Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, NE.
Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE.
Ann Surg. 2020 Feb;271(2):296-302. doi: 10.1097/SLA.0000000000003042.
Comparative analyses of survival and funding statistics in cancers with high mortality were performed to quantify discrepancies and identify areas for intervention.
Discrepancies in research funding may contribute to stagnant survival rates in pancreatic ductal adenocarcinoma (PDAC).
The Surveillance, Epidemiology, and End Results database was queried for survival statistics. Funding data were obtained from the National Cancer Institute (NCI). Clinical trial data were obtained from www.clinicaltrials.gov. Cancers with high mortality were included for analyses.
Since 1997, PDAC has received lesser funding ($1.41 billion) than other cancers such as breast ($10.52 billion), prostate ($4.93 billion), lung ($4.80 billion), and colorectal ($4.50 billion). Similarly, fewer clinical trials have been completed in PDAC (n = 608) compared with breast (n = 1904), lung (n = 1629), colorectal (n = 1080), and prostate (n = 1055) cancer. Despite this, since 1997, dollars invested in PDAC research produced a greater return on investment with regards to 5-year overall survival (5Y-OS) compared with breast, prostate, uterine, and ovarian cancer. Incremental cost-effectiveness analysis demonstrates that millions (liver, non-Hodgkin lymphoma, and melanoma) and billions (colorectal and lung) of dollars were required for each additional 1% increase in 5Y-OS compared with PDAC. Funding of research towards early diagnosis of PDAC has decreased by 19% since 2007. For nearly all cancers, treatment-related research receives the highest percentage of NCI funding.
Funding of PDAC research is significantly less than other cancers, despite its higher mortality and greater potential to improve 5Y-OS. Increased awareness and lobbying are required to increase funding, promote research, and improve survival.
对高死亡率癌症的生存和资金统计数据进行比较分析，以量化差异并确定干预领域。
研究资金的差异可能导致胰腺导管腺癌（PDAC）的生存率停滞不前。
从监测、流行病学和结果数据库中查询生存统计数据。从美国国立癌症研究所（NCI）获得资金数据。从 www.clinicaltrials.gov 获得临床试验数据。纳入高死亡率癌症进行分析。
自 1997 年以来，PDAC 的资金投入（14.1 亿美元）少于乳腺癌（105.2 亿美元）、前列腺癌（49.3 亿美元）、肺癌（48 亿美元）和结直肠癌（45 亿美元）等其他癌症。同样，与乳腺癌（n = 1904）、肺癌（n = 1629）、结直肠癌（n = 1080）和前列腺癌（n = 1055）相比，PDAC 完成的临床试验更少（n = 608）。尽管如此，自 1997 年以来，与乳腺癌、前列腺癌、子宫癌和卵巢癌相比，投资于 PDAC 研究的资金在 5 年总生存率（5Y-OS）方面产生了更高的投资回报。增量成本效益分析表明，与 PDAC 相比，每增加 5Y-OS 的 1%需要花费数百万美元（肝癌、非霍奇金淋巴瘤和黑色素瘤）和数十亿美元（结直肠癌和肺癌）。自 2007 年以来，PDAC 早期诊断研究的资金减少了 19%。对于几乎所有癌症，与治疗相关的研究获得了 NCI 资金的最高百分比。
尽管 PDAC 的死亡率更高，改善 5Y-OS 的潜力更大，但 PDAC 研究的资金投入明显少于其他癌症。需要提高认识和游说，以增加资金、促进研究和提高生存率。
