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Cancer Policy Monitor: February 8, 2022

Appropriations Update from Capitol Hill

–Marc B. Johnson, MPP

House and Senate Appropriations Committee leaders continue to negotiate the parameters for a Fiscal Year (FY) 2022 spending package. Negotiators must first come to agreement on top-line funding levels and subcommittee allocations before negotiating the substance of agency funding levels and language. House Majority Leader Steny Hoyer has expressed optimism that a bipartisan funding package could be voted on before the current continuing resolution (CR) ends on February 18, 2022. If a bill cannot be voted on by the end of the CR, Congress may need to pass another continuing resolution to finish the process.

Register Today! Virtual Congressional Briefing to Release AACR’s Report on COVID-19 and Cancer

–Marc B. Johnson, MPP

The AACR will host a virtual congressional briefing to release the AACR Report on the Impact of COVID-19 on Cancer Research and Patient Care on Wednesday, February 9 at 1 p.m. EST. The report highlights the impact the pandemic has had on patients with cancer, cancer research, how cancer researchers have responded to the challenges posed by COVID-19, and lessons learned during the pandemic that can be used to improve ongoing cancer research and patient care. 

Speakers include Sen. Amy Klobuchar (D-MN), Sen. Roy Blunt (R-MO), AACR CEO Margaret Foti, AACR Past President Antoni Ribas, and Ana Maria Lopez of Sidney Kimmel Cancer Center and Jefferson Health New Jersey. The briefing will also feature a live panel discussion with survivors of cancer whose stories are included in the report. 

Please register for the briefing.

No Surprises Act Went Into Effect on January 1

Health care is one of the few purchases people make without knowing the cost up front. The act requires providers to notify patients of their right to receive up-front pricing in the form of a good-faith estimate of the expected charges for all anticipated services, including drug costs, before they are scheduled. Learn more.

No Decision from FDA on Most Popular E-Cigarettes Five Months After Deadline

-Nicholas Warren, PhD

The Family Smoking Prevention and Tobacco Control Act of 2009 (TCA) requires tobacco product manufacturers to apply to the U.S. Food and Drug Administration (FDA) Center for Tobacco Products before introducing new products to the market. All new products must meet the standard of “appropriate for the protection of public health,” as determined by agency officials. While electronic nicotine delivery systems (ENDS), such as e-cigarettes, were not widely available and were not included in the original TCA, the law provides the FDA with the authority to deem new categories of tobacco products under its authority; the FDA deemed ENDS as tobacco products in May 2016. However, the FDA subsequently delayed pre-market tobacco product application (PMTA) deadlines for ENDS from 2018 to 2022. This decision contributed to a surge in youth uptake of ENDS and a perception among youth that the products were not harmful.

In response to this delay, a coalition of public health organizations sued the FDA to force timely action in 2019. The U.S. District Court agreed with the public health organizations that the FDA was required to move more quickly due to the “clear public health emergency” caused by ENDS. More than 6 million PMTAs for ENDS products were submitted by the court-ordered deadline of September 9, 2020, and the FDA was given one year to process all of the applications. To date, the FDA has granted marketing orders for one brand of ENDS, but denied 98 percent of the PMTAs for failing to demonstrate the products are “appropriate for the protection of public health.” These denials require manufacturers to remove their products from the market, but there has been limited enforcement action thus far. Concerningly, the FDA has yet to decide on PMTAs for ENDS products most popular among U.S. youth, which allows manufacturers to continue selling those products while the applications are pending. In January 2022, several public health organizations sent a letter to FDA CTP Director, Mitchell Zeller urging him to quickly reach decisions on the remaining PMTAs to protect public health.   

New HHS report finds ACA Provides No-Cost Access to Cancer Screenings for Hundreds of Millions of Americans

-Nicholas Warren, PhD

Preventive health services, such as cancer screenings, help patients by identifying a disease early or reducing the risk of being diagnosed with debilitating and costly diseases. A provision in the Patient Protection and Affordable Care Act of 2010 (ACA) requires private health insurance plans to cover preventive services with no out-of-pocket costs to patients if the service received an “A” or “B” grade from the U.S. Preventive Services Task Force (USPSTF). Examples of these services include routine screenings for colon, breast, cervical, and lung cancers, which greatly reduce the risk of dying from cancer.

A new report from the U.S. Department of Health and Human Services (HHS) found that more than 70 percent of Americans (232 million) now have health insurance plans covered by the ACA’s no-cost provision. Of these, 151 million were covered by private insurance plans, 61 million were Medicare beneficiaries, and 20 were million Medicaid expansion beneficiaries. The report found colon cancer screening rates benefited the most from the ACA, which contributed to decreased incidence and mortality from colon cancer and helped reduce disparities. Additionally, the USPSTF’s decision in 2021 to expand colon cancer screening guidelines to include patients as young as 45 years old will extend no-cost colon cancer screening to an additional 15 to 17 million Americans. These promising developments highlight the importance of the ACA in improving access to life- and cost-saving preventive services.

National Cancer Act of 1971: Fifty Years of Growing Survivorship

More people in the U.S. are alive after being diagnosed with cancer than ever before.  One reason is the influx of government investment in cancer centers and research labs resulting from the National Cancer Act. It advanced methods to detect cancer early and develop more effective treatments. Read article.

New Breast Cancer Risk Model Sets to Improve Health Equity

-Calais S. Prince, PhD

In the United States, non-Hispanic Black women diagnosed with breast cancer are younger, more likely to be diagnosed with advanced or aggressive forms of breast cancer, and have higher breast cancer related deaths when compared to non-Hispanic White women, highlighting significant cancer health disparities. There are many factors contributing to these cancer disparities including tumor biology, structural barriers preventing cancer screening, poverty, decreased primary care physician access, geographical isolation, and limited health care insurance. A new questionnaire based cancer risk model was developed across multiple institutions at the National Institutes of Health (NIH), the Carolina Breast Cancer Study (CBCS), the Black Women’s Health Study, and funded by the National Cancer Institute (NCI). The risk calculator aims to better predict the likelihood of breast cancer development in Black women under the age of 40. The success rate of this new model is comparable to the most used models to predict cancer risk in white women. Future efforts to improve the model at NCI’s Division of Cancer Epidemiology and Genetics involve analyzing genome wide association data from 300,000 women with breast cancer and 300,000 women without breast cancer across different races and ethnicities to develop and validate risk scores. Incorporating this model into electronic health records could better inform physicians about their patient’s breast cancer risk sooner, potentially bringing the biomedical field closer to addressing health equity.

Save the Date for the 2022 AACR-AACI Hill Day

The AACR and the Association of American Cancer Institutes (AACI) invite you to participate in a virtual Hill Day in support of cancer research on Capitol Hill on Wednesday, June 15, 2022. This Hill Day will bring cancer center directors, researchers, physician-scientists, cancer survivors and other advocates together to build support for a strong federal investment in biomedical research, and cancer research in particular, through the National Institutes of Health (NIH) and the National Cancer Institute (NCI).

Registration will open this spring; stay tuned for more information!