A report by the American Association for Cancer Research shows that cancer mortality in the United States has declined by 35% since the early 1990s. Overall, the five-year survival rate for all cancers combined reached 70% for patients diagnosed between 2015 and 2021. Federal science funding forms the backbone of biomedical research. But ongoing turmoil at the National Institutes of Health and National Cancer Institute has threatened certain areas of foundational research . After delays in grant awards and clinical trial disruptions, Congress has thus far stepped in to appropriate most of the requisite funds. But the future of federal government-sponsored research is facing a series of challenges.

The overall decrease in the cancer death rate between 1991 and 2024 translated into more than 4.8 million cancer deaths averted. Some of the greatest progress has been made with respect to blood, breast and lung cancers. Some blood cancers can now be managed as a chronic disease in a way similar to HIV. And thyroid, prostate and skin cancers now have a 95% or higher five-year survival rate. However, there are still much less tractable cancers, including liver, esophageal and pancreatic, all with less than a 22% five-year survival rate (pancreatic is just 13%).

Even in areas where scientific advances had proven elusive for so long, such as pancreatic cancer, the recent regulatory approval of Rasonque (daraxonrasib) offers newfound hope . For decades, pancreatic oncology research has often been referred to as the “graveyard of drug development” with a very high clinical trial failure rate. Now, a drug with a meaningful clinical benefit is available to patients. The once-daily oral tablet can extend the lives of advanced pancreatic cancer patients by a median of 13.2 months, compared with 6.7 months for those who received chemotherapy.

Survival rates for each type of cancer depend heavily on the stage of disease at diagnosis, patient age and health status. In addition, the fact that people are increasingly getting diagnosed at earlier stages helps boost the survival rate.

In addition to recent advances in cancer treatments, the decrease in the overall fatality rate can be attributed to factors such as early detection and improved lifestyle habits like smoking cessation.

To achieve progress in pharmaceutical oncology care of the kind we’ve seen since the early 1990s requires decades of government-funded basic research resulting in an improved knowledge base around disease pathology and potential ways to interrupt or halt tumor development and metastasis. And through industry-sponsored translational clinical trial research, drug companies can turn laboratory discoveries into marketable medical treatments. Both forms of research are necessary but entail a huge amount of uncertainty and risk.

Upon re-entering office, President Trump froze, disrupted or scaled back NIH funding for cancer research through midstream grant cancellations and proposed budget cuts. This affected dozens of ongoing cancer clinical trials.

This raises questions as to why the Trump administration set out in 2025 to disrupt federally sponsored research that has invariably served as a backbone for critical work on cancer biology. Ostensibly, officials advocated for changes to improve efficiency and root out Diversity, Equity and Inclusion initiatives. But in both 2025 and 2026, the Trump administration proposed cuts in federal funding for the National Institutes of Health and National Cancer Institute that went deeper than just streamlining grants and getting rid of DEI.

Nevertheless, Congress has largely rejected Trump’s proposed reductions in science funding every time it has considered them. Total NCI funding was mostly flat in 2025 with a slight decline in the number of research project grants. There was a steep drop in NIH research project grants, but the aggregate amount distributed to researchers nationwide didn’t fall.

Private industry has been picking up the slack and not merely in 2025 and 2026. The absolute number of industry-sponsored oncology trials has been steadily growing for years and currently far outpaces government funding. Endpoint News reports that the industry now plays a major role in determining what’s studied in clinical trials as well as recruitment of trial participants.

However, the industry’s investment usually doesn’t extend to foundational basic cellular research, which is dependent on NIH- and NCI-funding.

Food and Drug Administration approvals have continued apace. Between July 2025 and June 2026, regulators approved 11 new anticancer therapeutics and new uses for five existing drugs.

But despite the yearly slew of new marketing authorizations across different cancers — often the result of decades of previous research — there’s a considerable amount of unmet need. The decline of federal funding leaves gaps that the industry rarely covers due to a lack of commercial incentives; for example, basic and translational research on ultra-rare cancers. The NIH and NCI have been a driving force behind early (ultra) orphan cancer drug development.

Furthermore, there’s an acute need to study significant inequities in the burden of cancer that persist across sub-populations, such as Blacks, Hispanics and others. But the Trump administration’s cuts targeting disparities research in oncology could undermine our understanding of sub-population differences.

For example, disparities research points to access problems . associated with socioeconomic status . Less than 62% of lung cancer patients in the U.S. receive treatments recommended by the National Comprehensive Cancer Network guidelines, according to research recently published in the Annals of the American Thoracic Society. About 22% percent got no treatment, and 16% received treatment that was less intensive than recommended.

The study did not examine reasons for the disparities cited. But an educated guess suggests several possibilities. Some patients may simply opt not to get treatment. After weighing benefits and risks, they may decide that on balance treatment is not worth it.

But for some patients, lack of adequate access to healthcare is a probable reason. This applies to folks who are uninsured, but also to those who are underinsured with high levels of patient cost-sharing and coverage restrictions.

Specifically in regard to prescription drugs, access is multi-dimensional , with both regulatory and reimbursement drivers. Moreover, lower socioeconomic status appears to correlate with worse access.

The White House’s fiscal year 2027 proposed budget calls for a 12% cut to the overall NIH budget. The question is, will Congress override these cuts yet again. Experts suggest that continued progress against cancer will require collaboration among all key stakeholders, from those involved in scientific discovery to payers who make access possible. To this end, more stable and sustained federal investment is essential.