Introduction

CBCRP funds support research projects and training of both beginning and experienced scientists in breast cancer-related research

All Californians are touched by breast cancer, which has for decades taken a tragic toll among the people of this state. The cost of this disease is measured in human suffering, in lives lost, in wasted potential, and in medical care dollars. In 1997 alone, it is estimated that 180,200 women in the US (18,865 in California alone) were diagnosed with breast cancer and 43,900 (4,605 in California) succumbed to the disease. Over half of these women were 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 decades of life for those who are lost. Recent data suggest that deaths from breast cancer may finally be decreasing, but the decrease has been small and does not reflect the following facts. First, a similar decrease in death rates was seen in the late 1970s, but was not sustained. Second, the current decrease could be due to 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 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 AB478, an ongoing 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 percent of the funds was allocated to the Breast Cancer Research Program (CBCRP), 50% to the Breast Cancer Early Detection Program and 5% to the California Cancer Registry. The California 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 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 an 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, have been developed. State funding provides critical leverage in developing new scientific infrastructure and networks crucial for a comprehensive approach to the problem of breast cancer. The 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.

1997 marked a year of important achievements for the CBCRP. A portfolio of exciting new projects was funded, and the Program moved to fund new areas of research, disseminate research results, and translate research findings into practical application. In 1996-1997, the CBCRP budget was $14.7 million. These funds support 66 multi-year projects to investigate the pathogenesis, etiology, prevention, early detection and treatment of breast cancer. The projects include large-scale research efforts, pilot studies of exciting and important new areas, collaborations among scientists from different fields and between scientists and community groups, 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), community agencies, medical centers, independent research institutes, federal laboratories, and biotechnology companies. The first projects funded by the Program in 1995 and 1996 are well underway, with progress reported here.

State funding provides critical leverage in developing new scientific infrastructure and networks crucial for a comprehensive approach to the problem of breast cancer.

As requested by the legislature, this Annual Report includes the following elements:

  1. The number and dollar amounts of research grants, including the amount allocated to indirect costs.
  2. The subject of research grants.
  3. The relationship between federal and state funding for breast cancer research.
  4. The relationship between each project and the overall strategy of the research program.
  5. A summary of research findings including discussion of promising new areas.
  6. The institutions and campuses receiving grant awards.

The 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.