“Mr. BLUNT, from the Committee on Appropriations, submitted the following R E P O R T…”

Excerpt taken from p. 90 – 91 of the REPORT

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2020

Childhood Cancer Data Initiative.—The Committee strongly supports the budget request to focus $50,000,000 a year toward pediatric cancer research over the next 10 years. The full budget request provided in the bill will facilitate a connected data infrastructure and integrate multiple data sources to make data work better for patients, clinicians, and researchers. 

Deadliest Cancers.—The Committee remains concerned that while more effective screening methods and treatments have lowered overall cancer incidence and death rates, several cancer types with particularly low survival rates have limited screening methods, and effective treatments for these cancers are also limited. The Recalcitrant Cancers Research Act of 2012 defined ‘‘recalcitrant cancers’’ as those with a 5 year survival rate below 50 percent. These cancers account for nearly half of all cancer deaths in the United States and include cancers of the brain, esophagus, liver, U:\2020REPT\07REPT\07REPT.006 September 17, 2019 (6:03 p.m.) 91 lung, ovary, pancreas, and stomach. The Committee notes that in 2020 NCI will report on the effectiveness of the scientific frameworks process NCI undertook for pancreatic adenocarcinoma and small cell lung cancer to improve prevention, detection, diagnosis and treatment.

NCI developed these frameworks at Congress’ direction for cancers with a 5 year survival rate of less than 20 percent and expected toll of at least 30,000 deaths per year in the United States. The Committee appreciates that NCI has led scientific planning efforts in recent years to explore research opportunities related to pancreatic cancer, small cell lung cancer, liver cancer, and glioblastoma. Given the high cost recalcitrant cancers exact on society and the lack of diagnostic and treatment resources currently available to help patients, the Committee directs NCI develop a scientific framework using the process outlined in the Recalcitrant Cancer Research Act of 2012 for stomach and esophageal cancers. These cancers have 5 year survival rates below 50 percent and are collectively expected to kill approximately 27,000 Americans in 2020. The Committee also urges NIH and NCI to continue to support research with an emphasis on developing screening and early detection tools and more effective treatments for all recalcitrant cancers. The Committee expects to receive an update on NCI-supported research to advance these goals in the fiscal year 2021 CJ. Also, the Committee directs NIH to add esophageal and stomach cancers to future Research, Condition, and Disease Categorization reports. 

Finally, the Committee recognizes that while overall cancer death rates continue to decline, successful treatment for some cancers, including many forms of childhood cancer, remains elusive.  The Committee encourages NCI to place a high priority on researching these cancers, which include anaplastic astrocytoma, diffuse intrinsic pontine glioma, glioblastoma, Juvenile myelomonocytic leukemia, high-risk neuroblastoma, recurrent osteosarcoma, rhabdomyosarcoma, and diffuse anaplastic Wilms tumors. The Committee requests an update on the progress being made for childhood cancer research in the fiscal year 2021 CJ. 

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