Widening the Gap:
How NIH Budget Cuts Amplify Cancer Disparities in Underserved Areas
by Vikas K. Singh, MD
The Trump administration’ s January 2025 executive action halting the National Institute of Health’ s( NIH) research funding had sent immediate shockwaves through the cancer research community, threatening to derail decades of scientific progress. 1 The indefinite suspension of grant reviews immobilized over $ 1.5 billion in NIH research funding, much of it directed toward cancer-related initiatives paralyzing laboratory operations and delaying vital clinical trials. 2 The National Cancer Institute( NCI), the largest single institute within the NIH in terms of budget, receives a significant portion of NIH funding to support groundbreaking efforts in cancer prevention, diagnostics and the development of novel therapies. These critical initiatives were suddenly placed at risk. While federal courts temporarily blocked the freeze, allowing some operations to resume, uncertainty lingered and continued to erode institutional stability.
That instability peaked again in July 2025, when the administration briefly paused up to $ 15 billion in NIH grants, triggering renewed alarm among medical researchers. Although the pause was reversed within hours, the unpredictable policy environment has created deep anxiety across the cancer research ecosystem. 3 Such instability disrupts long-term planning, stalls multi-year projects and deters early-career scientists from staying in the field, particularly in vulnerable areas like Kentucky’ s Appalachian region, where NIH funding supports both research and access to care, and maintains livelihoods.
The consequences are particularly acute in Kentucky’ s Appalachian region, where high smoking prevalence, combined with delay in diagnosis, results in lung cancers found only in late stage: therefore mortality rates far exceed the national average [ Table 1 ]. This region exemplifies the urgent need for sustained research investment. NIH funding has supported over 100 oncology clinical trials, including studies targeting genetic risk factors such as smoking-linked mutations in smokers. The suspension jeopardizes these efforts, threatening to exacerbate health disparities in an already underserved population.
As a practicing medical oncologist in Kentucky, I have witnessed firsthand the devastating impact of delayed and reduced cancer screenings during the COVID-19 pandemic. We saw a concerning rise in patients presenting with later-stage cancers, particularly for breast,
( continued on page 20) September 2025 19