Director's Message

We as a nation stand at that defining moment in history when a surge of new technologies and the fruits of many years of investigation will yield, over the next two decades, unimagined leaps forward in our understanding of cancer and our ability to control and eliminate it. To take full advantage of these opportunities, three themes will dominate NCI's planning and decision making: discovery, development, and delivery. Our challenge will be to continue to accelerate the engine of discovery, to translate knowledge gained about the genetic, molecular, and cellular basis of cancer into the development of interventions to detect, diagnose, treat, and prevent cancer, and to ensure that these interventions are delivered to all who need them.

We need to hone our efforts toward an integrated systems approach to the study of cancer. We must take advantage of the explosion in technology and biological research to comprehensively weave together the disparate pieces of knowledge that reveal how cancer develops and progresses within the context of the human system. That is, we must consider the protein along with the gene that produces it, the tumor in the context of both its immediate "microenvironment" and the broader environment of the body, and the whole person in the context of the behavioral, social, and environmental factors that influence cancer.

We must ensure the application of our research knowledge to cancer care. The National Cancer Institute will collaborate with other agencies and private groups to eliminate unnecessary delays, along the pathway of discovery-development-delivery for lifesaving interventions against cancer. While adhering to our NCI mandate, I am committing NCI to rigorously disseminate our research results, with special emphasis on our comprehensive Cancer Centers, to inform both clinical practice and public health with state-of-the-art science.

For Fiscal Year 2004, we are adding to our plan and budget proposal new initiatives to better understand the tumor microenvironment, cancer survivorship, and the interface of aging and cancer. We also place greater emphasis on translational research to move potential preventive, diagnostic, and therapeutic interventions into clinical trials and to integrate more effective cancer care and control interventions into clinical practice and public health programs. Our intramural research program will set a new standard as an exemplar of translational research.

We are working to find new and more effective ways to collaborate aggressively both inside and outside of the National Institutes of Health, especially through partnerships with our Nation's community of physicians, nurses, other clinician specialists, and cancer survivors.

We will redouble our efforts to eliminate disparities by ensuring that every American, regardless of race, income, and gender, has access to high quality and timely cancer prevention, screening, diagnosis, and treatment. And we will strive to understand and reduce biologic, socioeconomic, and cultural disparities in the incidence of cancer among diverse population groups.

We will also ask that our programs be examined against the criteria recently established in support of the President's Management Agenda, and I am committed to making sure that progress toward the goals described in the following pages is evaluated against the objectives of sound and comprehensive science.

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