Full Text CA-96-006
 
MINORITIES IN MEDICAL ONCOLOGY
 
NIH GUIDE, Volume 25, Number 4, February 16, 1996
 
RFA:  CA-96-006
 
P.T. 34, FF

Keywords: 
  Oncology 

 
National Cancer Institute
 
Letter of Intent Receipt Date:  March 14, 1996
Application Receipt Date:  May 14, 1996
 
PURPOSE
 
The Comprehensive Minority Biomedical Program of the National Cancer
Institute (NCI) announces the availability of minority medical
oncology awards. The purpose of these awards is to:
 
o  Encourage recently trained underrepresented minority clinicians to
acquire clinical training and research experience in clinical
oncology;
 
o  Increase representation of minorities in clinical oncology.
 
These awards will provide the opportunity for recent, clinically
trained underrepresented minority physicians and D.O.'s to gain
sufficient research and clinical experience to become practicing
clinical oncologists with experience in biomedical research.
 
HEALTHY PEOPLE 2000
 
The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000",
a PHS-led national activity for setting priority areas.  This Request
For Applications (RFA), Minorities in Medical Oncology, is related to
the priority area of cancer. Potential applicants may obtain a copy
of "Healthy People 2000" (Full Report:  Stock No. 017-0001-00474-0 or
Summary Report:  Stock No. 017-0001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington,
DC 20402-9325 (telephone 202-512-1800).
 
ELIGIBILITY REQUIREMENTS
 
This award is designed to provide an intensive, supervised clinical
and research experience for underrepresented minority physicians.
The award is intended for individuals with an M.D. or D.O. degree.
For the purpose of this award, underrepresented minorities are
defined as individuals who are African Americans, Latinos (Mexican
American, Cuban, Puerto Rican, Central American), Native Americans,
and non-Asian Pacific Islanders.  Awards will be limited to
individuals who are citizens or permanent residents of the United
States.
 
Candidates for the award should have broad clinical training,
demonstrate individual competence in clinical activities, must
document a serious intent for a research and/or clinical career in
clinical oncology, and must document a sensitivity to cultural issues
impinging upon the practice of medicine among the major U.S. ethnic
populations.  The candidates must be nominated by an institution on
the basis of qualifications, interests, accomplishments, motivation,
and the potential for a career in oncology.  Evidence of the
institution's commitment to the applicant's clinical and/or research
development must be documented.
 
Candidates must have at least one sponsor or advisor who is
recognized as an accomplished clinician, and at least one sponsor or
advisor who is recognized as an accomplished independent investigator
in the proposed research area.
 
Applicants for this award may not concurrently submit an application
for an NIH Research Career Development Award, or a Mentored Research
Scientist Development Award (K01).  Current principal investigators
on PHS research grants are not eligible applicants.
 
The grantee institution must be a domestic non-profit research
institution, school or comparable institution with well- established
training programs in clinical oncology and biomedical research in
oncology including clinical trials, adequate numbers of highly
trained faculty in the clinical and biomedical sciences areas as they
relate to cancer, and a demonstrated commitment to the development of
the clinical and research careers of young physicians in oncology.
 
MECHANISM OF SUPPORT
 
Awards in response to this RFA will use the Clinical Investigator
Award (K08).  Planning, direction and execution of the proposed
training program will be the responsibilities of the applicant and
the sponsor(s).  The total project period for an application
submitted in response to this RFA may not exceed four years.  The
anticipated award date is September 30, 1996.
 
Each award is non-renewable and non-transferable from one awardee to
another awardee.  Funding beyond the first year of the award is
contingent upon satisfactory progress during the preceding year, as
documented in the required Progress Report.
 
FUNDS AVAILABLE
 
The estimated total costs available for the first year support of the
program is $750,000.  There will be approximately nine new awards
made at a direct cost level of $65,000 per year.
 
RESEARCH OBJECTIVES
 
Background
 
Substantial national and local efforts have been made and are
continuing to be made to reduce cancer morbidity and mortality in the
general population.  However, in spite of these efforts, projections
made for 1994 were 1.2 million newly diagnosed cancer cases and
approximately 550,000 cancer deaths.
 
Past patterns of cancer incidence and mortality predict that a
disproportionate share of this increase in U.S. cancer incidence and
mortality will be borne by minorities.  Specifically, past and
current SEER data show Hispanics residing in New Mexico and Arizona
have been excess cancer incidences of the cervix, stomach and
gallbladder.  American Indians from New Mexico and Arizona show
excess cancer rates for stomach, cervix uteri, liver and gallbladder
cancers, with the incidence rate for gallbladder cancer being the
highest of any racial group; and rates for this group for the period
1975-1984 showed the poorest survival of any racial group for 8
evaluated cancer sites.  Alaska Natives have the highest cancer
incidence rates among any racial group for cancer of the oral cavity
and pharynx, colon and rectum, cervix uteri, and kidney and pelvis;
and the incidence of gallbladder cancer is comparable to that of
American Indians.  Finally, cancer mortality rates for all sites for
Blacks are almost 2.5- times greater than for Whites.
 
Contributing to the cancer burden of U.S. minorities is their limited
access for treatment to minority physicians with appropriate cultural
sensitivities.  This is largely due to the small numbers of U.S.
minority clinical oncologists.  Data from the American Medical
Association for 1994 show that of 11,224 U.S. oncologists, only 184
(1.6 percent) were of African American descent, 336 (3.0 percent)
were of Hispanic descent, and 3 (0.03 percent) were of Native
American descent. Current statistics on medical specialties among
U.S. medical school graduates do not portend a significant change in
this situation.  Specifically, of the total 1993 medical school
graduates (15,555), only  0.9 percent had selected oncology as their
area of specialization, and only 0.2 percent (30) of graduates
selecting an oncology specialization were underrepresented
minorities. In 1994, only 11.2 percent of all medical school
applicants were underrepresented minorities, a proportion that had
not changed significantly from the value of 10.8 percent six years
earlier.
 
A reduction in the overall mortality rate in minority populations
would substantially impact known cancer statistics.  Cultural
barriers to cancer diagnosis/treatment and to preventive health care
advice will take on added importance as the techniques of molecular
epidemiology are increasingly applied to identify minority
individuals and family members at high risk for cancer. As a result
of this new technology, physicians will increasingly be called upon
to deal with culturally sensitive issues, such as prophylactic
surgery for family members, and/or major changes in lifestyle
possibly even including childbearing.  It is therefore imperative
that a sufficient number of minority oncologists be available so that
access to care is not limited by the number of oncologists sensitive
to cultural issues.  Additionally, the oncologists must have an
understanding of the new technologies being developed that will
assist in the diagnosis/treatment of cancers and the predictions of
cancer risk.  This understanding can best be provided by a research
experience in the development/application of these technologies.
Areas of research of particular interest for this purpose might
include but are not limited to the development and applications of
biomarkers for assessing cancer risk in minority populations; cancer
treatment or prevention clinical trials targeting minority
populations; and psychosocial aspects of cancer prevention and
control in defined populations.
 
INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN
SUBJECTS
 
It is the policy of NIH that women and members of minority groups and
their subpopulations must be included in all NIH supported biomedical
and behavioral research projects involving human subjects, unless a
clear and compelling rationale and justification is provided that
inclusion is inappropriate with respect to the health of the subjects
or the purpose of the research.  This new policy results from the NIH
Revitalization Act of 1993 (Section 492B of Public Law 103-43) and
supersedes and strengthens the previous policies (Concerning the
Inclusion of Women in Study Populations, and Concerning the Inclusion
of Minorities in Study populations), which have been in effect since
1990.  The new policy contains some provisions that are substantially
different from the 1990 policies.
 
All investigators proposing research involving human subjects should
read the "NIH Guidelines For Inclusion of Women and Minorities as
Subjects in Clinical research" which have been published in the
federal register of March 28, 1994 (FR 59 14508-14513) and reprinted
in the NIH Guide for Grants and Contracts, Volume 23, Number 11,
March 18, 1994.
 
Investigators also may obtain copies of the policy from the program
staff listed under INQUIRIES.  Program staff may also provide
additional relevant information concerning the policy.
 
LETTER OF INTENT
 
Prospective applicants are asked to submit, by March 14, 1996, a
letter of intent that includes a descriptive title of the proposed
research, the name, address, and telephone and FAX numbers of the
Principal Investigator, the identities of other key personnel and
participating institutions, and the number and title of the RFA in
response to which the application may be submitted.  Although a
letter of intent is not required, is not binding, and does not enter
into the review of a subsequent application, the information that it
contains allows NCI staff to estimate the potential review workload
and avoid conflict of interest in the review.
 
The letter of intent is to be sent to:
 
Lester Gorelic, Ph.D.
Division of Extramural Activities
National Cancer Institute
6130 Executive Boulevard, Room 620 - MSC 7405
Bethesda, MD  20892-7405
Rockville, MD  20852 (express/courier service)
Telephone:  (301) 496-7344
FAX:  (301) 402-4551
Email:  gorelicl@dea.nci.nih.gov
 
APPLICATION PROCEDURES
 
The research grant application form PHS 398 (rev. 5/95) is to be used
in applying for these grants.  Applications kits are available at
most institutional offices of sponsored research and may be obtained
from the Grants Information Office, Office of Extramural Outreach and
Information Resources, National Institutes of Health, 6701 Rockledge
Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301/435-0714,
email:  girg@drgpo.drg.nih.gov; and from the program administrator
listed under INQUIRIES.
 
The RFA label available in the PHS 398 (rev. 5/95) application form
must be affixed to the bottom of the face page of the application.
Failure to use this label could result in delayed processing of the
application such that it may not reach the review committee in time
for review.  In addition, the RFA title and number must be typed on
line 2 of the face page of the application form and the YES box must
be marked.
 
Submit a signed, typewritten original of the application, including
the Checklist, and three signed photocopies, in one package to:
 
DIVISION OF RESEARCH GRANTS
NATIONAL INSTITUTES OF HEALTH
6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (express/courier service)
 
At time of submission, two additional copies of the application must
be sent to:
 
Ms. Toby Friedberg
Division of Extramural Activities
National Cancer Institute
6130 Executive Boulevard, Room 636 - MSC 7405
Bethesda, MD  20892-7405
Rockville, MD  20852 (express/courier service)
 
Applications must be received by May 14, 1996.  If an application is
received after that date, it will be returned to the applicant
without review.  The Division of Research Grants (DRG) will not
accept any application in response to this RFA that is essentially
the same as one currently pending initial review, unless the
applicant withdraws the pending application.  The DRG will not accept
any application that is essentially the same as one already reviewed.
This does not preclude the submission of substantial revisions of
applications already reviewed, but such applications must include an
introduction addressing the previous critique.
 
Information to be Included in the Application
 
Candidates must provide a description of the proposed research and
clinical career training development for the period of the award in
section 2 of the application under "Research Plan."  The candidate
must be prepared to commit full-time effort to the objectives of this
award.  It is required that a minimum of 25 percent effort be devoted
to the research program, and that the remaining effort be devoted to
clinical training in medical oncology.  The percent effort devoted to
research can be uniformly distributed over the four-year award
period, or can be concentrated during one year of the four-year award
period.
 
The reasons for a commitment to clinical oncology practice in
underserved minority populations and to research in these populations
must be clearly described.
 
The sponsor(s)/advisor(s) for the clinical and research aspect of
this award must provide:
 
o  Her/his concept of a clinical and/or a research plan for the
candidate.
 
o  A current curriculum vitae with a complete bibliography and
listing of research support.
 
o  A letter indicating her/his evaluation of the proposed candidate
and her/his willingness to provide guidance and support
 
Evidence of the commitment of the institution to the candidate's
clinical and research training, and career development, must be
provided.  Finally, adequate access to underserved populations for
the purposes of clinical training and research must be demonstrated.
 
The applicant institution must provide a signed statement of the
candidate's eligibility for this award in terms of both being a
minority underrepresented nationally in clinical oncology and a U.S.
citizen.  Where appropriate, the candidate must provide a copy of the
Alien Registration Receipt card.  The candidate also must provide,
where applicable, information on other past, current and pending
awards, including all federal and non-federal fellowships, grants or
contracts.  For each grant listed, the candidate must provide the
complete grant number, the subject of the research, the title of the
candidate's position, and the candidate's percent effort.
 
The candidate should provide a detailed plan for her/his clinical and
research development programs.  This plan should not be prepared by
the sponsor.  The candidate's input should be shown clearly, as this
input represents a criterion for evaluating the candidate's clinical
and research potentials.  This plan should include the following
information:
 
o  Aspects of the candidate's educational and training background
that qualify her/him for participation in the program described;
 
o  Areas in the candidate's educational and training background that
can be developed by the proposed program;
 
o  Sufficient detail in the description of the proposed clinical
training program to permit adequate evaluation. (If, during the
course of the outlined study, the awardee should find that she/he
would like to alter the direction or emphasis of the research, such a
change may be made with the approval of the sponsor and of the
National Cancer Institute);
 
o  How these plans are intended to promote the candidate's career in
clinical oncology;
 
o  The strength of the commitment of the candidate to the practice of
clinical oncology in the U.S. minority population.
 
o  Adequate justification of all budget items;
 
o  A list of all centers, institutions or laboratories that will
participate in the clinical and research development programs. This
list should include the names of the sponsors and other investigators
who have agreed to participate in the program, and the resources and
space available to the candidate.  Each sponsor and institution must
provide a letter indicating support of this program and a commitment
of space and resources.  These letters must be submitted as part of
the application;
 
o  Four copies of each of the candidate's publications.
 
The candidate must also provide three letters of reference.  These
letters should be forwarded by the referees directly to:
 
Ms. Toby Friedberg
Division of Extramural Activities
National Cancer Institute
6130 Executive Boulevard, Room 636 - MSC 7405
Bethesda, MD  20892-7405
Rockville, MD  20851 (express/courier service)
 
Budget
 
Salary:  The proposed salary should be based upon the candidate's
training, experience and accomplishments,but should not exceed
$50,000 per year (excluding fringe benefits).  The salary must be
consistent with the established salary structure at the institution
and with salaries actually provided by the institution from its own
funds to other staff members of equivalent qualifications,rank and
responsibilities.
 
Allowable Costs:  Supplies, Travel, Equipment, Fringe Benefits, and
Other Expenses.  The award will provide up to a total of $15,000 per
year for the costs necessary for the pursuit of the objectives of
this program.
 
The award may not be used to support the awardee's private clinical
practice, professional consultation, or other comparable activities.
Any fees for providing medical services generated by the awardee must
be handled as specified by PHS policy.  An awardee may,
however,engage in scholarly writing, deliver occasional outside
lectures and serve in an advisory capacity to the public or to
non-profit organizations, provided such activities are incidental in
the amount of time involved and are consistent with institutional
policy.  Awards will not be made to individuals who have substantial
administrative responsibilities.
 
REVIEW CONSIDERATIONS
 
Upon receipt, applications will be reviewed for completeness by DRG
and responsiveness by the NCI program staff.  Incomplete applications
will be returned to the applicant without further consideration.  If
the application is not responsive to the RFA, DRG staff may contact
the applicant to determine whether to return the application to the
applicant or submit it for review in competition with unsolicited
applications at the next review cycle.  Applications that are
complete and responsive to the RFA will be evaluated for scientific
and technical merit by an appropriate NCI peer review group with the
review criteria stated below.  As part of the initial merit review,
all applications will receive a written critique and may undergo a
process in which only those applications deemed to have the highest
scientific merit will be discussed, assigned a priority score, and
receive a second level review by the National Cancer Advisory Board.
 
Review Criteria
 
o  the candidate's potential for a career in clinical oncology.
 
o  appropriateness and adequacy of the experimental approach and
methodology proposed to carry out the research.
 
o  the overall merit of the candidate's plan for clinical training.
 
o  the overall merit of the candidate's plan for research and the
development of research skills appropriate to the practice of modern
clinical oncology.
 
o  the candidate's commitment to the servicing of the U.S. medically
underserved populations.
 
o  the quality of the candidate's clinical training and experience.
 
o  objectives, design, and direction of the clinical and research
training programs.
 
o  caliber of research advisors including successful competition for
research support.
 
o  training environment, including the institutional commitment, the
quality of the facilities, and the availability of research and
clinical support.
 
o  appropriateness of the proposed budget and duration in relation to
the proposed research.
 
The initial review group will also examine the adherence to special
requirements, and the provisions for the protection of human and
animal subjects, the safety of the research environment, and
conformance with the NIH Guidelines for the Inclusion of Women and
Minorities as Subjects in Clinical Research.
 
AWARD CRITERIA
 
The anticipated date of award is September 30, 1996.  Applications
will compete for available funds with all other approved
applications.  The following will be considered in making funding
decisions:  Quality of the proposed project as determined by peer
review, availability of funds, and program priority.
 
INQUIRIES
 
Written and telephone inquiries are encouraged.  The opportunity to
clarify any issues or questions from potential applicants is welcome.
 
Direct inquiries regarding programmatic issues to:
 
Lester S. Gorelic, Ph.D.
Division of Extramural Activities
National Cancer Institute
6130 Executive Boulevard, Room 620 - MSC 7405
Bethesda, MD  20892-7405
Rockville, MD  20852 (express/courier service)
Telephone:  (301) 496-7344
FAX:  (301) 402-4551
Email:  gorelicl@dea.nci.nih.gov
 
Direct inquiries regarding fiscal matters to:
 
Mrs. Joan Metcalfe
Grants Administration Branch
National Cancer Institute
6120 Executive Boulevard, Room 243 - MSC 7150
Bethesda, MD  20892-7150
Rockville, MD  20852 (express/courier service)
Telephone:  (301) 496-7800 ext 228
FAX:  (301) 496-8601
Email:  metcalfj@gab.nci.nih.gov
 
AUTHORITY AND REGULATIONS
 
This program is described in the catalog of Federal Domestic
Assistance No. 93.398.  Awards are made under authorization of the
Public Health Service Act, Title IV, Part A (Public Law 78- 410), as
amended by Public Law 99-158, 42 USC 241 and 285) and administered
under PHS grants policies and Federal Regulations 42 CFR 52 and 45
CFR Part 74.  This program is not subject to the intergovernmental
review requirements of Executive order 12372 or Health Systems Agency
Review.
 
The PHS strongly encourages all grant recipients to provide a
smoke-free workplace and promote the non-use of all tobacco products.
In addition, Public Law 103-227, The Pro-Children Act of 1994,
prohibits smoking in certain facilities ( or, in some cases, any
portion of a facility) in which regular or routine education,
library, day care, health care or early childhood development
services are provided to children.  This is consistent with the PHS
mission to protect and advance the physical and mental health of the
American People.
 
.

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