Research output and the public health burden of cancer: is there any relationship? U.S. & Canada Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Monday, April 18, 2016

Research output and the public health burden of cancer: is there any relationship? U.S. & Canada

Blogger's Note:  although ovarian cancer data is not included - interesting (but not surprising)

Current Oncology (open access-register first)

....our publication results are restricted to Canada and the United States, and therefore our results might not be generalizable to other parts of the world.
(My) Blogger's Key Points:
Although our study does not establish a causal relationship, those data suggest a significant disconnect between the public health burden from various cancers and the relative research intensity.
 Here, we evaluated whether clinical cancer research output (total publications and number of clinical trials) is proportional to the public health burden (measured by mortality) for 10 major cancers in Canada and the United States. We also explored the relationship between research funding and research output.
 Although the volume of scientific publications is often used as a metric for research productivity, the extent to which volume correlates with improvements in human health is not known. Furthermore, the use of a journal’s impact factor as an indicator of research quality has critical limitations4,14,15.
.... When adjusting for years of life lost, they found that breast cancer and leukemia received a relatively higher degree of funding and that lung cancer was underfunded. They modelled disease burden using years of life lost and mortality, and concluded that both measures provide valuable insight into the population burden of cancer and should be considered in the allocation of cancer research funding. Building on that work, Carter and Nguyen evaluated funding allocations by the U.S. National Cancer Institute11. They found considerable mismatch between funding levels and disease burden. Breast cancer, prostate cancer, and leukemia were funded at levels higher than their relative burden, while bladder, esophagus, liver, oral, pancreatic, and uterine cancers were relatively underfunded.
 Breast cancer and prostate cancer received $73,036,061 and $36,297,058 (Canada) in research funding respectively—about 8 times and 4 times the amount that would be proportional to their corresponding cancer mortality.



The relative distribution of research output across cancer sites is not well described. Here, we evaluate whether the volume of published research is proportional to the public health burden of individual cancers. We also explore whether research output is proportional to research funding.


Statistics from the Canadian and American cancer societies were used to identify the top ten causes of cancer death in 2013. All journal articles and clinical trials published in 2013 by Canadian or U.S. authors for those cancers were identified. Total research funding in Canada by cancer site was obtained from the Canadian Cancer Research Alliance. Descriptive statistics and Pearson correlation coefficients were used to describe the relationship between research output, cancer mortality, and research funding.


We identified 19,361 publications and 2661 clinical trials. The proportion of publications and clinical trials was substantially lower than the proportion of deaths for lung (41% deaths, 15% publications, 16% clinical trials), colorectal (14%, 7%, 6%), pancreatic (10%, 7%, 5%), and gastroesophageal (7%, 5%, 3%) cancers. Conversely, research output was substantially greater than the proportion of deaths for breast cancer (10% deaths, 29% publications, 30% clinical trials) and prostate cancer (8%, 15%, 17%). We observed a stronger correlation between research output and funding (publications r = 0.894, p < 0.001; clinical trials r = 0.923, p < 0.001) than between research output and cancer mortality (r = 0.363, p = 0.303; r = 0.340, p = 0.337).


Research output is not well correlated with the public health burden of individual cancers, but is correlated with the relative level of research funding.


....Relative to other diseases, oncology has greater relative funding and a disproportionate representation in higher-impact medical journals6. However, within oncology, the number of publications4,6, clinical trials7, and research funding811 might not be distributed across cancer sites relative to the burden of disease. To our knowledge, no published study has described the interrelationships of disease burden, research output, and research funding within oncology. For the present study, we evaluated whether the volume of published cancer research is proportional to the public health burden by cancer site. We also explored whether research output is proportional to research funding by cancer site. We hypothesized that cancer research output (total publications and clinical trials) does not reflect the relative mortality for the various disease sites, but is more reflective of available research funding......

 Identifying Cancers with the Greatest Public Health Burden
Using 2013 statistics from the Canadian Cancer Society and the American Cancer Society, we identified the cancers responsible for the greatest number of deaths in Canada and the United States2,12. A priori, we excluded non-Hodgkin lymphoma, leukemia, and liver or intrahepatic biliary cancer from our study because those malignancies have multiple subtypes, and we did not feel that our bibliometric search would accurately identify related research output. Thus, the top 10 cancers, by mortality, considered here are lung, colorectal, breast, prostate, pancreatic, bladder, gastroesophageal, melanoma, kidney, and uterine cancers.


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