II 118th CONGRESS 1st Session S. 1994 IN THE SENATE OF THE UNITED STATES June 14, 2023 Mr. Kelly (for himself and Mr. Tillis ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to require medical facilities of the Department of Veterans Affairs to share certain data with State cancer registries, and for other purposes.

1. Short title This Act may be cited as the Counting Veterans' Cancer Act of 2023 . 2. Findings and purpose (a) Findings Congress finds the following: (1) According to 2017 data from National Program of Cancer Registries of the Centers for Disease Control and Prevention, approximately 26,500 cancer cases among veterans were not reported to State cancer registries funded through such Program. (2) Established by Congress in 1992 through the Cancer Registries Amendment Act ( Public Law 102–515 ), the National Program of Cancer Registries under section 399B of the Public Health Service Act ( 42 U.S.C. 280e ) collects data on cancer occurrence (including the type, extent, and location of the cancer), the type of initial treatment, and outcomes. (3) The Centers for Disease Control and Prevention support central cancer registries in 46 States, the District of Columbia, Puerto Rico, certain territories of the United States in the Pacific Islands, and the United States Virgin Islands. (4) The data obtained by registries described in paragraph (3) combined with data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute and mortality data from National Center for Health Statistics of the Centers for Disease Control and Prevention comprise the official United States Cancer Statistics. (5) The United States Cancer Statistics reflect all newly diagnosed cancer cases and cancer deaths for the entire population of the United States, except for unreported veterans. (6) Federal law requires the Centers for Disease Control and Prevention and the National Cancer Institute to collect cancer data for all newly diagnosed cancer cases, but that currently cannot be achieved due to frequent lack of reporting by medical facilities of the Department of Veterans Affairs. (7) Releasing all data from medical facilities of the Department to State cancer registries will provide more complete data for health care providers, public health officials, and researchers to— (A) measure cancer occurrence and trends at the local and national level; (B) inform and prioritize cancer educational and screening programs; (C) evaluate efficacy of prevention efforts and treatment; (D) determine survival rates; (E) conduct research on the etiology, diagnosis, and treatment of cancer; (F) ensure quality and equity in cancer care; and (G) plan for health services. (8) Capturing cancer data from medical facilities of the Department in State cancer registries and the United States Cancer Statistics can benefit veterans by— (A) improving the ability to identify cancer-related disparities in the veteran community; (B) improving understanding of the cancer-related needs of veterans, which can be incorporated into State Comprehensive Cancer Control planning for screening and treatment programs funded by the Centers for Disease Control and Prevention; and (C) increasing opportunities for veterans with cancer to be included in more clinical trials and cancer-related research and analysis being done outside of the health care system of the Department. (b) Purpose It is the purpose of this Act to improve care for veterans by ensuring all data on veterans diagnosed with cancer are captured by the national cancer registry programs supported by the National Program of Cancer Registries of the Centers for Disease Control and Prevention and the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. 3. Requirement that Department of Veterans Affairs share data with State cancer registries (a) Sharing of data with State cancer registries (1) In general Subchapter II of chapter 73 of title 38, United States Code, is amended by adding at the end the following new section: 7330E. Sharing of data with State cancer registries (a) Sharing by the Department (1) In general The Secretary shall share with the State cancer registry of each State, if such a registry exists, qualifying data for all individuals who are residents of the State and have received health care under the laws administered by the Secretary. (2) Requirements relating to data shared In sharing data under paragraph (1) with a State cancer registry, the Secretary shall comply with the requirements for non-Department facilities to report data, in a manner that is as complete and timely as possible, without requiring a data use agreement in place between the Department and each State cancer registry— (A) to State cancer registries that are supported by the National Program of Cancer Registries of the Centers for Disease Control and Prevention under section 399B of the Public Health Service Act ( 42 U.S.C. 280e ); (B) to State cancer registries that are supported by the Surveillance Epidemiology and End Results Program of the National Cancer Institute authorized under the National Cancer Act of 1971 ( Public Law 92–218 ); and (C) to State cancer registries as set forth in relevant State laws and regulations that authorize a cancer registry. (b) Qualifying data defined In this section, the term qualifying data , with respect to a State cancer registry, means all data required to be provided to the registry pursuant to the authorities specified in subparagraphs (A) through (C) of subsection (a)(2). . (2) Clerical amendment The table of sections at the beginning of subchapter II of such chapter is amended by inserting after the item relating to section 7330D the following new item: 7330E. Sharing of data with State cancer registries. . (b) Sharing by State cancer registries The Director of the Centers for Disease Control and Prevention shall assist State cancer registries described in subparagraphs (A) and (B) of section 7330E(a)(2) of title 38, United States Code, as added by subsection (a)(1), in facilitating, to the extent allowed under State laws regulating the cancer registry program, the sharing with the Secretary of Veterans Affairs of data in the possession of each such registry regarding diagnosis of cancer for each veteran— (1) enrolled in the system of annual patient enrollment established and operated under section 1705(a) of such title; or (2) registered to receive care from the Department of Veterans Affairs under section 17.37 of title 38, Code of Federal Regulations, or successor regulations.