Report to the NHS Central Research & Development Committee

Despite many significant advances in our understanding of basic mechanisms and progress in the treatment of a range of different forms of malignant disease, cancer still places a large burden on patients and their families and on society more generally. Current incidence rates of cancer in the United Kingdom suggest that one in three people will develop a cancer at some time in their lives. Most of the new cases will occur in elderly people. The Health of the Nation has set targets to reduce the size of the problem. But more yet needs to be learnt.

This report represents the work of the fifth Advisory Group on NHS R&D needs. The Group was chaired by Professor Peter Selby and its report, which has been endorsed by the CRDC, is very welcome. It is intended that the programme of work commissioned as a result of this review will complement the work of others in the cancer research field, particularly those active in the basic sciences, by focusing upon NHS cancer services. The programme will also complement the other relevant work within the NHS R&D programme, especially in health technology assessment.

The problems that cancer poses for society are manifold and it is entirely appropriate that the recommendation of Peter Selby's Group are wide ranging. Indeed, the breadth of coverage illustrates well the intended scope of the NHS R&D Programme encompassing, for example, primary prevention, the impact of genetics on screening and diagnosis, the natural history of early disease and other issues relevant to the organisation and delivery of services. Also welcome are the observations in the report on clinical trial infrastructure, cancer registries and health economics.

The Advisory Group had the advantage of considerable forward planning. This allowed access to existing information, to the result of an extensive consultation, interaction and the work of related groups and organisations. Through Peter Selby, the Chief Medical Officer's Expert Advisory Group of Cancer provided important insights into R&D needs in fields such as variation in disease outcome, palliative care services and cancer care for elderly people. The discussion promoted by the NHS R&D cancer review, itself, has been extremely constructive and I hope that this report will stimulate a continuing debate of how R&D can best be targeted to improve health and services in this important area.

Michael Peckham
Director of Research and Development
July 1994

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