Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, and.
Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois.
J Natl Compr Canc Netw. 2019 Jul 1;17(7):849-854. doi: 10.6004/jnccn.2018.7280.
Nonprofit organizations (NPOs) in oncology are vital for patient advocacy and funding research for rare cancers, young investigators, and innovative projects. However, some cancers may be underfunded relative to their burden. This study examined the alignment of cancer burden by histology with NPO funding for each histology.
This nationwide, cross-sectional study conducted from October 2017 through February 2018 included all oncology NPOs with >$5 million in annual revenue. Total revenue from NPOs supporting individual cancer types with the incidence, mortality, and person-years of life lost (PYLL) for each cancer type was compared using scatter plots and Pearson correlation coefficients. Correlation of expenditure types (eg, fundraising, patient education) with revenue was assessed using Pearson correlation coefficients. Effect of disease association with a stigmatized behavior (eg, lung cancer and smoking) was evaluated using descriptive statistics.
A total of 119 cancer-related NPOs were included, generating approximately $6 billion in annual revenue in 2015. Cancers with the largest revenue were breast cancer ($460 million; 33.2%), leukemia ($201 million; 14.5%), pediatric cancers ($177 million; 12.8%), and lymphoma ($145 million; 10.5%). Breast cancer, leukemia, lymphoma, and pediatric cancers were all well funded compared with their incidence, mortality, and PYLL. Gastrointestinal (colorectal, pancreas, and hepatobiliary), gynecologic (ovarian, cervical, and endometrial), brain, and lung cancers were poorly funded in all 3 metrics. All cancers associated with a stigmatized behavior were poorly funded in at least 2 metrics. Increased spending on fundraising, administrative costs, patient education, and treatment was highly correlated with increased revenue (Pearson correlation coefficients all >0.92).
NPO funding by cancer type is not proportionate with individual cancer burden on society. Disease stigma negatively impacts funding. A significant need exists to increase awareness and funding for many undersupported but common and highly lethal cancers.
肿瘤学领域的非营利组织（NPO）对于患者倡导和为罕见癌症、年轻研究人员以及创新项目提供研究资金至关重要。然而，某些癌症的资金可能相对不足，与其负担不成比例。本研究通过检查每个组织病理学类型的癌症负担与 NPO 资金之间的一致性，来评估癌症负担与组织病理学类型之间的关系。
这是一项全国性的、横断面研究，于 2017 年 10 月至 2018 年 2 月进行，包括所有年收入超过 500 万美元的肿瘤学 NPO。使用散点图和 Pearson 相关系数比较了 NPO 支持的各个癌症类型的总收入，以及每种癌症的发病率、死亡率和生命损失年数（PYLL）。使用 Pearson 相关系数评估了支出类型（例如筹款、患者教育）与收入之间的相关性。使用描述性统计评估了与污名化行为（例如肺癌与吸烟）相关的疾病的影响。
共纳入 119 个与癌症相关的 NPO，在 2015 年产生了约 60 亿美元的年收入。收入最高的癌症分别为乳腺癌（4.60 亿美元；33.2%）、白血病（2.01 亿美元；14.5%）、儿科癌症（1.77 亿美元；12.8%）和淋巴瘤（1.45 亿美元；10.5%）。乳腺癌、白血病、淋巴瘤和儿科癌症的收入均与发病率、死亡率和 PYLL 相比得到了很好的资助。胃肠道（结直肠癌、胰腺癌和肝胆癌）、妇科（卵巢癌、宫颈癌和子宫内膜癌）、脑癌和肺癌在所有 3 个指标中都得到了较少的资助。所有与污名化行为相关的癌症在至少 2 个指标中都得到了较少的资助。筹款、行政费用、患者教育和治疗方面的支出增加与收入的增加高度相关（Pearson 相关系数均>0.92）。
根据癌症类型，NPO 的资助与癌症对社会的个体负担不成比例。疾病污名化对资金产生负面影响。需要提高对许多支持不足但常见且高度致命的癌症的认识和资助。
