Priority setting at NIDDKD is determined by a planning process that establishes a framework for program activities. This program plan is submitted to the NIDDKD Advisory Council for discussion. Of the six sections in the current program plan, one references ''minority activities" and highlights minority initiatives, research projects, center activities, and training and career development programs.
NIDDKD's cancer-related research is coordinated with NCI via a formalized memorandum of understanding that establishes NCI's primary responsibility for research on carcinoma of the prostate and NIDDKD's primary responsibility for research on noncancerous conditions, including research on the growth, development, and maturation of the prostate.
NIDDKD reports that it allocated a total of $33.4 million for research related to cancer among minority and medically underserved groups. This funding supports 142 programs or research grants. Nearly $1.5 million of this funding was allocated to the minority emphasis within the NIDDKD clinical trial on Medical Treatment of Prostatic Symptoms (MTOPS); this money represents 20 percent of the total funding for MTOPS. NIDDKD supported a workshop to identify barriers to the successful recruitment and retention of minority participants in this study and provided funding for 11 of 17 participating clinical centers to develop minority recruitment plans specific to their locales.
In collaboration with NCI and NIAID, NIDDKD has sought to stimulate research on Helicobacter pylori and its relationship to digestive diseases and cancer, particularly in minority populations, by establishing an RFA in January 1997. The RFA calls for studies on the epidemiology of Helicobacter in minority populations, genetic susceptibility to Helicobacter infection, and the clinical course of infection. The RFA notes that 10 to 12 awards are anticipated, with $2.5 million in funding available for awards. Before FY 1997, NIDDKD offered RFAs for studies of the regulation of prostate growth, the molecular epidemiology of prostate carcinogenesis, clinical trials of medical therapy in benign prostatis hyperplasia, hormonal regulation of breast-specific growth factors, and other studies of cancers that disproportionately affect ethnic minority populations.
NHLBI reported a dramatic increase in cancer-related research expenditures from FY 1985 to FY 1997. In 1985, NHLBI allocated $3.87 million to cancer-related research; this figure increased to $50.7 million in FY 1993 and $57.6 million in FY 1997, spurred in large part by the cancer portion of the Women's Health Initiative (WHI; see below), of which $16.7 million is included in the FY 1993 total and $19.5 million is included in