Relationship between Federal and State Funding for Breast Cancer Research

The California Breast Cancer Research Program is distinct from research programs funded by the federal government in both the CBCRP’s source of funding and in the types of research funded.

Sources of Funding

Funding for breast cancer research in the U.S. is available from a variety of sources:

The California Breast Cancer Research Program is unique in its funding source. Rather than coming from the state general fund or solely from voluntary donations, almost all of the Program’s funds come from a 45 percent share of revenue from a two-cent State tax on cigarettes. This source of funds is declining and temporary. In the past, measures were proposed in the California State Legislature that would have had the indirect effect of decreasing funding for the CBCRP by $5 million; similar measures may be proposed, and may pass, in the future.

The CBCRP also receives some funding from individual contributions and from the income tax check-off program, which allows individuals the opportunity to make voluntary donations on state income tax returns. Voluntary tax contribution funding is a result of legislation passed by the California State Legislature that authorizes donations for five years. During 2007, AB28, a bill authored by Assembly Member Jared Huffman, became law. This legislation provides individuals the opportunity to make donations to the CBCRP through voluntary tax contributions for the coming five years.

To increase this source of revenue, the CBCRP conducts a public outreach and fundraising effort, the Community Partners Program. A distinguished panel of Californians provides leadership to the Community Partners Program as members of the Community Partners Executive Team. The Executive Team is chaired by Sherry L. Lansing, Founder, Sherry Lansing Foundation, and Regent, University of California.

Since 2002, the CBCRP’s Community Partners Program has pursued two goals: increasing donations through the income tax voluntary contribution program and new sources, and increasing public awareness of the CBCRP.

Community Partners Program:
Increasing Voluntary Donations

More than 43,000 individuals donated over $569,000 to the CBCRP during 2007 through the state income tax check-off program. This made the CBCRP one of the check-off program's top beneficiary organizations for the year.

The following grants were funded in part through voluntary tax contributions in 2007:

Breast Cancer Risks in California Nail Salon Workers
Peggy Reynolds and Linda Okahara
Northern California Cancer Center and Asian Health Services

Intraductal Therapy of DCIS: a Presurgery Study
Susan Love
Dr. Susan Love Research Foundation

Modulation of Breast Cancer Stem Cell Response to Radiation
Frank Pajonk
University of California, Los Angeles

Molecular Imaging of Metastatic Lymph Nodes in Breast Cancer
Ella Jones
University of California, San Francisco

Multinuclear MRI of Breast Tumors
Brian Hargreaves
Stanford University

Science Literacy & Breast Cancer Clinical Trials Education
Georgia Sadler and Natasha Riley
University of California, San Diego and Vista Community Clinic

The Relationship of BRCA1 and HMGA2 in Breast Cancer
Connie Tsai
University of California, Irvine

The CBCRP also provides a number of other opportunities to make financial contributions to the Program's work. The CBCRP is a participant organization in the Community Campaign of the United Way of California, which allows residents of the state to make donations at their place of work. During 2007, the CBCRP received donations from the United Way of the Bay Area, United Way of the Capitol Region, United Way Silicon Valley, United Way Southeastern Philadelphia, and the United Way State Employees Charitable Campaign.

This year, the public demonstrated continued enthusiasm for the CBCRP’s research. Businesses, community groups, and individuals initiated their own efforts to provide funds for the Program’s research, without being solicited to do so. The Just Darling Fashion Boutique in Oakland held a fashion show dedicated to many of the boutique's customers who have been affected by breast cancer, and chose the CBCRP as the beneficiary of the event. Runners participating in the San Francisco Marathon came close to doubling their goal of raising $10,000 for the CBCRP, raising $19,536.50. The top fundraisier was runner Molly O'Mara, who brought in $8,891, second was Scott Harrison, with $5,079, and third was Donna Vazfidar, with $2,650. America's Charities and Community Health Charities also made contributions to the CBCRP.

Businesses that made the CBCRP the beneficiary of their community or employee fundraising efforts included: AT&T Employee Giving Program, Amgen Corporation Matching Gift Program, Honey From the Bee, and Wells Fargo Community Support Campaign. In addition, the CBCRP received contributions from the Kaiser Permanente Community Giving Campaign, and the Superior Court of California - County of San Bernardino.

The public has also responded to the opportunity to make donations via the Program’s Web site, www.CABreastCancer.org.

Community Partners Program:
Increasing Awareness of the CBCRP

During 2007, the CBCRP's outreach campaign focused on raising awareness of both the Program's work and on increasing citizen contributions via their state income tax forms.

The CBCRP has a five-minute video that showcases the Program. This video—narrated by TV host, breast cancer survivor, and former Olympic figure skater Peggy Fleming—is shown at exhibits and outreach events. A CD or DVD of the video is sent to anyone who requests it, free of charge.

With the assistance and participation of Community Partners, individual donors to CBCRP, and breast cancer advocacy organizations, the CBCRP held public exhibits over the past year calling attention to the opportunity to donate to the CBCRP on state tax returns. During 2007, in addition, the CBCRP conducted a combined outreach effort with other California nonprofit organizations who receive state tax return contributions. Together, the CBCRP and these nonprofit organizations created a radio and Internet marketing campaign to alert the public to the income tax check-off program. The campaign was conducted in partnership with the tax preparation firm Jackson Hewitt and California radio stations. It included radio public service announcements in English and Spanish, along with a Web site highlighting all nonprofit organizations included in the income tax check-off program. To augment this campaign, the CBCRP conducted its own on-air and Internet-based campaign alerting the public to the opportunity to make donations to the CBCRP via the income tax checkoff. The campaign included radio spots on Bay Area stations KDFC, KOIT, and KMAX. Targeted advertising was mailed to CBCRP and University of California contacts, and to California female certified public accountants. Governor Arnold Schwarzenegger further boosted California's awareness of the opportunity to make donations through the tax check-off by issuing an official proclamation declaring April 5, 2007, as Checkoff California Day.

The CBCRP made its special Web site dedicated to the income tax check-off, www.endbreastcancer.org, more user friendly during 2007. Over the coming year, the site will inform stakeholders about fundraising progress and also about progress researchers are making with the grants funded via contributions made on state income tax returns.

The CBCRP gained exposure in a variety of media over 2007. CBCRP Director Dr. Marion H. E. Kavanaugh-Lynch appeared on the radio program It's Your Call on San Francisco radio station KALW and also on the Bay Area's KPIX TV. In addition, Dr. Kavanaugh-Lynch's comments appeared in a story in the Sacramento Bee, which also appeared in the Seattle Times. CBCRP-funded research projects were covered over KGO Channel 7 San Francisco, and on the Web sites ScienceDaily.com, ConsumerAffairs.com, and MedPageToday.com.

Unmet Need

Ensuring the CBCRP’s present funding sources and increasing funds from new sources are both necessary. Current funds are not sufficient to do all that needs to be done. The CBCRP is unable to make grants to meet the following needs:

Since the CBCRP’s major source of funding, the state tobacco tax, is decreasing every year, the Program will not be able to meet these critical needs or continue to fund the broad range of projects it has funded in the past.

Types of Research Funded by the CBCRP:
Fulfilling our Mandate

One of the CBCRP’s mandates is to “fund innovative and creative research, with a special emphasis on research that complements, rather than duplicates, the research funded by the federal government.” The CBCRP fulfills this mandate in three ways:

  1. By identifying gaps in the research funded by the federal government, and providing funding to fill those gaps
  2. By having expert reviewers from across the U.S. review grant applications for their innovation and impact
  3. Before funding a grant application, reviewing it for overlap with current and pending funding from other agencies

Filling Research Gaps

The federal government funds most health-related research through the National Institutes of Health (NIH). The NIH view is on capitalizing…investigator-initiated research.” The primary basis on which the NIH chooses grants for funding is their scientific merit, not their relevance to a particular disease. As a result, most research proposals submitted to the NIH address scientific questions in which the investigators have theoretical and empirical interest, even though there may be no clear relevance to particular diseases.

Only a small percentage of NIH funds go to research in issues the NIH has identified as particularly important to specified diseases (i.e., Requests for Applications). The majority of NIH funds support the most scientifically meritorious research regardless of the applicability of the research to particular diseases.

In contrast, a fundamental priority for the CBCRP is to fund research that will speed progress in preventing and curing breast cancer. The CBCRP’s advisory Breast Cancer Research Council sets the Program’s funding priorities, taking into account:

The council attempts to identify and fill important gaps in knowledge about breast cancer, and reviews priorities yearly in light of changes in the research field, successes and failures of previous funding initiatives, and the results of previous funding.

The CBCRP is conducting a five-year program initiative, begun in 2005, to fill a significant gap in breast cancer research. This initiative addresses two overlapping research questions that California is uniquely positioned to address. They are the relationship between breast cancer and the environment, and the reasons for the unequal burden of breast cancer among various populations of women. More information on this initiative may be found in a previous section of this report, “The CBCRP Strategy for Funding Research.”

Choosing Research for Innovation and Impact

The CBCRP created its own scoring system to allow the Program’s expert reviewers to differentiate applications that are especially innovative and that have the most potential impact on breast cancer. The scoring system has improved the Program’s ability to choose the most innovative and creative research for funding.

In the past, the majority of research funding agencies, including the CBCRP and the National Institutes of Health, scored funding proposals with a single score based solely on scientific merit. With this method, an application with an excellent research plan to test an idea that wasn’t particularly novel could receive the same score as an application with a flawed research plan to test a novel idea. The CBCRP’s scoring method, based on the recommendations
of an NIH Advisory Committee, can distinguish these two applications. The CBCRP scores applications separately for innovation, impact, approach, and feasibility. The CBCRP’s advisory Breast Cancer Research Council uses these separate scores to inform their funding recommendations. Under the CBCRP's “impact” criterion, researchers are required to describe the steps necessary to turn their research into products, technologies, or interventions that will have an impact on breast cancer, and describe where their study fits into this critical path.

Reviewing Grant Proposals for
Overlap with Federal Funding

As a final step to ensure that CBCRP-funded research doesn’t duplicate federally-funded research, breast cancer science experts in other states and Program staff scientists review all grants recommended for funding for overlap with current and pending federal grants. If overlap with federal funding is found, the overlapping grant (or portion of the grant) is not funded.

Taking Leadership to Coordinate
Federal, State, and International Funding

During 2007, the CBCRP participated in the start of a nationwide effort to reduce barriers and waste in research toward the goal of ending breast cancer. Along with other U.S. breast cancer research funding agencies, industry representatives, regulators, advocates, and social scientists, the CBCRP took part in the Collaborative Summit on Breast Cancer Research. Participants in the summit formed the National Breast Cancer Planning Committee, which will review the national breast cancer research agenda and assist U.S. breast cancer organizations in identifying gaps, opportunities and overlaps in research into the disease. The committee will also produce a report to the general public on how key breast cancer organizations use donations to fund research.

In addition, the CBCRP is working to make it easier to avoid duplication among research funding agencies and to speed progress in breast cancer research by increasing communication among agencies that fund breast cancer research. One way the Program pursues these goals is by taking part in developing a research classification system to encourage agencies to report their funding in a way that is more accessible and meaningful to other agencies and the public.

The CBCRP joined with six other cancer research funding organizations in the U.S., 15 of the largest government and charitable cancer research funders in the United Kingdom, and the key government and non-government cancer research funders in Canada to launch the International Cancer Research Portfolio (ICRP) Web site (www.cancerportfolio.org). This Web site includes research abstracts from more than 14,000 current and past research projects. The online database is searchable by cancer type, scientific area, funding organization, and other selected criteria. The Web site allows scientists to identify possible collaborators, plan their research based on current research, and facilitate dialogues among cancer researchers. Access to this information about ongoing research also aids research funding organizations in strategic planning for future spending. In addition, the Web site is a useful tool for other groups. Policy makers may use the database during the formulation of new health care and service delivery policies. Healthcare professionals, patients, survivors, and advocates may review the current status of funded research.

The partners in this effort are dedicated to making current research information available to funding agencies and the public, and to promoting scientific collaboration. To extend coordination further, the ICRP partners invite representatives from the other organizations to attend their scientific meetings and review in person their funded research. During 2008, the ICRP will take international coordination to a higher level by completing a review of all funded cancer research grants in the U.S., U.K., and Canada that will point to gaps in research and make recommendations for research priorities to fill those gaps.