Notice of Intent to Publish a Funding Opportunity Announcement for Mechanisms that Impact Cancer Risk after Bariatric Surgery (R21 Clinical Trial Not Allowed)
Notice Number:

Key Dates

Release Date:
June 25, 2021
Estimated Publication Date of Funding Opportunity Announcement:
August 02, 2021
First Estimated Application Due Date:
November 01, 2021
Earliest Estimated Award Date:
June 01, 2022
Earliest Estimated Start Date:
June 01, 2022
Related Announcements

NOT-CA-21-090 - Notice of Intent to Publish a Funding Opportunity Announcement for Mechanisms that Impact Cancer Risk after Bariatric Surgery (R01 Clinical Trial Optional)

Issued by

National Cancer Institute (NCI)


The National Cancer Institute (NCI) intends to promote a new initiative by publishing a Funding Opportunity Announcement (FOA) with special receipt, referral, and/or review conditions (PAR) to solicit applications for research projects addressing mechanisms that impact cancer risk after bariatric surgery. The goal of the proposed funding announcements is twofold, to promote studies examining the mechanism(s) through which bariatric surgery impacts cancer risk, and to draw in talented scientists who study bariatric surgery to investigate its effects on cancer, rather than shorter term outcomes such as weight loss and diabetes.

This Notice of Intent to Publish (NOITP) is being provided to allow potential applicants sufficient time to develop meaningful collaborations and responsive projects. It should be noted that to facilitate the entry of new investigators, especially new clinical investigators, into the field, preliminary data will not be allowed for R21 applications. Furthermore, applications that include collaborators from fields outside of cancer research will be given special programmatic consideration. A companion R01 PAR will be issued which encompasses a similar research focus but will emphasize more established projects.

The FOA is expected to be published in late Summer 2021 with an anticipated application due date in Fall 2021. Details of the planned pre-application webinar will be announced after publication of the FOA.

This FOA will utilize the R21 activity code with clinical trial not allowed. Details of the planned FOA are provided below.

Research Initiative Details

Obese patients undergo bariatric surgery for a variety of reasons, including weight loss and improvement in metabolic dysfunction. Physician advice regarding the potential benefit of bariatric surgery and cancer risk reduction can currently only be given in generalities based on large scale studies, not targeted to the individual. Many but not all bariatric surgery investigations document an overall cancer risk reduction among women but not men. Some but not all bariatric surgery studies have found that both women and men undergoing bariatric surgery have an increased risk of colorectal cancer (CRC). Older studies which assessed bariatric surgery and cancer risk may not be useful to guide targeted advice to patients, as one of the most common procedures performed in the past, gastric banding, is only performed in 1% of bariatric surgery procedures today. The two most common bariatric surgery procedures currently performed are sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB). As such, planned animal and/or human studies should focus on the mechanistic effects of the two procedures that are currently in common use. Human biospecimens and/or data may be available from cohorts to enhance the studies proposed including the Longitudinal Assessment of Bariatric surgery (LABS), Adolescent Bariatrics: Assessing Health Benefits & Risks (Teen-LABS), and NCI Cohort Consortium Members.

Questions that would be considered responsive include, but are not limited to:

  • Do alterations in cancer risk biomarkers occur before weight loss? If so, in what organ, tissue, or cell type do they originate?
  • Is maximum weight loss or long-term weight loss more important for cancer risk reduction? If so, how do the two differ at a cellular and/or biochemical level?
  • What mechanism(s) explain the evidence that bariatric surgery is more beneficial in cancer risk reduction in women than men?
  • Does bariatric surgery increase or decrease the risk of CRC, and if so, what are the mechanism(s)?
  • Which cancers are favorably impacted by bariatric surgery, and what are the mechanism(s) that explain the effect?
  • Does the specific bariatric surgery procedure influence cancer impact? If so, what are the mechanism(s) driving the difference in impact?
  • Does racial or ethnic background influence the cancer impact of bariatric surgery, and if so, what are the mechanism(s) involved?
  • How does bariatric surgery affect the penetrance of high-risk genetic cancer predisposition?

Responsive proposals may investigate animal models, human studies, or a combination of both. A project which focuses entirely on in vitro investigations is not responsive to this PAR.

The PAR will be open to all qualified applicants, including new and early-stage investigators, who can establish and lead a multi-disciplinary research project to enable the fulfillment of the intended program goals.

More details will be outlined in the forthcoming FOA.

Funding Information
Estimated Total Funding

Up to $1,000,000 in fiscal year (FY) 2022

Expected Number of Awards


Estimated Award Ceiling

$200,000 in direct costs per years

Primary Assistance Listing Number(s)

93.393, 93.394, 93.395, 93.396, 93.399

Anticipated Eligible Organizations
Small Business
Public/State Controlled Institution of Higher Education
Private Institution of Higher Education
Nonprofit with 501(c)(3) IRS Status (Other than Institution of Higher Education)
Eligible Agencies of the Federal Government
U.S. Territory or Possession
For-Profit Organization (Other than Small Business)

Applications are not being solicited at this time. 


Please direct all inquiries to:

Edward Sauter, M.D., Ph.D.

Division of Cancer Prevention
National Cancer Institute (NCI)



Kristine Willis, Ph.D.
Division of Cancer Biology
National Cancer Institute (NCI)
Telephone: 240-276-6213

Philip Daschner, Ph.D.
Division of Cancer Biology
National Cancer Institute (NCI)
Telephone: 240-276-6227

Weekly TOC for this Announcement
NIH Funding Opportunities and Notices