research will exceed $3.23 billion, fueled in large part by the Clinton Administration's request for NCI appropriations of $2.77 billion.

The National Institute of Environmental Health Sciences (NIEHS) holds the second largest portfolio of cancer-related research among the institutes at NIH, with allocations of $84.44 million in FY 1997, a figure that approached nearly $90 million in FY 1998. The National Heart, Lung, and Blood Institute (NHLBI) is third in cancer-related funding with funding, of $57.6 million in FY 1997, followed by the National Institute of Allergy and Infectious Diseases (NIAID) with funding of $43 million and the National Institute on Diabetes and Digestive and Kidney Diseases (NIDDKD) with funding of $33.4 million (see Table 3-1).

Examined by spending on specific cancer sites, cancer types, diseases related to cancer, and types of research mechanisms, NIH reports spending the greatest amount of money on cancer clinical trials (more than $400 million in FY 1997, an increase of more than $150 million from FY 1990), followed by funding for breast cancer (more than $330 million in FY 1997, a fourfold increase over FY 1990 levels of $81 million), cancer prevention and control activities (nearly $240 million in FY 1997, up from $80.5 million in FY 1990), AIDS-related cancers ($224 million spend in FY 1997, up from $149 million in FY 1990), and lung cancer ($132 million in FY 1997, up from $65 million in FY 1990). Among cancers that disproportionately affect ethnic minority and medically underserved communities (in addition to the cancer types described above), NIH spent $74 million across ICDs on prostate cancer-related research in FY 1997 (up from $13.2 million in FY 1990), $54 million on cervical cancer (an increase of $30 million from FY 1990 levels), approximately $100 million on colorectal cancer (nearly doubling spending from $51.2 million in FY 1990), and $39 million on ovarian cancer (nearly four times the $10.5 million spent in FY 1990). In contrast, other cancers that disproportionately affect minority and medically underserved groups, such as liver cancer ($33 million in FY 1997) and uterine cancer ($8.6 million in FY 1997), have not received substantial increases in funding, with increases of only about $5 million and $2 million, respectively, since FY 1990. It must be noted, however, that funding for these disease areas can and often does overlap. Basic research and clinical research that benefits more than one type of cancer site are included in estimates of total funding for each cancer (see Table 3-2; National Institutes of Health, 1998).

Office of Research on Minority Health

The NIH Office of Research on Minority Health (ORMH) was established in 1990 by then-director of NIH William Raub and was authorized by the U.S. Congress in the 1993 National Institutes of Health Revitalization



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