(1) There are almost 10,000,000 cancer sur-
vivors (those living with, through, and beyond can-
cer) in the United States. 
(2) Three out of every four American families 
will have at least one family member diagnosed with 
cancer. 
(3) The size of the population of survivors of 
childhood cancers has grown dramatically, to 
270,000 individuals of all ages as of 1997. 
(4) In 1960, only 4 percent of children with 
cancer survived more than 5 years, but treatment 
advances have changed the outlook for many chil-
dren diagnosed with cancer. 
(5) According to the Intercultural Cancer Coun-
cil, because of disparities in health care delivery 
throughout the cancer care continuum—from pre-
vention, screening, and diagnosis through cancer 
treatment, follow-up, and end-of-life care—minority, 
poor, and other medically underserved communities 
are more likely to be diagnosed with late stage dis-
ease, experience poorer treatment outcomes, have 
shorter survival time with less quality of life, and ex-
perience a substantially greater likelihood of cancer 
death. 
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(6) The Institute of Medicine, in its report enti-
tled ‘‘From Cancer Patient to Cancer Survivor: Lost 
in Transition’’, states that there are disparities in 
cancer survivorship. For instance, African Ameri-
cans are underrepresented in the cancer survivor 
population—they made up approximately 13 percent 
of the United States population in 2000, but only 8 
percent of the survivor population. 
(7) The 5-year survival rate for children with 
cancer improved from 56 percent for those diag-
nosed between 1974 and 1976 to 79 percent for 
those diagnosed between 1995 and 2000. 
(8) One in 640 adults from age 20 to 39 has 
a history of cancer. 
(9) As many as two-thirds of childhood cancer 
survivors are likely to experience at least one late ef-
fect of treatment, with as many as one-fourth expe-
riencing a late effect that is serious or life-threat-
ening. The most common late effects of childhood 
cancer 
are 
neurocognitive 
and 
psychological, 
cardiopulmonary, endocrine and musculoskeletal, 
and second malignancies. 
(10) Some late effects are identified early in 
follow-up and are easily resolved, while others may 
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become chronic problems in adulthood and may have 
serious consequences. 
(11) The late effects of treatment may change 
as treatments evolve, which means that the moni-
toring and treatment of late effects may need to be 
modified on a routine basis. 
(12) The Institute of Medicine, in its reports on 
cancer survivorship entitled ‘‘Childhood Cancer Sur-
vivorship: Improving Care and Quality of Life’’ and 
‘‘From Cancer Patient to Cancer Survivor: Lost in 
Transition’’, has offered a number of recommenda-
tions for improving monitoring and follow-up care 
for cancer survivors and enhancing the cancer survi-
vorship research agenda. 
(13) The Institute of Medicine has also noted 
the significant health insurance problems that may 
be experienced by survivors of childhood cancer as 
well as adult cancer survivors and has recommended 
that policy makers take action to ensure access to 
care, including appropriate follow-up care, by all 
cancer survivors. 
(14) The annual cost of cancer in the United 
States is almost $190,000,000,000 in direct and in-
direct costs. 
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(15) In fiscal year 2001, the National Institutes 
of Health invested $38,000,000 in survivorship, or 
less than $4.25 per survivor. 
SEC. 3. CDC CANCER CONTROL PROGRAMS. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317S the following: 
‘‘SEC. 317T. CANCER CONTROL PROGRAMS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall expand and intensify the cancer control pro-
grams of the Centers, including programs for conducting 
surveillance activities or supporting State comprehensive 
cancer control plans. 
‘‘(b) CERTAIN ACTIVITIES.—In carrying out sub-
section (a), the Secretary shall— 
‘‘(1) in collaboration with the Director of the 
National Cancer Institute, provide guidance to 
States on projects and interventions that may be in-
corporated into State comprehensive cancer control 
programs to improve the long-term health status of 
childhood cancer survivors, including childhood can-
cer survivors in minority and other medically under-
served populations; 
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‘‘(2) encourage States to incorporate strategies 
for improving systems of care for childhood cancer 
survivors and their families into State comprehensive 
cancer plans; and 
‘‘(3) collaborate with the Director of the Na-
tional Cancer Institute to improve existing surveil-
lance systems or develop appropriate new systems 
for tracking cancer survivors and assessing their 
health status and risk for other chronic and dis-
abling conditions. 
‘‘(c) CHILDHOOD CANCER SURVIVORSHIP.— 
‘‘(1) FOCUS ON CHILDHOOD CANCER SURVIVOR-
SHIP.—In conducting or supporting national, State, 
and local comprehensive cancer control programs 
through the Centers for Disease Control and Preven-
tion, the Secretary shall enhance such programs— 
‘‘(A) to include a focus on childhood cancer 
survivorship, including survivorship in minority 
and other medically underserved populations; 
and 
‘‘(B) to include childhood cancer survivor-
ship initiatives for improving— 
‘‘(i) the monitoring of survivors of all 
forms of cancer; and 
‘‘(ii) follow-up treatment for survivors. 
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