Policy challenges for cancer research: a call to arms.

Research has delivered remarkable benefits for cancer patients and their families since James Watson and Francis Crick wrote the now immortal line, 'We wish to propose a structure for the salt of deoxyribonucleic acid' thus setting the molecular foundations for the modern era of cancer control. The pace of technological innovation from fundamental scientific discoveries to the policy impact of huge population studies has been breathtaking. One has only to contrast a paper on the treatment of solid epithelial cancers written by Henri Tagnon and colleagues in 1966 (Eur J Cancer2 51-7) with the myriad of chemotherapeutic approaches at the oncologists disposal today. Inevitably, as the tide of research has risen so it has bought the flotsam and jetsam of regulations and policies. Some have been helpful, many pointless and too many actually harmful. Naturally, some of these regulatory and general policies (by this I mean those concerned with funding, structure and organization) have been specifically targeted at cancer research, e.g. US National Cancer Act 1971, whilst others have been a product of the general regulatory environment with indirect consequences for cancer research, e.g. EU Data Protection Directive 1995. Policy issues thus cover a vast terrain criss-crossed by complex interdependencies between scientific areas, countries S&T policies and socio-political constructs. Unfortunately, there has been little attention paid to the consequences of these policy issues from which the research community has, by and large, been passenger rather than driver.Global investment in cancer research is now at unprecedented levels. The recently published report by the European Cancer Research Managers Forum has found some 14 billion euros being annually spent worldwide on cancer research (this figure includes industry but overall probably underestimates spend by at least one billion [2]). With the ageing demographics of developed countries and the catch-up effect in developing countries, the rising burden of cancer is driving research activity in cancer ever upwards. Opportunities for delivering even greater measures for preventing and controlling cancer abound, but the shackles of bureaucracy (stifling regulations and poor research policies) threaten this future more than ever-'Man is born free and everywhere he is in chains'. Jean-Jacques Rousseau's quote could equally be applied to spirit of research creativity in today's environment. So what are the main issues and what is to be done?