Portfolio analysis of NCI-funded policy implementation science grants (fiscal years 2014-2023)

The dynamic landscape of cancer implementation science (IS) has seen a significant rise in the use of policy as a tool. This analysis explores the multifaceted nature of policy in IS, not only as a directive to be adopted or implemented but also as context that can influence or a strategy that can shape and support effective implementation of cancer control interventions.

The NIH Query View Report tool was used to identify National Cancer Institute-funded IS grants related to policy between fiscal years 2014-2023. Three coders reviewed the abstracts and specific aims of the grants to ensure a focus on IS, followed by a secondary review to verify the relation to policy. Eligible grants were then coded to determine policy conceptualization methods, level of policy being targeted, alignment with U.S. National Cancer Institute activities, cancer continuum focus, cancer type(s), and cancer content area.

Of the 41 IS grants identified, 14 (34.1%) were included in the analysis. More than half (n = 8, 57.1%) of the grants were awarded in FY2020-2023. Most (n = 10, 71.4%) grants conceptualized policy as something to implement, 28.6% (n = 4) each conceptualized policy as a strategy to use or as something to adopt, and 35.7% (n = 5) as context to understand. Ten grants (71.4%) addressed cancer prevention, three grants (21.4%) addressed new innovations, and two grants each (14.3%) addressed expanding access to cancer screenings and supporting cancer survivors and their caregivers. No grants examined policies that address toxic and environmental exposures. Seven grants (50%) addressed the National Cancer Institute activities of increasing access to care.

The NCI funds policy IS across the cancer continuum and in alignment with several National Cancer Institute activities. However, there remain many opportunities to expand policy IS, especially regarding policies that impact cancer diagnosis, treatment, and survivorship and policies related to environmental exposures. Our study highlights key opportunities to conduct research that will inform the adoption, implementation, and use of policies to address the cancer burden in the U.S..