"Office of the Surgeon General, Salaries and expenses"-. 1966 total estimated obligations---. 1967 estimated obligations---- Total change‒‒‒‒ Increases: Mandatory: 1. Annualization of positions new in 1966_-. 2. Annualization of commissioned officers' pay increase_- 4. Annualization of general schedule pay increase‒‒‒‒‒‒ Program: Subtotal, mandatory increases_ 1. Research grants- $163, 768, 000 -55, 000 -7,000 163, 706, 000 163, 957, 000 +251, 000 132, 000 93, 000 11,000 178, 000 414, 000 344,000 428, 000 168, 000 54, 000 Research grants. The program increase of $344,000 will provide $217,000 for general research support grants, $5,000 for scientific evaluation grants, and $118,000 for specialized research centers. The program increase is offset by a decrease of $1,500,000 for programed chemotherapy grants. Fellowships. The program increase of $428,000 is requested to provide inFreased emphasis in the research career development program. Training-The program increase of $168,000 is requested to augment the new cancer clinical training program started in 1966. Direct research. The program increase of $54,000 is requested to support 9 new positions in the areas of increased emphasis such as cell biology and surgery. Collaborative studies.-The program increase of $798,000 is requested for support of contracts and 8 new positions in the areas of chemical carcinogenesis, viral oncology, experimental therapeutics, and clinical trials. The program inrease is offset by a decrease of $1,500,000 for chemotherapy contracts. Review and approval of grants. The program increase of $4,000 is requested for support of one additional position for program planning. Program direction. The program increase of $187,000 and 2 positions is requested to augment program planning activities. (1) In the opinion of the committee a task force on breast cancer should be established to permit intensive program development in the treatment of breast cancer (p. 27). (2) The committee recognized the need to train future practitioners in order to insure that cancer patients will benefit from the advances made through research (p. 28). (3) The committee expected that a really thorough study be made to determine what changes are necessary-legislative, organizational, personnel, level of funding, etc-for the achievement of greater progress in the fight against cancer. (p. 36). (4) Opportunities for progress are clearly evident in the study of virus causation of cancer in areas other than leukemia (p. 36). 1966 Senate Report (1) The committee made a provision for the expansion of the virus-leukemia program in the areas of epidemiology, laboratory and clinical research, and research and development (p. 44). ACTION TAKEN OR TO BE TAKEN (1) A breast cancer task force has been formed and is working on the development of a comprehensive program plan. A special report will be furnished the committee as soon as practicable. (2) A special report will be furnished the committee on clinical cancer training grants prior to the appropriation hearings. (3) The Cancer Institute has been completely reorganized to bring together programmatic activities relating to cancer causation. (4) A special report will be furnished the committee on special virus-leukemia program prior to the appropriation hearings. (1) See (4) above. These funds support research activities in the cancer field within universities. hospitals, laboratories, research institutes, and other public or private nonprofit institutions. These grants stimulate new investigations in fields requiring exploration. Support is provided for projects which range from smaller and circumscribed activities to broad and composite programs that integrate the research interests of many investigators in a variety of scientific disciplines. These grants also make possible the performance of complex clinical research in centers which offer an opportunity for precise observations and controls by investigators with varied interests and techniques in an environment offering specialized facilities, bed arrangements, and core laboratories. PROGRAM PLANS IN 1966 AND 1967 The amount provided for noncompeting continuations in 1967 is $2,683,000 below the 1966 level. This decrease is partially offset by a request for an increase of $1,187,000 in the level of support of competing applications for regular research grants. The Institute will continue to sponsor extensive research on malignant growth at the level of populations, the individual patient, cells, and subcellular components. Many studies will be aimed at the viral etiology of malignant disease, with particular emphasis on the possible virus causation of some human cancers. Other projects will seek to determine the relationship of chemicals to cancer, and the carcinogenic and cocarcinogenic effects of these chemicals, radiation, and viruses. Special attention will be devoted to the spectrum of carcinogenic problems and hazards in man's total environment: atmosphere, water supply, food, drugs, tobacco, natural products, occupation, radiation, and infectious agents. Grants will stress research on therapy, especially chemotherapy and related pharmacologic studies of neoplastic disease. Other studies will deal with primary surgical therapy of human cancer, and the application of tools and techLiques from experimental radiobiology to radiation therapy. The programed chemotherapy grant program will continue to support the efforts of study groups, representing numerous hospitals, cooperating in clinical trials under highly developed protocols for various types of malignancies. Funds provided in the budget for childhood leukemia treatment will augment the programs of the major centers by supporting accommodations for use outside the hospital during periods when the patients are ambulatory or are being treated on a research basis in outpatient units. These funds will also support use of the plasma pherisis technique at additional institutions, and thus make possible an increased availability of platelet replacement therapy for reducing the frequency and severity of hemorrhage in patients receiving antileukemic treatment. During 1966 and 1967, funds designated for clinical research centers will support an expanded operation of the 20 currently active programs, and will permit the establishment of 2 additional centers. In this connection, it should be pointed oct that cancer clinical research funds are used not only for support of the research resource (hospital beds, core laboratories, etc.), but also for the associated research carried out in the center. Some of the activities will be particularly directed toward the urgent need for upgrading the quality of drug trials. The role of cancer clinical research centers has not been fully exploited in this area, and increasing efforts in this direction can be expected. A major step toward this end has very recently been taken with the establishment of a new center, using 1966 funds, at Yale University. In addition, the availability of $600,000 in 1966 and 1967 for life islands and related reverse isolation units such as laminar flow units will involve the existing cancer clinical research centers. These sums will be sufficient to establish and to operate 2 additional installations. Specialized research center grants will be awarded in 1966 and 1967 for sup port of costs incurred by institutions in the development of long-range plans for cancer research, training, and clinical service. The plans may be developed very broadly for a wide spectrum of cancer research activities, including institutionwide programs on etiology, detection and diagnosis, treatment, epidemiology, statistics and followup, administration and management of cancer programs, education and training. In some cases, these grants will make possible planning for a more circumscribed area, such as the development of specialized instrumentation important for cancer activities. These grants will permit an appraisal of cancer activities to date, and a time-phased projection of mission, objectives, scientific program development, resources, information handling, potential sources of funds, recruitment needs and salary scales. The budget for 1966 and 1967 reflects the application of the newly authorized cost-sharing arrangements to competing research grant projects (new and renewal). This cost-sharing plan considers the full indirect cost of the research project in arriving at the Federal and non-Federal share. For continuation of previously approved projects the earlier limitation of 20 percent or less for indirect cost is applied with an assurance of some sponsor cost participation. Total fellowships: 1966 estimate. 1967 estimate.. Increase or decrease.. Fellowships $3,742, 000 4, 170, 000 +428, 000 INTRODUCTION The fellowship program provides research training to individuals whose career development extends from the immediate postdoctoral period through the more advanced stages of scientific attainment. Postdoctoral awards support qualified individuals with a doctor's degree, but with little or no previous research experience. Special fellowships, by contrast, are intended to support advanced and specialized training for scientists who have had at least 3 years of research experience and who have demonstrated research accomplishment or potential. This activity also includes the research career program, consisting of develop ment and career awards. Development awards are provided to highly promising younger scientists who require support for 5 to 10 years in order to improve their research skills and to develop a capability for independent investigation. Career awards are intended for continued support of established senior investigators, thereby creating additional full-time and stable research positions in medical schools and other institutions engaged in conducting cancer research. |