,,ii  #aai? ,,congress  #b;d ,session   
,s4 #dgag  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #i1 #bjbf,mr4    
,m>key 7= himself & ,ms4 ,klobu*>7      
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,public ,heal?    
,s]vice ,act to require ! ,director ( ! 
,national ,in/itutes ( ,heal? to develop
 a national /rategy to address "y adult 
canc]s1 & = o!r purposes4  #a4 ,%ort    
title ,?is ,act may be cit$ z ! ,asal   
,sayas ,national ,/rategy on ,"y ,adult 
,canc]s ,act4  #b4 ,f9d+s ,congress f9ds
 t-- 7#a7 canc] is ! second mo/ common  
cause ( dea? 9 ! ,unit$ ,/ates1 ) ov]   
#b1jjj1jjj new cases diagnos$ annually &
 an expect$ #fbf1adj canc] dea?s 9      
#bjbf2  7#b7 ! incid5ce ( canc] 9       
individuals ages #ah to #di 7ref]r$ to 9
 ?is section z "y adults71 has ris5 #gi 
p]c5t globally betwe5 #aiij & #bjai1 &  
mortality f canc] 9 t age gr\p has ris5 
by #bh p]c5t2  7#c7 ! incid5ce ( "y     

adult canc]s is pr$ict$ to increase by  
#cj p]c5t globally f #bjai to #bjcj2    
7#d7 ea* ye> 9 ! ,unit$ ,/ates1         
approximately #bjj1jjj "y adults are    
diagnos$ ) canc] & approximately #cj1jjj
 "y adults die f canc]2  7#e7 ! incid5ce
 ( canc]s 9 "y adult wom5 is n[ #hb     
p]c5t high] ?an ! incid5ce ( canc]s 9 "y
 adult m51 & canc]s 9 "y adult wom5 has 
increas$ by #ea p]c5t s9ce #bjjb2  7#f7 
! economic co/ 9 ! ,unit$ ,/ates ( "y   
adult canc]s is e/imat$ at              
#ej1jjj1jjj1jjj to #hj1jjj1jjj1jjj      
annually1 due to co/s relat+ to m$ical  
c>e1 out-(-pocket exp5ses1 lo/          
productivity1 c>egiv] burd51 & premature
 dea?s2  7#g7 rates ( "y adult canc]s   
are increas+ significantly = dige/ive   
canc]s1 includ+ colorectal & pancreatic 
canc]s1 lung canc]s1 gynecological      
canc]s1 includ+ c]vical1 ut]9e1 & ov>ian
 canc]s1 brea/ canc]s1 pro/ate canc]s1  
te/icul> canc]s1 ?yroid canc]s1         
melanoma1 s>coma1 lymphoma1 leukemia1 & 
head & neck canc]s2  7#h7 colorectal    

canc]s are ! lead+ cause ( "y adult     
canc]-relat$ dea?s 9 ! ,unit$ ,/ates1 & 
! second-lead+ cause ( canc] ov]all2    
7#i7 lung canc] is ! lead+ cause ( canc]
 dea? 9 bo? m5 & wom5 9 ! ,unit$ ,/ates1
 & rates are ris+ among "y adults1      
includ+ = non-smok]s1 ! majority ( :om  
are wom52  7#aj7 "s canc]s1 includ+     
colorectal canc]s & lung canc]s1 are m  
likely to be m advanc$ at diagnosis & h 
worse survival rates = "y adults ?an =  
individuals 9 o!r age gr\ps2  7#aa7     
curr5t eligibility crit]ia = canc]      
scre5+1 includ+ = colorectal & lung     
canc]s1 fail to id5tify _m "y adults :o 
develop ^! diseases2  7#ab7 "y adult    
canc]s h significant %ort- & long-t]m   
social & economic impacts on            
individuals1 _! families1 & society1 &  
are l9k$ to high] risk ( long-t]m heal? 
problems 9 survivors2  7#ac7 ! risk     
factors contribut+ to "y adult canc]s   
rema9 complex & may include int]action (
 g5etic & biological factors1 z well z  
life/yle & environm5tal exposures1 mak+ 

id5tification ( at-risk gr\ps difficult2
  7#ad7 "y adults ) canc] face an av]age
 delay ( #g mon?s betwe5 symptom onset &
 treatm5t1 v]sus #a mon? = individuals  
age #ej & ov]2 &  7#ae7 b>ri]s to       
diagnosis = "y adult canc]s include     
scre5+ ineligibility l9k$ to age1 delay 
9 pres5tation to prim>y c>e aft] symptom
 appe>ance1 m frequ5t misattribution (  
symptoms to less sev]e conditions1 &    
delay 9 ref]ral to a canc] speciali/4   
#c4 ,national /rategy to address "y     
adult canc]s ,section #djb ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bhb7
 is am5d$ by add+ ! foll[+3  7p7 ,asal  
,sayas ,national ,/rategy on ,"y ,adult 
,canc]s  7#a7 ,9 g5]al ,n lat] ?an #ah  
mon?s aft] ! date ( enactm5t ( ! ,asal  
,sayas ,national ,/rategy on ,"y ,adult 
,canc]s ,act1 ! ,director ( ,,nih %all  
develop & submit to ! relevant          
committees ( ,congress1 & po/ on !      
websites ( ! ,national ,in/itutes (     
,heal? & ! cle>+h\se e/abli%$ pursuant  
to p>agraph 7#b77;,g71 a national       

/rategy to address "y adult canc]s1 to  
be kn[n z ! ,asal ,sayas ,national      
,/rategy on ,"y ,adult ,canc]s4  7#b7   
,requirem5ts ,! national /rategy "u     
p>agraph 7#a7 %all-- 7,a7 conduct &     
provide an inv5tory ( curr5t "y adult   
canc] rese>* programs1 initiatives1 &   
s]vices across ! ,national ,in/itutes ( 
,heal? & o!r ,f$]al ag5cies2  7,b7      
develop a national education campaign = 
! public & heal? c>e pr(essionals on !  
symptoms (1 & risk factors =1 "y adult  
canc]s1 :i* %all-- 7i7 id5tify          
culturally relevant /rategic priorities 
& objectives = su* national education   
campaign2  7ii7 provide education to1 & 
raise public aw>5ess among1 ! g5]al     
public ab\t symptoms & risk factors = "y
 adult canc]s2 &  7iii7 provide         
education to prim>y c>e1 em]g5cy1       
ob/etrics & gynecology1 pulmon>y1 &     
ga/ro9te/9al heal? c>e pr(essionals &   
o!r heal? c>e pr(essionals reg>d+ !     
signs1 symptoms1 & risk factors = !     
lead+ types ( "y adult canc]s 9 ! ,unit$

 ,/ates2  7,c7 id5tify /rategic rese>*  
priorities & objectives across          
biom$ical1 behavioral1 & environm5tal   
rese>* areas1 includ+ by-- 7i7 conduct+ 
an assessm5t ( "y adult canc] rese>*1   
includ+ areas ( opportunity ) respect to
 basic1 cl9ical1 epidemiologic1 &       
translational rese>*2  7ii7 det]m9+     
priorities & objectives to advance !    
diagnosis1 treatm5t1 cure1 & prev5tion (
 "y adult canc]s2  7iii7 evaluat+ issues
 relat+ to improv+ access to c>e = "y   
adults ) canc]2  7iv7 id5tify+ em]g+    
sci5tific opportunities1 ris+ public    
heal? *all5ges1 & sci5tific k gaps2 &   
7v7 evaluat+ opportunities = new        
te*nologies to id5tify risk factors1    
biom>k]s1 & t>get$ !rapies = "y adult   
canc]s2  7,d7 review1 9 c>ry+ out       
subp>agraph 7,b7-- 7i7 disease burd5 9 !
 ,unit$ ,/ates ( "y adult canc]s 9 total
 & by canc] type1 includ+ ! pot5tial =  
an economic return on inve/m5t to !     
,unit$ ,/ates1 due to lives sav$1       
increas$ productivity1 & decreas$ m$ical

 co/s1 f fund+ rese>*1 prev5tion1       
scre5+1 diagno/ics1 treatm5t1 & cures2  
7ii7 diff]5ces among "y adult canc]s 9  
total & by canc] type among             
sociodemographic gr\ps1 includ+ by--    
7,i7 sex2  7,,ii7 race & e?nicity2      
7,,iii7 /atus z a vet]an1 memb] ( !     
,arm$ ,=ces1 or family memb] ( a vet]an 
or memb] ( ! ,arm$ ,=ces2  7,,iv7       
disability /atus2  7,v7 pr(essions t may
 increase canc] risk2 &  7,,vi7 ,tribal 
populations1 rural populations1 &       
m$ically und]s]v$ populations 7z def9$ 9
 section #ccj7;b77#c772  7iii7          
multi-in/itute & multi-ag5cy priorities1
 includ+ coord9ation ( rese>* among !   
national rese>* in/itutes1 ! national   
c5t]s1 & ,f$]al ag5cies2  7iv7 b>ri]s to
 p>ticipation 9 cl9ical trials = "y     
adults2  7v7 special ne$s associat$ )   
treatm5t among ! non-p$iatric "y adult  
population1 su* z conc]ns associat$ )   
pres]v+ f]tility1 m5tal heal? issues1 & 
employm5t2  7vi7 exi/+ ,f$]al res\rces1 
su* z reports1 databases1 & guidance2 & 

7vii7 o!r factors ! ,director ( ,,nih   
det]m9es appropriate1 9 consultation ) !
 ,director ( ! ,national ,canc]         
,in/itute1 ! heads ( o!r national rese>*
 in/itutes1 & ! heads ( ,f$]al ag5cies2 
7,e7 provide recomm5dations ) respect   
to-- 7i7 advanc+ biom$ical1 life/yle1 & 
environm5tal rese>* into ! causes ( "y  
adult canc]s1 by type ( canc]2  7ii7    
improv+ me?ods = e>ly detection & scre5+
 ( "y adult canc]s1 by type ( canc]1    
includ+ education campaigns = ! public &
 heal? c>e pr(essionals & res\rces to   
increase aw>5ess ( symptoms2  7iii7     
improv+ scre5+ guidance & ! developm5t (
 new diagno/ics ) respect to v>i\s types
 ( "y adult canc]s2  7iv7 r$uc+ b>ri]s  
to insurance cov]age ( scre5+ = "y adult
 canc]s2  7v7 ensur+ timely reviews (   
canc] scre5+ recomm5dations by ! ,unit$ 
,/ates ,prev5tive ,s]vices ,task ,=ce t 
assess rese>* f9d+s = canc]s t are ris+ 
9 "y adults2  7vi7 apply+ te*nologies1  
includ+ innovative electronic heal?     
record tools1 to id5tify biom>k]s & o!r 

risk factors & to t>get treatm5t options
 = "y adult canc]s2  7vii7 apply+       
te*nologies1 includ+ innovative         
electronic heal? record tools1 to       
increase ! use by heal? c>e provid]s (  
recomm5dations = id5tification (        
symptoms1 family hi/ory1 h]$it>y        
syndromes1 or o!r risk factors t c\ld   
contribute to ! "y adult canc]          
diagnosis2  7viii7 evaluat+ curr5t      
!rapies & develop+ new treatm5ts1       
includ+ biom>k] id5tification &         
precision m$ic9e1 = "y adult canc]s2    
7ix7 address+ & dissem9at+ prev5tion    
/rategies2  7x7 address+ b>ri]s to      
conduct+ rese>* reg>d+ "y adult canc]s2 
7xi7 address+ b>ri]s to p>ticipation 9  
cl9ical trials = "y adults ) canc]2     
7xii7 increas+ ef=ts to improve m$ical  
education & k among heal? c>e           
pr(essionals ( "y adult canc]s1 includ+ 
risk factors1 symptoms1 scre5+ & e>ly   
detection te*niques1 prev5tion1 &       
treatm5t options2  7xiii7 e/abli%+ )9 ! 
,national ,canc] ,in/itute a ,national  

,c5t]s ( ,excell5ce = ,"y ,adult ,canc]s
 program 7or a comp>able alt]native7 t  
w\ld create & support hubs across !     
,unit$ ,/ates = rese>*1 cl9ical c>e1 &  
public & pr(essional education2  7xiv7  
support+ ! psy*osocial ne$s (           
individuals und]go+ treatm5t = "y adult 
canc]s1 includ+ family1 f]tility        
pres]vation1 & "w-relat$ issues2  7xv7  
address+ ! ne$s ( c>egiv]s ( "y adult   
canc] pati5ts2 &  7xvi7 o!r topics1 z   
det]m9$ by ! ,director ( ,,nih1 9       
consultation ) ! ,f$]al ,coord9at+      
,committee on ,"y ,adult ,canc]s        
e/abli%$ "u p>agraph 7#c77;,a72  7,f7   
describe opportunities = collaboration )
 ,f$]al dep>tm5ts & ag5cies & ! private 
sector1 z appropriate2 &  7,g7 e/abli%  
an onl9e ,f$]al cle>+h\se to provide to 
! g5]al public1 pati5ts1 c>egiv]s1 heal?
 c>e pr(essionals1 & rese>*]s in=mation 
on "y adult canc]s1 ) res\rces1         
includ+-- 7i7 in=mation on risk factors1
 symptoms1 & scre5+ eligibility2  7ii7  
in=mation reg>d+ rese>* f9d+s1 cl9ical  

trials1 & rese>* fund+ opportunities2 & 
7iii7 cl9ical practice guidel9es = heal?
 c>e pr(essionals4  7#c7 ,f$]al         
,coord9at+ ,committee on ,"y ,adult     
,canc]s  7,a7 ,9 g5]al ,9 c>ry+ out ?is 
subsection1 ! ,director ( ,,nih %all    
e/abli% a committee1 to be kn[n z !     
,f$]al ,coord9at+ ,committee on ,"y     
,adult ,canc]s-- 7i7 to consult &       
provide input on ! developm5t ( !       
national /rategy "u p>agraph 7#a72 &    
7ii7 n less frequ5tly ?an once e #b     
ye>s1 to submit to ! relevant committees
 ( ,congress a progress report reg>d+ ! 
implem5tation ( su* national /rategy4   
7,b7 ,memb]%ip ,! coord9at+ committee   
e/abli%$ "u subp>agraph 7,a7 %all be    
compos$ (-- 7i7 ! ,director ( !         
,national ,canc] ,in/itute2  7ii7 !     
heads ( o!r national rese>* in/itutes1  
national c5t]s1 & (fices )9 ! ,national 
,in/itutes ( ,heal?1 z det]m9$          
appropriate by ! ,director ( ,,nih1     
includ+ ! ,national ,he>t1 ,lung1 &     
,blood ,in/itute1 ! ,national ,in/itute 

( ,diabetes & ,dige/ive & ,kidney       
,diseases1 ! ,eunice ,k5n$y ,%riv]      
,national ,in/itute ( ,*ild ,heal? &    
,human ,developm5t1 ! ,national ,human  
,g5ome ,rese>* ,in/itute1 ! ,national   
,in/itute ( ,m5tal ,heal?1 ! ,(fice (   
,rese>* on ,wom5's ,heal?1 & ! ,national
 ,in/itute on ,m9ority ,heal? & ,heal?  
,disp>ities2  7iii7 ! ,director ( !     
,(fice ( ,sci5ce & ,te*nology ,policy2  
7iv7 ! ,secret>y ( ,heal? & ,human      
,s]vices2  7v7 ! ,director ( ! ,c5t]s = 
,disease ,control & ,prev5tion2  7vi7 ! 
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices2  7vii7 ! ,commission]
 ( ,food & ,drugs2  7viii7 ! ,assi/ant  
,secret>y = ,m5tal ,heal? & ,sub/ance   
,use2  7ix7 ! ,director ( ! ,indian     
,heal? ,s]vice2  7x7 ! ,director ( !    
,(fice ( ,m9ority ,heal? ( ! ,dep>tm5t (
 ,heal? & ,human ,s]vices2  7xi7 !      
,director ( ! ,(fice on ,wom5's ,heal? (
 ! ,dep>tm5t ( ,heal? & ,human ,s]vices2
  7xii7 ! ,director ( ! ,ag5cy =        
,heal?c>e ,rese>* & ,quality2  7xiii7 ! 

,director ( ! ,advanc$ ,rese>* ,projects
 ,ag5cy-,heal?2  7xiv7 ! ,assi/ant      
,secret>y ( ,def5se = ,heal? ,affairs2  
7xv7 ! ,"u ,secret>y = ,heal? = !       
,dep>tm5t ( ,vet]ans ,affairs2  7xvi7 ! 
,director ( ! ,(fice ( ,sci5ce ( !      
,dep>tm5t ( ,en]gy2  7xvii7 ! ,director 
( ! ,national ,sci5ce ,f\ndation2       
7xviii7 ! ,adm9i/rator ( ! ,environm5tal
 ,protection ,ag5cy2  7xix7             
repres5tatives ( pati5t advocacy gr\ps2 
7xx7 repres5tatives ( academic rese>*   
in/itutions2  7xxi7 repres5tatives ( !  
biom$ical indu/ry2  7xxii7              
repres5tatives & lead]s ( community     
heal? in/itutions2 &  7xxiii7 o!rs1 z   
det]m9$ by ! ,director4  7#d7           
,def9itions ,9 ?is subsection3 7,a7     
,relevant committees ( ,congress ,! t]m 
relevant committees ( ,congress means-- 
7i7 ! ,committee on ,heal?1 ,education1 
,labor1 & ,p5sions ( ! ,s5ate2  7ii7 !  
,committee on ,f9ance ( ! ,s5ate2  7iii7
 ! ,committee on ,appropriations ( !    
,s5ate2  7iv7 ! ,committee on ,en]gy &  

,comm]ce ( ! ,h\se ( ,repres5tatives2   
7v7 ! ,committee on ,ways & ,means ( !  
,h\se ( ,repres5tatives2 &  7vi7 !      
,committee on ,appropriations ( ! ,h\se 
( ,repres5tatives4  7,b7 ,"y adult ,!   
t]m "y adult means an individual betwe5 
! ages ( #ah & #di4  4