Introduction
All Californians are touched by breast cancer, which has for decades taken a tragic toll among the people of California. The cost of this disease is measured in human suffering, in lives lost, in wasted potential, and in medical care dollars. In 1996 alone, it is estimated that 184,000 women in the US (20,000 in California alone) were diagnosed with breast cancer and 44,300 (4,500 in California) succumbed to the disease. Over half of these women are in the prime of their lives (less than age 65), depriving children of their parents, the private and public sectors of experienced employees at their height of productivity, and those who are lost of decades of life. Very recent data suggests that deaths from breast cancer may finally be decreasing, but the decrease has been small, and does not reflect other facts. A similar decrease in death rates was seen in the late 1970s, but was not sustained. Second, the current decrease could be due to lead time bias with an increase in the proportion of in situ and early stage cancers being diagnosed. Finally, death rates for African American women have actually increased over this same time period.
In 1993, the California legislature recognized the need to respond to the continuing crisis of breast cancer. At that time, the state had no comprehensive public health plan to address breast cancer. With the passage of AB2055 and AB 478, an ongoing (although declining) source of funds from tobacco taxes was secured to support three arms of a state effort to decrease the human and economic cost of breast cancer in California. Forty-five per cent of the funds were allocated to the Breast Cancer Research Program, 50% to the Breast Cancer Early Detection Program and 5% to the California Cancer Registry. The Breast Cancer Research Program was established at the University of California to spearhead research efforts on the causes, prevention, detection and cure of breast cancer. The Breast Cancer Research Council, which is an advisory committee to the University, determines the goals and priorities of the research program, establishes program policies, oversees peer review of submitted applications and makes funding recommendations. Review committees composed of expert scientists and breast cancer advocates from outside California are brought together each year to evaluate the scientific merit of applications.
The CBCRP funds support research projects and training of both beginning and experienced scientists in breast cancer-related research. The funds that the Program directs to research on the causes, prevention, detection and cure of breast cancer are not just monies spent, but are investments in the future of Californians. By encouraging and identifying innovative research on breast cancer, and attracting and training some of the most talented and gifted scientists into this area of research, California is making a research investment that can pay vital dividends for all Californians in years to come. The specific areas of research supported, as determined by the Breast Cancer Research Council with input from stakeholders across the state, include basic and clinical science, social and behavioral science, technology development, and public health research. New program areas in translational and collaborative research, as well as community partnerships, are being developed. These funds provide critical leverage in developing new scientific infrastructure and networks crucial for a broad-based and comprehensive approach to the problem of breast cancer. CBCRP's challenge is to allocate funds rapidly and flexibly to assure that new and promising ideas are brought quickly to bear on the understanding and prevention, detection and cure of breast cancer.
1996 marked a year of important achievements for the CBCRP. A portfolio of exciting new projects was funded. In addition, specific activities to facilitate the identification and implementation of new areas of research funding, dissemination of research results, and translation of research findings into practical application were undertaken. In 1995-1996, the CBCRP budget was $14.7 million. These funds currently support 60 projects to investigate the pathogenesis, etiology, prevention, early detection and treatment of breast cancer. The projects include large-scale research plans, pilot studies of exciting and important new areas, and training projects for researchers early in their careers or new to breast cancer research. These studies are being carried out at universities (public and private), medical centers, independent research institutes, federal laboratories, and biotechnology companies. The first projects funded by the Program in 1995 are now well underway, with preliminary progress reported for here the first time.
This 1996 Annual Report describes CBCRP's recent activities, goals, progress, and plans for the challenges that lie ahead on the road to decreasing the human and economic cost of breast cancer for the people of California.
