[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4717 Introduced in Senate (IS)]
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119th CONGRESS
2d Session
S. 4717
To amend the Public Health Service Act to require the Director of the
National Institutes of Health to develop a national strategy to address
young adult cancers, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 9, 2026
Mr. Markey (for himself and Ms. Klobuchar) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to require the Director of the
National Institutes of Health to develop a national strategy to address
young adult cancers, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Asal Sayas National Strategy on
Young Adult Cancers Act''.
SEC. 2. FINDINGS.
Congress finds that--
(1) cancer is the second most common cause of death in the
United States, with over 2,000,000 new cases diagnosed annually
and an expected 626,140 cancer deaths in 2026;
(2) the incidence of cancer in individuals ages 18 to 49
(referred to in this section as ``young adults''), has risen 79
percent globally between 1990 and 2019, and mortality from
cancer in that age group has risen by 28 percent;
(3) the incidence of young adult cancers is predicted to
increase by 30 percent globally from 2019 to 2030;
(4) each year in the United States, approximately 200,000
young adults are diagnosed with cancer and approximately 30,000
young adults die from cancer;
(5) the incidence of cancers in young adult women is now 82
percent higher than the incidence of cancers in young adult
men, and cancers in young adult women has increased by 51
percent since 2002;
(6) the economic cost in the United States of young adult
cancers is estimated at $50,000,000,000 to $80,000,000,000
annually, due to costs relating to medical care, out-of-pocket
expenses, lost productivity, caregiver burden, and premature
deaths;
(7) rates of young adult cancers are increasing
significantly for digestive cancers, including colorectal and
pancreatic cancers, lung cancers, gynecological cancers,
including cervical, uterine, and ovarian cancers, breast
cancers, prostate cancers, testicular cancers, thyroid cancers,
melanoma, sarcoma, lymphoma, leukemia, and head and neck
cancers;
(8) colorectal cancers are the leading cause of young adult
cancer-related deaths in the United States, and the second-
leading cause of cancer overall;
(9) lung cancer is the leading cause of cancer death in
both men and women in the United States, and rates are rising
among young adults, including for non-smokers, the majority of
whom are women;
(10) some cancers, including colorectal cancers and lung
cancers, are more likely to be more advanced at diagnosis and
have worse survival rates for young adults than for individuals
in other age groups;
(11) current eligibility criteria for cancer screening,
including for colorectal and lung cancers, fail to identify
many young adults who develop these diseases;
(12) young adult cancers have significant short- and long-
term social and economic impacts on individuals, their
families, and society, and are linked to higher risk of long-
term health problems in survivors;
(13) the risk factors contributing to young adult cancers
remain complex and may include interaction of genetic and
biological factors, as well as lifestyle and environmental
exposures, making identification of at-risk groups difficult;
(14) young adults with cancer face an average delay of 7
months between symptom onset and treatment, versus 1 month for
individuals age 50 and over; and
(15) barriers to diagnosis for young adult cancers include
screening ineligibility linked to age, delay in presentation to
primary care after symptom appearance, more frequent
misattribution of symptoms to less severe conditions, and delay
in referral to a cancer specialist.
SEC. 3. NATIONAL STRATEGY TO ADDRESS YOUNG ADULT CANCERS.
Section 402 of the Public Health Service Act (42 U.S.C. 282) is
amended by adding the following:
``(p) Asal Sayas National Strategy on Young Adult Cancers.--
``(1) In general.--Not later than 18 months after the date
of enactment of the Asal Sayas National Strategy on Young Adult
Cancers Act, the Director of NIH shall develop and submit to
the relevant committees of Congress, and post on the websites
of the National Institutes of Health and the clearinghouse
established pursuant to paragraph (2)(G), a national strategy
to address young adult cancers, to be known as the `Asal Sayas
National Strategy on Young Adult Cancers'.
``(2) Requirements.--The national strategy under paragraph
(1) shall--
``(A) conduct and provide an inventory of current
young adult cancer research programs, initiatives, and
services across the National Institutes of Health and
other Federal agencies;
``(B) develop a national education campaign for the
public and health care professionals on the symptoms
of, and risk factors for, young adult cancers, which
shall--
``(i) identify culturally relevant
strategic priorities and objectives for such
national education campaign;
``(ii) provide education to, and raise
public awareness among, the general public
about symptoms and risk factors for young adult
cancers; and
``(iii) provide education to primary care,
emergency, obstetrics and gynecology,
pulmonary, and gastrointestinal health care
professionals and other health care
professionals regarding the signs, symptoms,
and risk factors for the leading types of young
adult cancers in the United States;
``(C) identify strategic research priorities and
objectives across biomedical, behavioral, and
environmental research areas, including by--
``(i) conducting an assessment of young
adult cancer research, including areas of
opportunity with respect to basic, clinical,
epidemiologic, and translational research;
``(ii) determining priorities and
objectives to advance the diagnosis, treatment,
cure, and prevention of young adult cancers;
``(iii) evaluating issues relating to
improving access to care for young adults with
cancer;
``(iv) identifying emerging scientific
opportunities, rising public health challenges,
and scientific knowledge gaps; and
``(v) evaluating opportunities for new
technologies to identify risk factors,
biomarkers, and targeted therapies for young
adult cancers;
``(D) review, in carrying out subparagraph (B)--
``(i) disease burden in the United States
of young adult cancers in total and by cancer
type, including the potential for an economic
return on investment to the United States, due
to lives saved, increased productivity, and
decreased medical costs, from funding research,
prevention, screening, diagnostics, treatment,
and cures;
``(ii) differences among young adult
cancers in total and by cancer type among
sociodemographic groups, including by--
``(I) sex;
``(II) race and ethnicity;
``(III) status as a veteran, member
of the Armed Forces, or family member
of a veteran or member of the Armed
Forces;
``(IV) disability status;
``(V) professions that may increase
cancer risk; and
``(VI) Tribal populations, rural
populations, and medically underserved
populations (as defined in section
330(b)(3));
``(iii) multi-institute and multi-agency
priorities, including coordination of research
among the national research institutes, the
national centers, and Federal agencies;
``(iv) barriers to participation in
clinical trials for young adults;
``(v) special needs associated with
treatment among the non-pediatric young adult
population, such as concerns associated with
preserving fertility, mental health issues, and
employment;
``(vi) existing Federal resources, such as
reports, databases, and guidance; and
``(vii) other factors the Director of NIH
determines appropriate, in consultation with
the Director of the National Cancer Institute,
the heads of other national research
institutes, and the heads of Federal agencies;
``(E) provide recommendations with respect to--
``(i) advancing biomedical, lifestyle, and
environmental research into the causes of young
adult cancers, by type of cancer;
``(ii) improving methods for early
detection and screening of young adult cancers,
by type of cancer, including education
campaigns for the public and health care
professionals and resources to increase
awareness of symptoms;
``(iii) improving screening guidance and
the development of new diagnostics with respect
to various types of young adult cancers;
``(iv) reducing barriers to insurance
coverage of screening for young adult cancers;
``(v) ensuring timely reviews of cancer
screening recommendations by the United States
Preventive Services Task Force that assess
research findings for cancers that are rising
in young adults;
``(vi) applying technologies, including
innovative electronic health record tools, to
identify biomarkers and other risk factors and
to target treatment options for young adult
cancers;
``(vii) applying technologies, including
innovative electronic health record tools, to
increase the use by health care providers of
recommendations for identification of symptoms,
family history, hereditary syndromes, or other
risk factors that could contribute to the young
adult cancer diagnosis;
``(viii) evaluating current therapies and
developing new treatments, including biomarker
identification and precision medicine, for
young adult cancers;
``(ix) addressing and disseminating
prevention strategies;
``(x) addressing barriers to conducting
research regarding young adult cancers;
``(xi) addressing barriers to participation
in clinical trials for young adults with
cancer;
``(xii) increasing efforts to improve
medical education and knowledge among health
care professionals of young adult cancers,
including risk factors, symptoms, screening and
early detection techniques, prevention, and
treatment options;
``(xiii) establishing within the National
Cancer Institute a National Centers of
Excellence for Young Adult Cancers program (or
a comparable alternative) that would create and
support hubs across the United States for
research, clinical care, and public and
professional education;
``(xiv) supporting the psychosocial needs
of individuals undergoing treatment for young
adult cancers, including family, fertility
preservation, and work-related issues;
``(xv) addressing the needs of caregivers
of young adult cancer patients; and
``(xvi) other topics, as determined by the
Director of NIH, in consultation with the
Federal Coordinating Committee on Young Adult
Cancers established under paragraph (3)(A);
``(F) describe opportunities for collaboration with
Federal departments and agencies and the private
sector, as appropriate; and
``(G) establish an online Federal clearinghouse to
provide to the general public, patients, caregivers,
health care professionals, and researchers information
on young adult cancers, with resources, including--
``(i) information on risk factors,
symptoms, and screening eligibility;
``(ii) information regarding research
findings, clinical trials, and research funding
opportunities; and
``(iii) clinical practice guidelines for
health care professionals.
``(3) Federal coordinating committee on young adult
cancers.--
``(A) In general.--In carrying out this subsection,
the Director of NIH shall establish a committee, to be
known as the `Federal Coordinating Committee on Young
Adult Cancers'--
``(i) to consult and provide input on the
development of the national strategy under
paragraph (1); and
``(ii) not less frequently than once every
2 years, to submit to the relevant committees
of Congress a progress report regarding the
implementation of such national strategy.
``(B) Membership.--The coordinating committee
established under subparagraph (A) shall be composed
of--
``(i) the Director of the National Cancer
Institute;
``(ii) the heads of other national research
institutes, national centers, and offices
within the National Institutes of Health, as
determined appropriate by the Director of NIH,
including the National Heart, Lung, and Blood
Institute, the National Institute of Diabetes
and Digestive and Kidney Diseases, the Eunice
Kennedy Shriver National Institute of Child
Health and Human Development, the National
Human Genome Research Institute, the National
Institute of Mental Health, the Office of
Research on Women's Health, and the National
Institute on Minority Health and Health
Disparities;
``(iii) the Director of the Office of
Science and Technology Policy;
``(iv) the Secretary of Health and Human
Services;
``(v) the Director of the Centers for
Disease Control and Prevention;
``(vi) the Administrator of the Centers for
Medicare & Medicaid Services;
``(vii) the Commissioner of Food and Drugs;
``(viii) the Assistant Secretary for Mental
Health and Substance Use;
``(ix) the Director of the Indian Health
Service;
``(x) the Director of the Office of
Minority Health of the Department of Health and
Human Services;
``(xi) the Director of the Office on
Women's Health of the Department of Health and
Human Services;
``(xii) the Director of the Agency for
Healthcare Research and Quality;
``(xiii) the Director of the Advanced
Research Projects Agency-Health;
``(xiv) the Assistant Secretary of Defense
for Health Affairs;
``(xv) the Under Secretary for Health for
the Department of Veterans Affairs;
``(xvi) the Director of the Office of
Science of the Department of Energy;
``(xvii) the Director of the National
Science Foundation;
``(xviii) the Administrator of the
Environmental Protection Agency;
``(xix) representatives of patient advocacy
groups;
``(xx) representatives of academic research
institutions;
``(xxi) representatives of the biomedical
industry;
``(xxii) representatives and leaders of
community health institutions; and
``(xxiii) others, as determined by the
Director.
``(4) Definitions.--In this subsection:
``(A) Relevant committees of congress.--The term
`relevant committees of Congress' means--
``(i) the Committee on Health, Education,
Labor, and Pensions of the Senate;
``(ii) the Committee on Finance of the
Senate;
``(iii) the Committee on Appropriations of
the Senate;
``(iv) the Committee on Energy and Commerce
of the House of Representatives;
``(v) the Committee on Ways and Means of
the House of Representatives; and
``(vi) the Committee on Appropriations of
the House of Representatives.
``(B) Young adult.--The term `young adult' means an
individual between the ages of 18 and 49.''.
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