The Cancer Money Trail: Before the Money
Before we follow the world's cancer research money, we need to understand the disease humanity has been trying to understand for thousands of years.
The Cancer Money Trail is a US Policy Grid investigation into how cancer research is funded, where the money goes, what it produces, and how discoveries can move from laboratories into health systems and commercial development. The first step is to understand the disease itself. Without that context, a large funding number can sound more meaningful than it really is.
There was almost certainly no single “first cancer patient”
It is tempting to ask who the first person with cancer was. Historically, that question cannot be answered. Cancer existed before modern medical records, and ancient descriptions cannot always be confirmed with modern pathology. What can be established is the earliest surviving evidence that humans recognised diseases resembling cancer.
The earliest surviving evidence
The U.S. National Cancer Institute’s SEER Training programme identifies ancient Egyptian medical papyri as the earliest known surviving descriptions. The Edwin Smith and George Ebers papyri contain descriptions of cancer written around 1600 BC and are believed to preserve material from sources as early as about 2500 BC. The Smith papyrus deals with surgical cases, while the Ebers papyrus records pharmacological, mechanical and magical approaches.
That distinction matters. These records are evidence of early medical observation, not modern pathological diagnoses. We should not retroactively give an ancient patient a modern cancer subtype when the evidence cannot support it.
From observation to classification
SEER’s historical record shows that Hippocrates described a breast tumour around 400 BC using the term karkinoma, the word from which carcinoma derives. Centuries later, systematic records began to change what doctors could know about cancer at population level. SEER records a 1629 reference to cancer as a cause of death in England and a 1728 London “General Census of Cancer” as an early systematic collection of cancer information.
This was a major transition. Cancer was no longer only something observed in an individual patient. It could gradually become something counted, compared and studied across populations.
When did science begin connecting cancer with causes?
One landmark came in 1775, when Percivall Pott identified a relationship between chimney-soot exposure and squamous cell carcinoma of the scrotum among chimney sweeps. NCI describes this as the first clear link between an environmental exposure and cancer.
The significance is larger than the historical episode itself. Cancer research increasingly became a search for causes and mechanisms rather than simply a search for ways to remove a visible tumour. That shift eventually opened the door to epidemiology, pathology, molecular biology and prevention research.
Cancer is not one disease
NCI says there are more than 100 types of cancer. Cancers are commonly named for the organ or tissue in which they form, but they can also be classified by the type of cell involved. Even two cancers arising in the same organ can behave very differently.
Modern cancer biology explains part of that complexity through genetic change. Mutations can affect proto-oncogenes, tumour-suppressor genes and DNA-repair genes. NCI notes that each person’s cancer can have a unique combination of genetic changes, and those differences can affect how a tumour behaves and whether it responds to a particular treatment.
Why “cancer” is a misleadingly simple word
The word cancer covers diseases with different causes, biology, growth rates, patterns of spread and treatment options. A slow-growing tumour and an aggressive metastatic cancer are not the same clinical problem. A cancer caused primarily by an infectious agent raises different prevention questions from one driven by inherited susceptibility or a mixture of environmental and biological factors.
That diversity is important for the money trail. A statement such as “billions are spent on cancer research” does not tell us what scientists are actually studying. The money may be supporting basic biology, prevention, diagnosis, surgery, radiotherapy, medicines, immunology, data science, clinical trials, survivorship or many other areas.
The global scale of the disease
The World Health Organization reported that cancer caused nearly 10 million deaths worldwide in 2024. WHO lists lung, breast, colorectal and prostate cancers among the most common cancers globally, while the leading causes of cancer death included lung, colorectal, liver, breast and stomach cancer.
IARC’s global estimates for 2022 similarly put the worldwide cancer burden at almost 20 million new cases and about 9.7 million deaths. These are estimates, not a literal count of every diagnosis and death. Different datasets use different years, definitions and modelling methods, which is why US Policy Grid will identify the source and year whenever a global number is used.
Prevention changes the money question
Cancer research is not only about finding new drugs. WHO identifies tobacco, alcohol, high body mass index, unhealthy diet, physical inactivity and air pollution among important risk factors, while cancer-causing infections such as HPV and hepatitis are particularly important in many lower-income settings.
IARC has also estimated that a substantial share of new cancers is linked to preventable risk factors. That creates a policy question alongside the scientific one: how much research funding goes toward preventing disease, detecting it earlier and making existing interventions work better, rather than only developing new treatments?
Why the history matters before we follow the money
The history shows that progress against cancer has never been one single breakthrough. It has been cumulative: observation, classification, pathology, epidemiology, prevention, surgery, radiation, chemotherapy, molecular biology, immunology and increasingly precise treatments.
Each stage creates different funding needs. A laboratory studying the biology of a tumour does not have the same costs as a multinational clinical trial. A cancer registry needs different infrastructure from a drug-development programme. A low-resource health system may need research into affordable surgery, diagnostics or radiotherapy rather than only another expensive medicine.
The money trail starts here
That is why the next part asks a deceptively simple question: where does the cancer research money actually come from?
There is no single global cancer-research account. Public agencies, charities, foundations, universities, international organisations and companies all contribute, and the datasets used to measure those contributions do not cover exactly the same things. The investigation therefore starts by defining the money before trying to count it.
Both sides. One record. Evidence before conclusions. Primary sources are prioritised. Facts, estimates and uncertainty are distinguished, and figures are not combined when their definitions, periods or coverage are materially different.