Converging Goals: Public Health & the Cancer Moonshot Initiative

This is the first post in a blog series on the National Comprehensive Cancer Network (NCCN) Policy Summit: Reducing the Cancer Burden through Prevention and Early Detection.

On September 16, the NCCN convened experts and stakeholders in D.C. for a policy summit spotlighting today’s cancer screening and prevention landscape, as speakers discussed what changes need to happen to create an equitable future for all people at risk—or not—for cancer. One such example of this future is the Cancer Moonshot Initiative and the work that is already being done to address inequities along the cancer care continuum. 

For example, the Association of Community Cancer Centers (ACCC) launched the Appalachian Community Cancer Alliance in June. By partnering with several of its oncology state societies, ACCC seeks to provide residents of the Appalachian Region with interdisciplinary, patient-centered approaches to cancer care, beginning with prevention and throughout survivorship, with an emphasis on enhanced quality of life. The alliance’s goal is to develop proven, practical solutions for improving the entire cancer care continuum in Appalachia and all underserved areas of the United States. The alliance aligns seamlessly with the goals of the Cancer Moonshot and was featured by Danielle Carnival, PhD, White House Cancer Moonshot coordinator, as one example of the progress that is being made as part of President Biden’s promise to “end cancer as we know it.”

The Role of Public Health

Public health is another key aspect of the Cancer Moonshot Initiative and integral to any effort looking to achieve equity in healthcare. According to Lisa Richardson, MD, MPH, director of the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention (CDC), public health offers support, especially in oncology/hematology, for mitigating disparities—it is the only disease that has federal legislation in place to require tracking and reporting of incidence, mortality, and more. 

This immense amount of publicly available data can and should be used to identify and mitigate health disparities to improve the patient experience and outcomes. Dr. Richardson is advocating for a more streamlined system at the CDC that would allow all data to be publicly shared much faster than its current model allows. By sharing trends and findings early, CDC data can be better used for quality benchmarking and improvement initiatives at local, state, and national levels. 

Just how do the CDC’s data and improvement efforts impact public health? Dr. Richardson shared that the agency’s efforts in increasing colorectal cancer screening is the best example of this work. The CDC utilized its Health Systems Change model in its Colorectal Cancer Control Program, emphasizing the use of multicomponent, evidence-based interventions to increase colorectal cancer screening among eligible adults. The program provided funding to applicable healthcare organizations to make changes at the system level, instilling an institutional change in thought: screening for colorectal cancer is not just a test; instead, it is a series of services that ends with no diagnosis or a confirmed diagnosis with treatment plans ready to be made.

Since the Colorectal Cancer Control Program’s inception in 2015, the CDC has reached 1.3 million patients (from just 50,000 patients) who qualify for colorectal cancer screening, working closely with more than 6,000 healthcare providers in about 800 clinics. The results: participating organizations that implemented 3 interventions saw a 12 percent increase and those that implemented 4 interventions saw a 33 percent increase in their colorectal cancer screening rate, which demonstrates an increase in providers’ use of multicomponent interventions to reach a confirmed diagnosis and improving colorectal cancer screening rates nationwide.

According to Dr. Richardson, CDC data and programs like the above offer support in identifying barriers to care, investigating and implementing solutions, and continuing to refine those solutions to ensure they are meeting the needs of every person entering the healthcare system. Additionally, the CDC is empowering scientists, getting accurate data from state health departments and health systems/hospitals, encouraging innovation, and promoting collaboration across organizations to improve public health in America. “If we don’t try, we’re never going to get there,” Dr. Richardson said, emphasizing that any public health efforts—whether on a local or national scale—should not be run by fear of failure. Instead, Dr. Richardson closed her keynote address by stating that it is important to fail, so you can learn from your experience, modify, and improve your solution(s)—a testament that can be applied to any cancer program or practice looking to mitigate the health disparities that impact their communities. 

Bringing It All Together

Just before this summit, on September 12, President Biden visited the JFK Library in Boston to further discuss his vision for the Cancer Moonshot Initiative. This address was in commemoration of the 60th anniversary of President Kennedy’s Moonshot speech. 

In his address, President Biden made 3 announcements:

• The appointment of Dr. Renee Wegrzyn as the inaugural director of the Advanced Research Projects Agency for Health, a new agency to drive biomedical innovation that supports the health of all Americans
• An executive order to launch the National Biotechnology and Biomanufacturing Initiative to ensure the U.S. continues to produce cutting-edge biotechnologies and other innovations
• An update of the Cancer Cabinet’s progress toward delivering game-changing cancer detection technologies and supporting talented researchers from across the nation.

As these announcements show, the Cancer Moonshot demonstrates President Biden's personal commitment to identify cancer as a federal priority and ending the disease as we know it. This priority then helps agencies like the CDC continue and improve the work they are doing, while bringing together stakeholders like ACCC to collaborate and develop partnerships to effect positive change in cancer care delivery.

In closing her keynote address, Dr. Carnival stated: “We need to bring the cancer care system to patients.” Delivering on this sentiment is where public health and the Cancer Moonshot Initiative converge.