancer, such as cancer genomics, prevention, treatment, and health disparities. Notably, the institute conducts both intramural research in its own facilities and supports extramural projects across the country. With a budget exceeding $7 billion, the NCI plays a crucial role in advancing cancer science and improving patient outcomes, especially as cancer remains a leading cause of death globally. The NCI also emphasizes the importance of public education and outreach, ensuring that cancer information is accessible to diverse communities. Overall, the NCI's ongoing efforts are vital in the fight against cancer, aiming to reduce its impact on public health.
National Cancer Institute (NCI)
Definition: A federal agency devoted to the study of cancer, as well as communication and education about this condition
Overview
The US Department of Health and Human Services (HHS) is the federal agency responsible for public health. The HHS includes eleven divisions, one of which is the National Institutes of Health (NIH). The National Cancer Institute (NCI) is one of twenty-seven institutes and centers within the NIH. The institute was established in 1937 under the National Cancer Institute Act and, in 1944, was made part of the National Institutes of Health under the Public Health Service Act. NCI is the principal federal agency for cancer research and training. Following special legislation in 1971 that amended the Public Health Service Act and created the National Cancer Act, the scope of the NCI has continued to broaden through new initiatives and legislation.
The purpose of the NCI is to eliminate cancer as far as possible and to discover treatment for those cancers that cannot be eradicated. The NCI approaches these goals by supporting research, coordinating efforts in prevention and treatment, facilitating the movement of research findings into medicine, and providing education and resources for patients and their families, health educators, and scientists. The NCI conducts research in its own laboratories and clinics in Bethesda, Maryland, but also supports and coordinates research projects conducted by universities, hospitals, research foundations, and businesses throughout the United States and many other countries.
The Organization and Focus of the NCI
The NCI is organized by the Office of the Director into nearly thirty centers, offices, and divisions. Each of the initiatives specializes in a different aspect of cancer research, although there is overlap among them. The Office of Cancer Centers, for example, supports cancer research at academic and research institutions across the United States, while the Office of Cancer Genomics specifically supports research programs that focus on the molecular components of cancer.
Another group, the Office of Cancer Nanotechnology Research, is in charge of the NCI Alliance for Nanotechnology in Cancer Program, which works to develop nanotechnology-based tools for research, detection, treatment, monitoring, and prevention. The Center to Reduce Cancer Health Disparities works through research, training, and partnerships to reduce cancer disparities among diverse populations. The Center for Global Health fosters international collaboration and sharing of research resources among government agencies, nongovernment organizations, biotechnology companies, and pharmaceutical companies. In 1998, the Office of Cancer Complementary and Alternative Medicine was established to coordinate research and communication activities in the arena of complementary and alternative medicine, both within the NCI and with other agencies.
The main purpose of the NCI's basic clinical intramural research program, the Center for Cancer Research, is to improve the lives of those affected by cancer as well as by HIV/AIDS. The NCI's other intramural initiative is the Division of Cancer Epidemiology and Genetics, whose goal is prevention. This division focuses on the factors that could lead to cancer growth, namely genetic predisposition, lifestyle factors, environmental contaminants, occupational exposures, medications, radiation, and infectious agents; the group also works on epidemiological methods development.
Research in cancer cell biology, such as carcinogenesis and cancer immunology, falls within the realm of the extramural Division of Cancer Biology. This division also examines the biological and health effects of exposure to ionizing and nonionizing radiation. The efforts of the Division of Cancer Prevention center on early detection methods and the efficacy of nutritional or lifestyle changes on cancer prevention. The results of research in this area led to the 5 a Day for Better Health program. Initiated in 1991, and continuing into the twenty-first century, this public-private partnership program is a collaborative effort between the food industry and the NCI, which encourages Americans to eat five or more servings of vegetables and fruits each day as part of a low-fat, high-fiber diet. The goal of this type of diet is to prevent the risk of cancer, heart disease, diabetes, and stroke. The Division of Cancer Treatment and Diagnosis includes programs in biomedical imaging, cancer diagnosis, cancer therapy evaluation, developmental therapeutics, and radiation research. The Division of Cancer Control and Population Sciences supports a wide array of research in the areas of surveillance, genetics, epidemiology, and behavior.
The mission of the Coordinating Center for Clinical Trials (CCCT), established in 2006, is to facilitate the bringing of new scientific discoveries and tools to the medical clinic. Research areas supported by the CCCT include cancer genetics, cancer vaccines and immunotherapy, molecular therapeutics, experimental transplantation, and advanced technology. The clinical cancer genetics program integrates all aspects of clinical and laboratory medicine, particularly in studies of breast, colon, renal, and prostate cancer. Processes include molecular diagnostics, novel imaging techniques, and the molecular assessment of normal tissues in at-risk populations. The cancer vaccines and immunotherapy program investigates the clinical feasibility of using vaccines against known conditions associated with cancer, such as the human papillomavirus (HPV vaccines Cervarix and Gardasil) and human immunodeficiency virus (HIV), as well as with cancer-specific products, such as in melanoma and in lymphomas. The molecular therapeutics program is concerned with most clinical trial experiments. Important discoveries include the development of paclitaxel (Taxol) as an effective anticancer agent, the development of zidovudine (AZT, Retrovir) as an important anti-HIV drug, and the use of adoptive immunotherapy in the treatment of malignant melanoma. The scientific thrust of the molecular therapeutics program is the belief that the analysis of the molecular profile of individual cancers will help determine the most effective chemotherapeutic approaches. The experimental transplantation program examines bone marrow biology to advance transplantation techniques and the effectiveness of this approach.
Integrating many programs and divisions is the advanced technology initiative. New technology is an essential key to identifying genetic elements involved in cancer initiation and progression, as well as in drug efficacy and drug resistance. Although many drugs have been discovered that inhibit the growth of cancer cells successfully, they also affect healthy cells. This causes side effects that have a negative impact on patients’ health and quality of life. New therapeutics and technology have been investigated to minimize or eliminate these side effects and enhance the effectiveness of therapy.
Another division of the NCI is the Division of Extramural Activities, which is responsible for handling all applications for funding and for monitoring research that has received funding from the NCI. Extramural activities also include the oversight of scientific communications. To enhance communication, the NCI has a number of advisory boards and groups that provide the institute with input from the public, medical, and research communities.
The NCI has helped strengthen the information base for cancer care decision-making. Researchers, medical providers, and patients seek to better understand what constitutes quality cancer care. The Cancer Information Service, established in 1975, is the section of the NCI that is the link to the public, attempting to explain research findings in a clear, timely, and understandable manner. To this end, the Cancer Information Service helps develop education efforts that target minority audiences and people with limited access to healthcare information or services.
Perspective and Prospects
To be successful in managing this range of responsibilities and breadth of mission, the NCI had a budget of over $7 billion dollars in the early 2020s. Although cancer is the second leading cause of death in the United States and is a leading cause of death worldwide, through the years, the work of the NCI has led to a decline in the number of deaths due to this disease. Creative and dedicated scientists at the NCI are committed to lowering its numbers even further.
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