Disease burden and research capital

53 cancers on the same page, largest first: how much disease there is, how much of a life each case takes, and how much NIH money each year of life lost attracts. The last column is the one the site was built to show, and it is read with the columns before it, not instead of them.

Rows overlap and must not be summed: lung cancer and small cell lung cancer, kidney cancer and Wilms tumour, melanoma and uveal melanoma, and the lymphoma subtypes are separate briefings over overlapping populations, and units differ where a source counts lesions rather than people. Cases, deaths, survival and median age are SEER Cancer Stat Facts (CBTRUS for glioblastoma), as recorded on each briefing with retrieval date and mapping; proxy marks a disease whose source counts a broader category. Years of life lost (YLL) = (1 − five-year relative survival) × (78.4 − median age at diagnosis) × cases; the three assumptions are stated on every briefing and are crude enough that this column separates a disease from one ten times its size, not from a neighbour. NIH figures are RePORTER obligations for the fiscal year, after each briefing's off-topic filter. "Targets drugged here" is the number of the briefing's listed genes that carry a drug whose FDA label names the disease, over the number listed.

How to read it

Prostate cancer has the most new cases and nearly the fewest years of life lost, because 98% of patients are alive at five years and the median age at death is above the reference life expectancy; its dollars per life-year are therefore among the highest, and the number says nothing about whether the research is well spent. Lung cancer is the reverse on every column. Neuroblastoma sits at the top because it has 650 cases a year and a paediatric research programme; the same money divided by a small denominator is a large number.

What the table can support: that two diseases of similar burden attract very different money (pancreatic and colorectal against breast), and that the diseases with the least money per life-year are the ones where most of the life is lost (lung, pancreatic, hepatocellular). What it cannot support: any claim that a given disease is over- or under-funded, which would need the cost of the research, what it has produced, and what else the money would buy.