,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #fjib  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #e1 #bjbj,mr4    
,dunn 7= himself & ,mr4 ,cunn+ham7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,vet]ans' ,affairs  ,a 
,,bill  ,to direct ! ,secret>y (        
,vet]ans ,affairs to e/abli% a national 
cl9ical pa?way = pro/ate canc]1 access  
to life-sav+ ext5d+ precision cl9ical   
trials & rese>*1 & = o!r purposes4  #a4 
,%ort title ,?is ,act may be cit$ z !   
,vet]an's ,pro/ate ,canc] ,treatm5t &   
,rese>* ,act4  #b4 ,f9d+s ,congress     
makes ! foll[+ f9d+s3 7#a7 ,pro/ate     
canc] is ! numb] "o canc] diagnos$ 9 !  
,vet]ans ,heal? ,adm9i/ration4  7#b7 ,a 
#aiif report publi%$ by ! ,national     
,academy ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e
 e/abli%$ a l9k betwe5 pro/ate canc] &  
exposure to h]bicides1 su* z ,ag5t      
,orange4  7#c7 ,x is ess5tial to        
ackn[l$ge t due to ^! circum/ances1     
c]ta9 vet]ans are made aw>e t !y are    
high-risk individuals :5 x comes to !   

pot5tial to develop pro/ate canc]4  7#d7
 ,9 be+ designat$ z high risk1 x is     
ess5tial t vet]ans are proactive 9 seek+
 e>li] prev5tative cl9ical s]vices = !  
e>ly detection & successful treatm5t (  
pro/ate canc]1 :e!r t be ?r\gh !        
,vet]ans ,heal? ,adm9i/ration or ?r\gh a
 community provid]4  7#e7 ,cl9ical      
prev5tative s]vices & initial detection 
are "s ( ! mo/ important compon5ts 9 !  
e>ly detection ( pro/ate canc] = vet]ans
 at high risk ( pro/ate canc]4  7#f7 ,= 
vet]ans ) pro/ate canc]1 includ+ pro/ate
 canc] t has meta/asiz$1 precision      
oncology1 includ+ biom>k]-driv5 cl9ical 
trials & innovations und]way ?r\gh !    
,pro/ate ,canc] ,f\ndation & ,dep>tm5t (
 ,vet]ans ,affairs p>tn]%ip1 repres5ts  
"o ( ! mo/ promis+ areas ( int]v5tions1 
treatm5ts1 & cures = su* vet]ans & _!   
families4  #c4 ,dep>tm5t ( ,vet]ans     
,affairs treatm5t & rese>* ( pro/ate    
canc]  7a7 ,e/abli%m5t ( cl9ical pa?way 
7#a7 ,9 g5]al ,n lat] ?an #cfe days aft]
 ! date ( ! enactm5t ( ?is ,act1 !      

,secret>y ( ,vet]ans ,affairs %all      
e/abli% 9 ! ,national ,surg]y ,(fice ( !
 ,dep>tm5t ( ,vet]ans ,affairs a        
national cl9ical pa?way = all /ages (   
pro/ate canc]1 f e>ly detection to      
end-(-life c>e includ+ recomm5dations   
reg>d+ ! use ( trans=mative innovations1
 rese>*1 & uni=m cl9ical data4  7#b7    
,elem5ts ,! national cl9ical pa?way     
e/abli%$ "u ?is subsection %all include 
! foll[+ elem5ts3 7,a7 ,a               
multi-discipl9>y plan = ! e>ly          
detection1 diagnosis1 & treatm5t (      
pro/ate canc] t includes1 z appropriate1
 bo? ,dep>tm5t m$ical facilities &      
community-bas$ p>tn]s & provid]s &      
rese>* c5t]s specializ+ 9 pro/ate canc]1
 especially su* c5t]s t h ent]$ into    
p>tn]%ips ) ! ,dep>tm5t4  7,b7 ,a       
sugge/$1 b n m&atory1 protocol = scre5+1
 diagnosis1 & treatm5t or c>e =         
subpopulations ) evid5ce-bas$ risk      
factors 7includ+ race1 e?nicity1        
socioeconomic /atus1 geographic         
location1 exposure risks1 & g5etic      

risks1 includ+ family hi/ory74  7,c7 ,a 
sugge/$ treatm5t protocol timeframe =   
ea* po9t ( c>e bas$ on sev]ity & /age ( 
canc]4  7#c7 ,public comm5t p]iod ,^u ! 
e/abli%m5t ( a propos$ cl9ical pa?way z 
requir$ "u ?is subsection1 ! ,secret>y  
%all publi% ! propos$ cl9ical pa?way 9 !
 ,f$]al ,regi/] & provide = a #de-;day  
p]iod = public comm5ts4 ,! ,secret>y--  
7,a7 may make any su* public comm5ts    
publicly available2 &  7,b7 make *anges 
to ! propos$ cl9ical pa?way 9 response  
to any su* comm5ts receiv$ us+ ! same   
process & crit]ia us$ to e/abli% !      
propos$ cl9ical pa?way4  7#d7           
,collaboration & coord9ation ,9 e/abli%+
 ! cl9ical pa?way requir$ "u ?is        
section1 ! ,secret>y %all-- 7,a7 provide
 = consid]ation ( o!r cl9ical pa?ways & 
rese>* f9d+s ( o!r dep>tm5ts & ag5cies1 
includ+ guidel9es t are widely recogniz$
 & guidel9es t are us$ z ! /&>d =       
cl9ical policy 9 oncology c>e1 su* z    
,national ,compreh5sive ,canc] ,network 
guidel9es2 &  7,b7 collaborate &        

coord9ate )-- 7i7 ! ,national ,in/itutes
 ( ,heal?2  7ii7 ! ,national ,canc]     
,in/itute2  7iii7 ! ,national ,in/itute 
on ,m9ority ,heal? & ,heal? ,disp>ities2
  7iv7 o!r ,in/itutes & ,c5t]s z !      
,secret>y det]m9es necess>y2  7v7 !     
,c5t]s = ,disease ,control & ,prev5tion2
  7vi7 ! ,dep>tm5t ( ,def5se2  7vii7 !  
,c5t]s = ,m$ic>e & ,m$icaid ,s]vices2   
7viii7 ! ,pati5t-,c5t]$ ,outcomes       
,rese>* ,in/itute2 &  7ix7 ! ,food &    
,drug ,adm9i/ration4  7#e7 ,publication 
,! ,secret>y %all-- 7,a7 publi% !       
cl9ical pa?way e/abli%$ "u ?is          
subsection on a publicly available      
,dep>tm5t website2 &  7,b7 regul>ly     
update ! cl9ical pa?way z ne$$ by review
 ( ! m$ical lit]ature & available       
evid5ce-bas$ guidel9es at lea/ annually1
 9 accordance ) ! crit]ia "u p>agraph   
7#b74  7b7 ,developm5t ( national canc] 
( ! pro/ate cl9ical c>e implem5tation   
program  7#a7 ,e/abli%m5t ,n lat] ?an   
#ij days aft] ! date ( ! enactm5t ( ?is 
,act1 ! ,secret>y %all submit to        

,congress a plan to e/abli% a           
compreh5sive pro/ate canc] program4     
7#b7 ,program requirem5ts ,!            
compreh5sive pro/ate canc] program      
%all-- 7,a7 be multidiscipl9>y & include
 ! au?ority to "w across cl9ical c>e    
l9es1 specialties1 & ! organizational   
divisions ( ! ,vet]ans ,heal?           
,adm9i/ration2  7,b7 receive direct     
ov]sight f ! ,deputy ,und]secret>y =    
,heal? ( ! ,dep>tm5t ( ,vet]ans         
,affairs2  7,c7 include a ye>ly program 
implem5tation evaluation to facilitate  
replication = o!r disease /ates or 9 o!r
 heal?c>e in/itutions2  7,d7 be metric  
driv5 & include ! developm5t ( qu>t]ly  
reports on ! quality ( pro/ate canc]    
c>e1 :i* %all be provid$ to ! lead]%ip (
 ! ,dep>tm5t1 m$ical c5t]s1 & provid]s &
 made publicly available 9 an electronic
 =m2  7,e7 made available z national    
decision support tools 9 ! electronic   
m$ical record2  7,f7 include an         
education plan = pati5ts & provid]s2 &  
7,g7 be fund$ appropriately to accompli%

 ! objectives ( ?is ,act4  7#c7 ,program
 implem5tation evaluation ,! ,secret>y  
%all e/abli% a program evaluation tool z
 an integral compon5t to le>n be/       
practices ( multidiscipl9>y disease-bas$
 implem5tation & to in=m ! ,dep>tm5t &  
,congress reg>d+ fur!r use ( ! disease  
specific model ( c>e deliv]y4  7#d7     
,pro/ate canc] rese>* ,! ,secret>y %all 
submit to ,congress a plan t provides = 
cont9ual fund+ ?r\gh ! ,(fice ( ,rese>* 
& ,developm5t ( ! ,dep>tm5t ( ,vet]ans  
,affairs = support+ pro/ate canc] rese>*
 design$ to position ! ,dep>tm5t z a    
national res\rce = quality report+      
metrics1 practice-bas$ evid5ce1         
comp>ative effectiv5ess1 precision      
oncology1 & cl9ical trials 9 pro/ate    
canc]4  7#e7 ,pro/ate canc] real "t     
regi/ry program ,! ,secret>y1 9         
collaboration ) data /ew>ds ( !         
,dep>tm5t ( ,vet]ans ,affairs1 sci5ti/s1
 & ! heads ( o!r ,dep>tm5ts1 ag5cies1 & 
non-gov]nm5tal organizations1 su* z     
f\ndations & non-pr(it organizations    

focus$ on pro/ate canc] rese>* & c>e1   
%all e/abli% a real-"t1 actionable1     
national pro/ate canc] regi/ry4 ,su*    
regi/ry %all be design$-- 7,a7 to       
e/abli% a sy/ematic & /&>diz$ database t
 enables intra-ag5cy collaboration by   
:i* to track vet]an pati5t progress1    
enable population managem5t programs1   
facilitate be/ outcomes1 & enc\rage     
future rese>* & fur!r developm5t (      
cl9ical pa?ways1 includ+ pati5t access  
to precision res\rces & treatm5ts &     
access to life-ext5d+ precision cl9ical 
trials2  7,b7 to employ novel me?ods (  
/ructur+ data1 includ+ natural language 
process+1 artificial intellig5ce1       
/ructur$ data cl9ical notes1 pati5t     
report$ outcome in/rum5ts1 & o!r tools1 
to ensure t all cl9ically mean+ful data 
is includ$2 &  7,c7 to be accessible    
to-- 7i7 cl9icians treat+ vet]ans       
diagnos$ ) pro/ate canc] & be+ treat$ = 
pro/ate canc] 9 conjunction ) ,dep>tm5t 
m$ical facilities2 &  7ii7 rese>*]s4    
7c7 ,cl9ical pa?way def9$ ,9 ?is        

section1 ! t]m cl9ical pa?way means a   
heal? c>e managem5t tool design$ ar\nd  
rese>* & evid5ce-back$ practices t      
provides direction = ! cl9ical c>e &    
treatm5t ( a specific episode ( a       
condition or ailm5t4