With automatic U.S. federal budget cuts kicking in, cancer centers are readying for a significant downturn in spending, especially because the cost savings must be achieved in the remaining half of the federal fiscal year.

Leaders worry that sudden drop in federal funding may impact young researchers most.

Owing to the automatic federal spending cuts mandated by the U.S. “sequestration” budget bill that kicked in on March 1, spending by the National Cancer Institute (NCI) and other federal agencies is likely to drop by around 5% in the fiscal year that ends September 30.

While details aren't yet known, cancer centers are readying for a significant downturn in spending, especially because the cost savings must be achieved in the remaining half of the fiscal year.

“We don't know how this all will play out, but the prospects look very difficult going forward,” says Scott Lippman, MD, director of the University of California San Diego Moores Cancer Center. “We're just trying to diversify as much as we can to keep things going, working 24/7 on grants, fundraising, and industry partnerships to leverage whatever resources we can, so that our clinical and basic researchers can continue to advance the field.”

Federal agencies are now operating under a Congressional continuing budget resolution that expires on March 27 and gives the NCI a slight increase over its fiscal year 2012 funding. The sequestration bill mandates an automatic cut of 5.1% in discretionary non-military spending, so if the continuing resolution is extended, the result will be about a 4.4% cut for the NCI.

That translates into about $219 million in cost savings to be made up in the current fiscal year.

“If sequestration stays in place, probably 9% in budget cuts need to be made in the remainder of the fiscal year,” says Kristina Vuori, president and interim chief executive of Sanford-Burnham Medical Research Institute in San Diego and Orlando, FL, and director of the Sanford-Burnham Cancer Center.

“At Sanford-Burnham, we planned our budget taking into the account the possibility of having to reduce expenses 18 months ago,” she says. “We decided to prepare and did reduce our expenses, depending on the area, by 10% to 15%, mainly in nonpersonnel costs.”

“Individual investigators live or die by their own grants, and every lab has to be flexible and scalable as grants come in,” Vuori notes. “What sequestration means in practice is that people just need to hunker down and focus on fewer projects. Like many others, I personally hope that the RO1 grant pool can be kept as intact as possible to keep great science going. Some great ideas will need to be put on the shelf, and hopefully there will be money available for them at another point in time. I don't think we can really move things as robustly forward as we have been, and in the end, of course, it's the patients who may suffer.”

“The biggest concern that many of us have is for the future of this field; will people be willing to invest their careers?” she adds. “It's not a very attractive picture for young scientists who are considering whether they enter medical research. It is a tough road to become an MD, MD/PhD, or PhD and then have to justify your job every day.”

Sequestration may have an immediate impact on the renewal amount for the cancer center support grant at Case Comprehensive Cancer Center in Cleveland. “We will be renewed, we had an outstanding score, but we have a start date of April 1, the day after the end of the dialogue about closing down budgets, so we are in that most vulnerable status for that grant,” says Director Stanton Gerson, MD.

Overall, Case receives about $90 million annually for cancer research from the NCI, other NIH institutes, and other federal organizations. “If we're talking about $7 to $8 million of cancer research funding that disappears, it's a huge reduction,” Gerson says. “As we all know, three quarters of this funding goes to salaries.”

“The biggest impact will be on 30 or 35 individuals at the trainee level who won't have positions,” he emphasizes. “Our contingencies are to squeeze across the board, and cut everybody back by a little piece here or there. But it will mean that investigators don't have the funds for that next appointment of a student or a postdoc, and those students and postdocs will go away. That's the next generation of scientists, and without their breakthroughs and discoveries, development of life-saving treatments will be delayed, with dire consequences for patients.”

“We hope to protect, as best we can, the potentially most vulnerable parts of our community: fully trained scientists who are applying for their first grants, experienced investigators who are renewing their grants and maintaining their research teams, and the trainees we will need for cancer research in the future,” said Harold Varmus, MD, NCI director, in a message sent on March 7 to NCI grantees and contractors.

Earlier that week, Varmus told the NCI Board of Scientific Advisors that funding constraints are likely to continue for years to come. He also commented that it might be worth having a discussion about the need to “adjust the size of our research community” rather than “protecting the system as it currently exists.”

Given the pressure on federal budgets, people are trying to be creative about new funding mechanisms. “It's not on the horizon now, but maybe we should think about a national privately run effort like Cancer Research UK,” Gerson comments.

“It is important to remember the downstream effect that these reductions in NCI funding have on patients, innovative trials, and discoveries that save lives, even though that major negative impact is delayed by the time it takes to go from discovery to cancer treatment,” he stresses.

In the long run, “there will be recognition on the part of the public and our politicians that the NIH remains the best investment the country could make,” Gerson predicts. In the meantime, “our joint and individual advocacy remains really important.” – Eric Bender