I 

108TH CONGRESS 

1ST SESSION H. R. 2986

To provide for the expansion and coordination of activities of the National 

Institutes of Health and the Centers for Disease Control and Prevention 

with respect to research and programs on cancer survivorship, and for 

other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 25, 2003

Mr. WICKER (for himself, Mr. HOYER, Mr. BLUNT, Mrs. CAPPS, Mr. TAYLOR

of Mississippi, Ms. CORRINE BROWN of Florida, Mr. WAMP, Ms. 

DELAURO, Mr. CUNNINGHAM, Mr. GOODE, Ms. NORTON, Mr. TIBERI, 

Ms. ROS-LEHTINEN, Mr. WAXMAN, Mr. KENNEDY of Rhode Island, Mr. 

RAHALL, and Mr. KING of New York) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL

To provide for the expansion and coordination of activities 

of the National Institutes of Health and the Centers 

for Disease Control and Prevention with respect to research and programs on cancer survivorship, and for 

other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Cancer Survivorship 

5 Research and Quality of Life Act of 2003’’. 
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1 SEC. 2. FINDINGS. 

2 The Congress finds as follows: 

3 (1) There are more than 9,600,000 individuals 

4 in the United States today who are cancer survivors 

5 (living with, through, and beyond cancer). 

6 (2) 61 percent of cancer survivors are 65 years 

7 of age and older. 

8 (3) 62 percent of adults diagnosed with cancer 

9 today will be alive 5 years from now. 

10 (4) In 1960, 4 percent of children with cancer 

11 survived more than 5 years. 

12 (5) 77 percent of children (age 0 through 14) 

13 diagnosed with cancer today will be living five years 

14 from now. 

15 (6) Three out of every four American families 

16 will have at least one family member diagnosed with 

17 cancer. 

18 (7) 24 percent of adults with cancer are parents 

19 who have a child 18 years or younger living in the 

20 home. 

21 (8) One of every four deaths in the United 

22 States is from cancer. In 2003, 556,500 Americans 

23 will die of cancer—more than 1,500 people a day. 

24 (9) The annual cost of cancer in the United 

25 States is $180,000,000,000 in direct and indirect 

26 costs. 
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1 (10) In fiscal year 2001 the National Institutes 

2 of Health invested $38,000,000 in survivorship—less 

3 than $4.25 per survivor. 

4 SEC. 3. CANCER CONTROL PROGRAMS. 

5 Section 412 of the Public Health Service Act (42 

6 U.S.C. 285a–091) is amended—

7 (1) in the first sentence, by inserting ‘‘, for sur8 vivorship,’’ after ‘‘treatment of cancer’’; 

9 (2) in paragraph (1)(B), by striking ‘‘cancer 

10 patients’’ and all that follows and inserting the fol11 lowing: ‘‘cancer patients, families of cancer patients, 

12 and cancer survivors, and’’; and 

13 (3) in paragraph (3), by inserting ‘‘and con14 cerning cancer survivorship programs,’’ after ‘‘con15 trol of cancer’’. 

16 SEC. 4. EXPANSION AND COORDINATION OF ACTIVITIES OF 

17 NATIONAL INSTITUTES OF HEALTH WITH RE18 SPECT TO CANCER SURVIVORSHIP RE19 SEARCH. 

20 (a) IN GENERAL.—

21 (1) TECHNICAL AMENDMENT.—Section 3 of 

22 Public Law 107–09172 (116 Stat. 541) is amended 

23 by striking ‘‘section 419C’’ and inserting ‘‘section 

24 417C’’. 
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1 (2) NEW SECTION.—Subpart 1 of part C of 

2 title IV of the Public Health Service Act (42 U.S.C. 

3 285 et seq.), as amended pursuant to paragraph (1) 

4 of this subsection, is amended by adding at the end 

5 the following section: 

6 ‘‘SEC. 417E. EXPANSION AND COORDINATION OF ACTIVI7 TIES WITH RESPECT TO CANCER SURVIVOR8 SHIP RESEARCH. 

9 ‘‘(a) IN GENERAL.—

10 ‘‘(1) EXPANSION OF ACTIVITIES.—The Director 

11 of NIH shall expand and coordinate the activities of 

12 the National Institutes of Health with respect to 

13 cancer survivorship research. 

14 ‘‘(2) ADMINISTRATION OF PROGRAM; COLLABO15 RATION AMONG AGENCIES.—The Director of NIH 

16 shall carry out this section acting through the Direc17 tor of the National Cancer Institute and in collabo18 ration with any other agencies that the Director de19 termines appropriate. 

20 ‘‘(b) OFFICE ON SURVIVORSHIP.—

21 ‘‘(1) IN GENERAL.—The Director of NIH shall 

22 establish an Office on Cancer Survivorship within 

23 the National Cancer Institute through which the ac24 tivities under subsection (a)(1) shall be implemented 

25 and directed. 
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1 ‘‘(2) ASSOCIATE DIRECTOR FOR CANCER SURVI2 VORSHIP; APPOINTMENT; FUNCTION.—There shall be 

3 in the National Cancer Institute an Associate Direc4 tor for Cancer Survivorship to coordinate and pro5 mote the programs in the Institute concerning can6 cer survivorship research. The Associate Director 

7 shall be appointed by the Director of the Institute 

8 from among individuals who, because of their profes9 sional training or experience, are equipped to ad10 dress the breadth of needs associated with cancer 

11 survivorship.’’. 

12 (b) FUNDING.—Section 417B of the Public Health 

13 Service Act (42 U.S.C. 285a–098) is amended by adding 

14 at the end the following subsection: 

15 ‘‘(e) OFFICE ON CANCER SURVIVORSHIP.—Of the 

16 amounts appropriated for the National Cancer Institute 

17 for a fiscal year, the Director of the Institute shall reserve 

18 an amount for the Office of Cancer Survivorship under 

19 section 417E(b)(1).’’.

20 SEC. 5. EXPANSION OF CDC COMPREHENSIVE CANCER 

21 PROGRAMS; PROGRAMS TO IMPROVE CAN22 CER SURVIVORSHIP. 

23 (a) IN GENERAL.—The Secretary of Health and 

24 Human Services (referred to in this section as the ‘‘Sec-
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1 retary’’), acting through the Director of the Centers for 

2 Disease Control and Prevention, shall—

3 (1) expand and update the National Com4 prehensive Cancer Control Program; 

5 (2) assist States, territories, tribal organiza6 tions, and the District of Columbia in developing 

7 and implementing a cancer prevention and control 

8 program so that each entity will have an active plan 

9 in place and so that States, territories, tribal organi10 zations, and the District of Columbia will conduct 

11 activities to prevent and control cancer and so that 

12 disparities in specific populations will be addressed; 

13 (3) establish programs that demonstrate how to 

14 prevent and control cancer and improve access to 

15 and the quality of cancer care among racial and eth16 nic minority and medically underserved populations 

17 with disproportionate incidence of or death from 

18 cancer; 

19 (4) promote cancer education, prevention, and 

20 early detection of cancer; and 

21 (5) award grants to public and nonprofit orga22 nizations for cancer control and prevention. 

23 (b) CERTAIN STUDIES AND PROGRAMS.—

24 (1) IN GENERAL.—The Secretary, acting 

25 through the Director of the Centers for Disease 
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1 Control and Prevention and in collaboration with the 

2 Director of the Office of Cancer Survivorship within 

3 the National Cancer Institute, shall study the unique 

4 health challenges associated with cancer survivorship 

5 and carry out projects and interventions to improve 

6 the long-term health status of cancer survivors. Such 

7 projects shall be carried out directly and through the 

8 awards of grants or contracts. 

9 (2) CERTAIN ACTIVITIES.—Activities under 

10 paragraph (1) include—

11 (A) the expansion, in collaboration with 

12 the Surveillance, Epidemiology, and End Re13 sults Program (SEER) at the National Cancer 

14 Institute and with the Agency for Healthcare 

15 Research and Quality, of current cancer surveil16 lance systems to track the health status of can17 cer survivors and determine whether cancer sur18 vivors are at-risk for other chronic and dis19 abling conditions; 

20 (B) assess the unique public health chal21 lenges associated with cancer survivorship; and 

22 (C) the development and implementation of 

23 a national public health cancer survivorship ac24 tion plan, in partnership with health organiza25 tions focused on cancer survivorship, to be car-
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1 ried out in coordination with the State-based 

2 comprehensive cancer control program of the 

3 Centers for Disease Control and Prevention, in 

4 collaboration with the Office of Cancer Survi5 vorship at the National Cancer Institute, and in 

6 consultation with other appropriate entities, to 

7 support and advance cancer survivorship 

8 through—

9 (i) surveillance and research; 

10 (ii) communication, education, and 

11 training; 

12 (iii) program, policies, and infrastruc13 ture; and 

14 (iv) access to quality care and serv15 ices. 

16 (c) COORDINATION OF ACTIVITIES.—The Secretary 

17 shall assure that activities under this section are coordi18 nated as appropriate with other agencies of the Public 

19 Health Service. 

20 (d) REPORT TO CONGRESS.—Not later than October 

21 1, 2004, the Secretary shall submit to the Congress a re22 port describing the results of the evaluation under sub23 section (a), and as applicable, the strategies developed 

24 under such subsection. 
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1 (e) AUTHORIZATION OF APPROPRIATIONS.—For the 

2 purpose of carrying out this section, there are authorized 

3 to be appropriated such sums as may be necessary for 

4 each of the fiscal years 2004 through 2008. 

5 SEC. 6. MONITORING AND EVALUATING QUALITY CANCER 

6 CARE AND CANCER SURVIVORSHIP. 

7 (a) IN GENERAL.—Part M of title III of the Public 

8 Health Service Act (42 U.S.C. 280e et seq.) is amended 

9 by inserting after section 399E the following section: 

10 ‘‘SEC. 399E–091. MONITORING AND EVALUATING QUALITY 

11 CANCER CARE AND CANCER SURVIVORSHIP. 

12 ‘‘(a) IN GENERAL.—The Secretary shall make grants 

13 to eligible entities for the purpose of enabling such entities 

14 to monitor and evaluate quality cancer care, develop infor15 mation concerning quality cancer care, and monitor cancer 

16 survivorship. The Secretary shall carry out this section 

17 jointly through the Director of the Centers for Disease 

18 Control and Prevention and the Director of the National 

19 Cancer Institute. 

20 ‘‘(b) ELIGIBLE ENTITIES.—For purposes of this sec21 tion, an entity is an eligible entity for a fiscal year if the 

22 entity—

23 ‘‘(1) operates a statewide cancer registry with 

24 funds from a grant made under section 399B for 

25 such fiscal year; 
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1 ‘‘(2) is certified by the North American Asso2 ciation of Central Cancer Registries. 

3 ‘‘(3) has personnel scientifically qualified to 

4 conduct population-based epidemiology or analyze 

5 health services or outcomes research; and 

6 ‘‘(4) has access to a broad-based clinical re7 search cohort or an established clinical case base. 

8 ‘‘(c) CONTRACTING AUTHORITY.—In carrying out the 

9 purpose described in subsection (a), an eligible entity may 

10 expend a grant under such subsection to enter into con11 tracts with academic institutions, cancer centers, and 

12 other entities, when determined appropriate by the Sec13 retary. 

14 ‘‘(d) APPLICATION FOR GRANT.—A grant may be 

15 made under subsection (a) only if an application for the 

16 grant is submitted to the Secretary and the application 

17 is in such form, is made in such manner, and contains 

18 such agreements, assurances, and information as the Sec19 retary determines to be necessary to carry out this section. 

20 ‘‘(e) AUTHORITY OF SECRETARY REGARDING USE OF

21 GRANT.—The Secretary shall determine the appropriate 

22 uses of grants under subsection (a) to achieve the purpose 

23 described in such subsection. 

24 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 

25 purpose of carrying out this section, there are authorized 
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1 to be appropriated such sums as may be necessary for 

2 each of the fiscal years 2004 through 2008.’’. 

3 (b) CONFORMING AMENDMENT REGARDING AU4 THORIZATION OF APPROPRIATIONS.—Section 399F(a) of 

5 the Public Health Service Act (42 U.S.C. 280e–094(a)) 

6 is amended in the first sentence by striking ‘‘this part,’’ 

7 and inserting ‘‘this part (other than section 399E–091),’’.

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