NCI's Action Plan for 2005 includes ongoing work in nine broad research priorities for focused efforts in core scientific and public health emphasis areas. Identified with assistance from our advisory boards, the larger research community, and the cancer advocacy community, these investments will allow us to accelerate the pace of discovery and to optimize use of existing and new knowledge for the development and delivery of evidence-based interventions.

Core Scientific Areas

Reaching our Challenge Goal to eliminate the suffering and death due to cancer will require long-term investment in large-scale and interdisciplinary studies to:

• Understand the interactions between Genes and the Environment as they relate to cancer.
• Elucidate the Signatures of the Cancer Cell and Its Microenvironment through a more integrative approach to cancer biology.
• Validate and develop effective agents aimed at Molecular Targets of Prevention, Diagnosis, and Treatment.
• Optimize Cancer Imaging and Molecular Sensing to both further research and allow for less invasive and more accurate cancer care.

As we more fully understand cancer-related molecular, cellular, microenvironment, behavioral, psychological, and social influences, we can develop more effective and less harmful approaches to cancer prevention, early detection, diagnosis, treatment, and control.

Areas of Public Health Emphasis

Purposeful investment must also be made for research and development in the public health arena:

• Tobacco and Tobacco-Related Cancers. We can no longer ignore the damage done by tobacco use in this country and the lure of smoking to our youth.
• Energy Balance. We must face the issues of overweight and obesity and the sedentary lifestyle that is plaguing our country and raising people's risk of developing cancer.
• Quality of Cancer Care. We must work on behalf of the millions of people in our country today who do not receive appropriate care for their cancer.
• Cancer-Related Health Disparities. Untold numbers of people suffer disproportionately from cancer and receive poorer care because of social position, economic status, cultural or language barriers, or geographic location.
• Aging and Cancer. The risk of developing cancer significantly increases with age and the cancer burden will escalate, as the population of older Americans expands. There is a clear need to continue to advance our understanding of the relationships between aging and the development and progression of cancer.
• Cancer Survivorship. The numbers of people surviving cancer have increased dramatically over the past several years. Sadly, a large portion of these people suffer post-treatment effects and do not receive the continued care they need.

Investment in each of these areas is at the heart of our ability to reach our Challenge Goal to eliminate suffering and death due to cancer. In each instance, we need better science to understand the complexities. And there is a pressing need to address the challenges posed to our Nation's healthcare system by the rising incidence of cancer in the aging U.S. population. For all Americans, we need evidence-based interventions that will prevent cancer from occurring and improve the health and quality of life for those who are affected by cancer.

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