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 re-
search and programs on cancer survivorship, and for 
other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Cancer Survivorship 
Research and Quality of Life Act of 2003’’.
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) There are more than 9,600,000 individuals 
in the United States today who are cancer survivors 
(living with, through, and beyond cancer). 
(2) 61 percent of cancer survivors are 65 years 
of age and older. 
(3) 62 percent of adults diagnosed with cancer 
today will be alive 5 years from now. 
(4) In 1960, 4 percent of children with cancer 
survived more than 5 years. 
(5) 77 percent of children (age 0 through 14) 
diagnosed with cancer today will be living five years 
from now. 
(6) Three out of every four American families 
will have at least one family member diagnosed with 
cancer. 
(7) 24 percent of adults with cancer are parents 
who have a child 18 years or younger living in the 
home. 
(8) One of every four deaths in the United 
States is from cancer. In 2003, 556,500 Americans 
will die of cancer—more than 1,500 people a day. 
(9) The annual cost of cancer in the United 
States is $180,000,000,000 in direct and indirect 
costs.
(10) In fiscal year 2001 the National Institutes 
of Health invested $38,000,000 in survivorship—less 
than $4.25 per survivor. 
SEC. 3. CANCER CONTROL PROGRAMS. 
Section 412 of the Public Health Service Act (42 
U.S.C. 285a–091) is amended—
(1) in the first sentence, by inserting ‘‘, for sur-
vivorship,’’ after ‘‘treatment of cancer’’; 
(2) in paragraph (1)(B), by striking ‘‘cancer 
patients’’ and all that follows and inserting the fol-
lowing: ‘‘cancer patients, families of cancer patients, 
and cancer survivors, and’’; and 
(3) in paragraph (3), by inserting ‘‘and con-
cerning cancer survivorship programs,’’ after ‘‘con-
trol of cancer’’. 
SEC. 4. EXPANSION AND COORDINATION OF ACTIVITIES OF 
NATIONAL INSTITUTES OF HEALTH WITH RE-
SPECT 
TO 
CANCER 
SURVIVORSHIP 
RE-
SEARCH. 
(a) IN GENERAL.—
(1) TECHNICAL
AMENDMENT.—Section 3 of 
Public Law 107–09172 (116 Stat. 541) is amended 
by striking ‘‘section 419C’’ and inserting ‘‘section 
417C’’.
(2) NEW SECTION.—Subpart 1 of part C of 
title IV of the Public Health Service Act (42 U.S.C. 
285 et seq.), as amended pursuant to paragraph (1) 
of this subsection, is amended by adding at the end 
the following section: 
‘‘SEC. 417E. EXPANSION AND COORDINATION OF ACTIVI-
TIES WITH RESPECT TO CANCER SURVIVOR-
SHIP RESEARCH. 
‘‘(a) IN GENERAL.—
‘‘(1) EXPANSION OF ACTIVITIES.—The Director 
of NIH shall expand and coordinate the activities of 
the National Institutes of Health with respect to 
cancer survivorship research. 
‘‘(2) ADMINISTRATION OF PROGRAM; COLLABO-
RATION AMONG AGENCIES.—The Director of NIH 
shall carry out this section acting through the Direc-
tor of the National Cancer Institute and in collabo-
ration with any other agencies that the Director de-
termines appropriate. 
‘‘(b) OFFICE ON SURVIVORSHIP.—
‘‘(1) IN GENERAL.—The Director of NIH shall 
establish an Office on Cancer Survivorship within 
the National Cancer Institute through which the ac-
tivities under subsection (a)(1) shall be implemented 
and directed.
‘‘(2) ASSOCIATE DIRECTOR FOR CANCER SURVI-
VORSHIP; APPOINTMENT; FUNCTION.—There shall be 
in the National Cancer Institute an Associate Direc-
tor for Cancer Survivorship to coordinate and pro-
mote the programs in the Institute concerning can-
cer survivorship research. The Associate Director 
shall be appointed by the Director of the Institute 
from among individuals who, because of their profes-
sional training or experience, are equipped to ad-
dress the breadth of needs associated with cancer 
survivorship.’’. 
(b) FUNDING.—Section 417B of the Public Health 
Service Act (42 U.S.C. 285a–098) is amended by adding 
at the end the following subsection: 
‘‘(e) OFFICE ON CANCER SURVIVORSHIP.—Of the 
amounts appropriated for the National Cancer Institute 
for a fiscal year, the Director of the Institute shall reserve 
an amount for the Office of Cancer Survivorship under 
section 417E(b)(1).’’.
SEC. 5. EXPANSION OF CDC COMPREHENSIVE CANCER 
PROGRAMS; PROGRAMS TO IMPROVE CAN-
CER SURVIVORSHIP. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’), acting through the Director of the Centers for 
Disease Control and Prevention, shall—
(1) expand and update the National Com-
prehensive Cancer Control Program; 
(2) assist States, territories, tribal organiza-
tions, and the District of Columbia in developing 
and implementing a cancer prevention and control 
program so that each entity will have an active plan 
in place and so that States, territories, tribal organi-
zations, and the District of Columbia will conduct 
activities to prevent and control cancer and so that 
disparities in specific populations will be addressed; 
(3) establish programs that demonstrate how to 
prevent and control cancer and improve access to 
and the quality of cancer care among racial and eth-
nic minority and medically underserved populations 
with disproportionate incidence of or death from 
cancer; 
(4) promote cancer education, prevention, and 
early detection of cancer; and 
(5) award grants to public and nonprofit orga-
nizations for cancer control and prevention. 
(b) CERTAIN STUDIES AND PROGRAMS.—
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Director of the Centers for Disease
Control and Prevention and in collaboration with the 
Director of the Office of Cancer Survivorship within 
the National Cancer Institute, shall study the unique 
health challenges associated with cancer survivorship 
and carry out projects and interventions to improve 
the long-term health status of cancer survivors. Such 
projects shall be carried out directly and through the 
awards of grants or contracts. 
(2) CERTAIN
ACTIVITIES.—Activities under 
paragraph (1) include—
(A) the expansion, in collaboration with 
the Surveillance, Epidemiology, and End Re-
sults Program (SEER) at the National Cancer 
Institute and with the Agency for Healthcare 
Research and Quality, of current cancer surveil-
lance systems to track the health status of can-
cer survivors and determine whether cancer sur-
vivors are at-risk for other chronic and dis-
abling conditions; 
(B) assess the unique public health chal-
lenges associated with cancer survivorship; and 
(C) the development and implementation of 
a national public health cancer survivorship ac-
tion plan, in partnership with health organiza-
tions focused on cancer survivorship, to be car-
ried out in coordination with the State-based 
comprehensive cancer control program of the 
Centers for Disease Control and Prevention, in 
collaboration with the Office of Cancer Survi-
vorship at the National Cancer Institute, and in 
consultation with other appropriate entities, to 
support 
and 
advance 
cancer 
survivorship 
through—
(i) surveillance and research; 
(ii) communication, education, and 
training; 
(iii) program, policies, and infrastruc-
ture; and 
(iv) access to quality care and serv-
ices. 
(c) COORDINATION OF ACTIVITIES.—The Secretary 
shall assure that activities under this section are coordi-
nated as appropriate with other agencies of the Public 
Health Service. 
(d) REPORT TO CONGRESS.—Not later than October 
1, 2004, the Secretary shall submit to the Congress a re-
port describing the results of the evaluation under sub-
section (a), and as applicable, the strategies developed 
under such subsection.
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2008. 
SEC. 6. MONITORING AND EVALUATING QUALITY CANCER 
CARE AND CANCER SURVIVORSHIP. 
(a) IN GENERAL.—Part M of title III of the Public 
Health Service Act (42 U.S.C. 280e et seq.) is amended 
by inserting after section 399E the following section: 
‘‘SEC. 399E–091. MONITORING AND EVALUATING QUALITY 
CANCER CARE AND CANCER SURVIVORSHIP. 
‘‘(a) IN GENERAL.—The Secretary shall make grants 
to eligible entities for the purpose of enabling such entities 
to monitor and evaluate quality cancer care, develop infor-
mation concerning quality cancer care, and monitor cancer 
survivorship. The Secretary shall carry out this section 
jointly through the Director of the Centers for Disease 
Control and Prevention and the Director of the National 
Cancer Institute. 
‘‘(b) ELIGIBLE ENTITIES.—For purposes of this sec-
tion, an entity is an eligible entity for a fiscal year if the 
entity—
‘‘(1) operates a statewide cancer registry with 
funds from a grant made under section 399B for 
such fiscal year;
‘‘(2) is certified by the North American Asso-
ciation of Central Cancer Registries. 
‘‘(3) has personnel scientifically qualified to 
conduct population-based epidemiology or analyze 
health services or outcomes research; and 
‘‘(4) has access to a broad-based clinical re-
search cohort or an established clinical case base. 
‘‘(c) CONTRACTING AUTHORITY.—In carrying out the 
purpose described in subsection (a), an eligible entity may 
expend a grant under such subsection to enter into con-
tracts with academic institutions, cancer centers, and 
other entities, when determined appropriate by the Sec-
retary. 
‘‘(d) APPLICATION FOR GRANT.—A grant may be 
made under subsection (a) only if an application for the 
grant is submitted to the Secretary and the application 
is in such form, is made in such manner, and contains 
such agreements, assurances, and information as the Sec-
retary determines to be necessary to carry out this section. 
‘‘(e) AUTHORITY OF SECRETARY REGARDING USE OF 
GRANT.—The Secretary shall determine the appropriate 
uses of grants under subsection (a) to achieve the purpose 
described in such subsection. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2008.’’. 
(b) CONFORMING
AMENDMENT
REGARDING
AU-
THORIZATION OF APPROPRIATIONS.—Section 399F(a) of 
the Public Health Service Act (42 U.S.C. 280e–094(a)) 
is amended in the first sentence by striking ‘‘this part,’’ 
and inserting ‘‘this part (other than section 399E–091),’’.
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