The Biden Cancer Moonshot: Ending Cancer As We Know It

In 2022, President Biden and First Lady Jill Biden reignited the Cancer Moonshot and set two bold but achievable goals-to cut the cancer death rate by at least half by 2047, preventing more than four million cancer deaths, and to improve the experience of people living with and surviving cancer. The Biden-Harris Administration, thanks to the leadership of the President and First Lady, has made tremendous progress in cancer prevention, detection, treatment, and care. This progress includes more than 125 new government actions and new commitments from more than 250 companies, nonprofits, academic institutions, and patient groups.

Ending cancer as we know it is core to President Biden's Unity Agenda, a set of priorities that Americans from every walk of life can support. The President and First Lady drove a whole-of-government response, including the formation of the first-ever Cancer Cabinet, bringing together more than 20 cabinet agencies, departments, and offices. The Biden-Harris Administration has delivered meaningful action, improving cancer prevention, early detection, treatment, and survivorship for the American people.

The Biden Cancer Moonshot achieved groundbreaking accomplishments:

• Made extraordinary investments and took historic actions to prevent cancer-including protecting 100 million Americans from exposures to per- and polyfluoroalkyl substances (PFAS), known as forever chemicals, and taking action to decrease smoking, the single largest driver of cancer deaths;
• Expanded efforts to catch cancer early when it is easiest to treat, bringing cancer screenings to more communities and recovering from 10 million screenings missed during the COVID-19 pandemic;
• Created a new research agency-the Advanced Research Projects Agency for Health (ARPA-H)-and delivered investments to drive innovative ways to prevent, detect, and treat cancer, and reach more people and communities; and
• Delivered first-ever reimbursable navigation services to improve the experience of millions facing cancer and improved access to and affordability of cancer care for all Americans.

UNPRECENDENTED ACTIONS TO END CANCER AS WE KNOW IT

The Biden Cancer Moonshot has driven a whole-of-society approach to tackling this disease. Since the Cancer Moonshot's reignition, private organizations including advocates, industry, health care payers and providers, people living with cancer and survivors, physicians, and researchers have stepped up to advance the goals of the Biden Cancer Moonshot.

From a new pilot to mitigate pediatric cancer drug shortages, to hundreds of bold actions and commitments that will ensure the momentum of the Biden Cancer Moonshot carries into the future, the public heeded the President's call to action with unprecedented private sector support to reduce the deadly impact of cancer and enhance survivorship.

This progress report details the historic impact that the Biden Cancer Moonshot has had on cancer prevention, early detection, innovation, and support for those facing cancer. This report also includes details on how this work will continue in 2025 and beyond.

PREVENTION: Delivered generational investments and actions to prevent cancer and protect Americans' health

Meeting the Biden Cancer Moonshot's goal of averting more than 4 million cancer deaths by 2047 requires preventing cancers before they start.

Reducing tobacco-related deaths: A major priority for President Biden and the Biden Cancer Moonshot is working to prevent cancer by tackling the largest single driver of cancer deaths in this country- tobacco smoking.

• The Food and Drug Administration (FDA) issued a proposed rule that, if finalized, would set a maximum nicotine level in certain combustible tobacco products, including cigarettes, thereby making them minimally or non-addictive. This rule would be the first of its kind globally-and a major step forward to reduce tobacco-related disease and death for millions of Americans. This rule puts the power back in the hands of individuals, enabling those who want to quit to be successful and preventing millions of youths and others from starting in the first place.

• The Biden Cancer Moonshot expanded programs across the Biden-Harris Administration to deliver effective smoking cessation services to more Americans, including veterans. For example, the Department of Health and Human Services (HHS) expanded a partnership between the National Cancer Institute (NCI) and the Indian Health Service to provide a new smoking cessation text message program-SmokefreeNATIVE-to help American Indian and Alaska Native adults and teens to quit smoking, and launched a new partnership between NCI and the Department of Veterans Affairs (VA) to engage veterans in tobacco-use treatment programs.

• The Biden-Harris Administration took historic actions to reduce e-cigarette use by American children to a record low, falling from 13% (or 3.6 million) of high school and middle schoolers in 2020 to 6% (or 1.6 million) in 2024. This is, in large part, due to public education campaigns and significant industry enforcement action-including warning letters, civil monetary penalties, and seizure of illegal products at the border-that the Administration has taken to ensure e-cigarettes not authorized by the FDA are not on the market. While the impact on cancer is far less significant than smoked tobacco products, e-cigarettes often include chemicals and particles that can be inhaled deep into the lungs.

Eliminating harmful exposures: The Bipartisan Infrastructure Law delivered a once-in-a-generation, multibillion-dollar investment in reducing environmental and toxic exposures known to cause cancer and other health effects, especially protecting at-risk communities that have too long suffered from the burden of exposures.

• The Biden-Harris Administration made historic investments to provide clean drinking water to all American families, dedicating more than $20 billion to remove PFAS, so-called forever chemicals, and other contaminants such as lead that cause cancer and other health issues. Since President Biden took office, more than 367,000 lead pipes have been replaced nationwide, benefitting 918,000 people by reducing exposures to this and other potent neurotoxins and carcinogens. The Environmental Protection Agency (EPA) also issued a final rule requiring drinking water systems across the country to replace every lead pipe in the country within 10 years, protecting Americans further from the dangers of lead exposure.

• This Administration established the first-ever national legally-enforceable drinking water standard for PFAS in April 2024, which will protect 100 million Americans from exposure to these cancer-causing contaminants.

• Through the Bipartisan Infrastructure Law, EPA dedicated more than $3 billion for cleanup projects at more than 100 toxic Superfund sites across the country. These sites include toxic chemicals from manufacturing facilities, processing plants, landfills, and mining, and can harm the health and well-being of local communities in urban and rural areas.

• After decades of attempts, the Biden-Harris Administration enacted a ban on chrysotile asbestos, the only known form of asbestos still used in the United States. Asbestos has long been linked to several cancers, including lung cancer and mesothelioma.

• The EPA also issued rules which will cut emissions of a potent carcinogen, ethylene oxide, by more than 90%.

• Under this Administration, the EPA expanded the reach of and strengthened the Safer Choice program, which helps consumers find certified products that maintain performance and do not contain listed carcinogens, including chemicals that release, form, or degrade to byproducts that are carcinogens, among other standards. The annual total volume of Safer Choice products increased, from 1.6 billion pounds in fiscal year (FY) 2021 to 2.4 billion pounds in FY2024. As of April 2024, the General Services Administration now requires government contractors to use products that meet strict health and environment standards such as Safer Choice, protecting custodial workers, federal employees, and those who visit government buildings every day.

Improving Nutrition: According to some estimates, upwards of 40-45% of cancers are related to factors impacted by diet, nutrition, and exercise. The Biden-Harris Administration took significant steps to increase healthy eating and prevent diet-related diseases, such as cancers, as part of the President's National Strategy for Hunger, Nutrition, and Health.

• Efforts spanned 20 federal agencies and included accelerating research on diet-related chronic diseases, including cancer, and translating research into impactful solutions that improve public health and well-being.

• Among other efforts, the Administration reduced sodium in foods, made school meals healthier, galvanized a Food Is Medicine movement to help ensure every American family has access to affordable, nutritious foods, integrated nutrition into the health care system, and fostered environments where Americans have the knowledge they need to make informed, healthy choices.

• The U.S Department of Agriculture instituted the Agricultural Science Center of Excellence for Nutrition and Diet for Better Health (ASCEND for Better Health), a virtual center to accelerate research on diet-related chronic diseases, including cancer, through partnerships with academic and human nutrition research centers. After starting with six centers in 2023 and 2024 focused on enabling research through big data and translating research through engagement with extension and community leaders focused in Black communities, ASCEND is adding six additional hubs to advance community engagement efforts in Hispanic, Tribal, and Insular Territory communities.

• To further the goals of the National Strategy for Hunger, Nutrition, and Health, the Biden-Harris Administration galvanized more than $10 billion in external commitments including through the White House Challenge to End Hunger and Build Healthy Communities.

Addressing infectious disease-related cancers: Vaccines that protect against human papillomavirus (HPV) infection can substantially reduce the risk of cervical cancer, and up to six cancers attributable to HPV.

• Under this Administration, NCI and Costa Rica investigators launched the ESCUDDO efficacy trial. ESCUDDO aims to evaluate the sufficiency of a single dose of HPV vaccination compared with two doses, which was the standard. If one dose is sufficient, vaccine uptake can become more widespread, reducing rates of HPV-related cancers, and helping us reach global goals to eliminate cervical cancer.

• CDC's Immunization Services Division entered cooperative agreements with the American Cancer Society (ACS) to improve HPV vaccination rates and vaccine equity through education, quality improvement projects, and other collaborative activities.

EARLY DETECTION: Rebounded from 10 million pandemic-era missed cancer screenings with a focus on equity

Over the course of the pandemic, Americans collectively missed more than 10 million recommended cancer screenings. Because screening enables cancer detection when it is most treatable, the President and the First Lady announced a call to action to improve access to and utilization of cancer screenings, with a focus on equity. Through her travel and collaborations, including with the National Football League's "Crucial Catch", Lifetime's "Stop Breast Cancer for Life", and the American Cancer Society, the First Lady focused on raising awareness of the importance of cancer screenings. Today, the United States has recovered from those missed screenings, which sets millions of Americans on a course for better cancer outcomes.

Because of the Biden Cancer Moonshot, nearly 8 million people received necessary screenings for breast, colorectal, lung, cervical, prostate, and skin cancer in response to outreach through telehealth, mobile screening vehicle events, and at-home screening. Nearly 400,000 of those screened had abnormal screening results that led to further diagnostic testing and early detection of cancer.

Expanding no-cost screenings: Expanded screening recommendations have unlocked no-cost cancer screening for millions of more Americans. As a result of new screening policies, more Americans can get screened to prevent cancer or detect cancers early, saving up to an estimated 200,000 lives.

• These guidelines include the United States Preventive Services Task Force (USPSTF) recommendation of starting colorectal cancer screening at age 45 rather than 50, expanded lung cancer recommendations to reach more at-risk individuals, and updating the recommendation for all women over 40 to receive breast cancer screenings every other year.

• Because of the direct efforts of the Biden Cancer Moonshot, people who make use of stool-based screening tests for colorectal cancer can now access no-cost colonoscopies, even after a positive result at home, rather than facing cost-sharing for diagnostic colonoscopy follow-ups.

Improving Screening Access: To improve access to screening in underserved communities, HHS invested $25 million over the past three years to partner Health Resources and Services Administration-funded health centers with NCI-Designated Cancer Centers so that more medically underserved people have access to recommended screenings and a path to receive a diagnosis and treatment. Additionally, the Centers for Disease Control and Prevention (CDC) committed $1 billion and has already delivered more than $250 million as part of the Biden Cancer Moonshot for cancer screening programs reaching underserved communities in every state, and many U.S. territories and Tribal organizations.

Taking care of our veterans: VA is making lung cancer screening available at every VA facility nationwide and has expanded at-home colorectal cancer screenings for more than 300,000 veterans. Notably, since the reignition of the Biden Cancer Moonshot, VA reported an 81% increase in veterans screened for lung cancer.

In response to the President and First Lady's call to action, the Biden Cancer Moonshot also secured cancer screening actions from the private sector that directly impacted 1 million Americans, and additional commitments from major corporations-including United Airlines, Target, and Lyft-to expand access to cancer screenings for American workers.

INNOVATION: Drove innovative ways to prevent, detect, and treat cancer to reach more people and communities

Investing in innovation:

• President Biden worked on a bipartisan basis with members of Congress to realize his vision and provide $4 billion in funding for ARPA-H, a new biomedical research agency charged with improving American health outcomes. With more than $500 million already committed to prevent, detect, and treat cancer, ARPA-H is driving high-risk, high-reward innovations to combat cancer and other diseases. Notable cancer-focused ARPA-H programs and projects include:
• Advanced Analysis for Precision cancer Therapy (ADAPT), to develop next-generation tools that predict the optimal treatment for each person facing advanced cancer, monitor tumors and determine precisely when they change, and ensure patients receive the right treatment at the right time.
• Precision Surgical Interventions (PSI), to develop technologies that will allow surgeons to perform more successful tumor-removal surgeries for people facing cancer. For the nearly two million Americans who are newly diagnosed with solid tumor cancers each year, surgical removal is often the first step in their treatment. PSI aims to make these surgeries more effective, reducing the need for repeat surgeries and decreasing the damage to healthy tissue, ultimately saving and extending lives.
• Curing the Uncurable via RNA-Encoded Immunogene Tuning (CUREIT), to develop generalizable mRNA platforms that can be harnessed to train the immune system to more effectively fight cancer and other diseases.
• ML/AI-Aided Therapeutic Repurposing In eXtended uses (MATRIX), to build a machine learning platform to rapidly pinpoint and validate existing medications to treat rare diseases, like many cancers, that currently have no effective therapies.
• Platform Optimizing SynBio for Early Intervention and Detection in Oncology (POSEIDON), to develop first-in-class, over the counter Multi-Cancer Detection (MCD) tests that screen for 30+ cancers at Stage 1. By putting affordable, accessible screening tools into the hands of more people across the country, POSEIDON seeks to increase survival rates and decrease cancer-related costs.

• As a result of the Biden Cancer Moonshot, the NCI has received a $4 billion budget increase during the Biden-Harris Administration over the prior four years.

• The Biden-Harris Administration has prioritized innovation for our nation's military service members and veterans facing cancer through over $400 million invested in both VA and the Department of Defense (DOD) in research initiatives addressing cancer in exposed service members.

• In addition, several federal agencies, including VA, the National Aeronautics and Space Administration (NASA), the Department of Agriculture (USDA), and DOD have mobilized funding that support cancer research, totaling $1.71 billion.

Reaching more people with clinical trials: Investments through FDA and the National Institutes of Health (NIH) continue to ensure clinical trials reach more communities and have diverse representation.

• FDA's Oncology Center for Excellence (OCE), created as part of the Cancer Moonshot and authorized in 2016 by the bipartisan 21^st Century Cures Act, has launched numerous projects focused on improving the generalizability of clinical trial data to the U.S. population to help ensure products are safe and effective for the intended population. Select examples include the OCE Equity Program to improve access to clinical trials for historically underrepresented populations, Project Patient Voice to facilitate patient-reported symptom data collected from cancer clinical trials, and Project ASIATICA to engage with Asian American, Native Hawaiian, and other Pacific Islander patients with cancer.

• NIH launched a $30 million pilot to test the feasibility of a national primary care research network, an innovative approach to integrate clinical trials and other scientific research into primary care settings.

Supporting future innovation:

• As part of the Biden Cancer Moonshot, HHS launched CancerX, a national accelerator to drive progress against cancer. This accelerator has already announced 16 startup companies in the inaugural cohort to bring innovation to people in the areas of clinical research; screening and diagnosis; treatment and management; clinical operations; and patient, caregiver, and survivor experience.

• The National Institutes of Science and Technology, along with Massachusetts General Hospital and the Genome in a Bottle Consortium, published extensive DNA sequence data from the first pair of tumor and normal samples from an individual with pancreatic cancer who gave permission for public data sharing. These public data and samples will help enable development of sequencing technologies, benchmarking of AI, and translation of new technologies to validated clinical tests for guiding cancer treatments.

• To continue progress and support the next generation of world-class and diverse scientists and cancer innovators, the Biden Cancer Moonshot launched the Cancer Moonshot Scholars program at NCI. This program has already supported two cohorts, 22 innovative early-career researchers from across the country that represent the diversity of the United States with over $11 million in investment to accelerate progress to end cancer as we know it.

The interagency work of the Cancer Cabinet to drive innovation that is reaching more communities includes:

• Leveraging AI to automate the extraction of critical clinical data from electronic health records, streamlining processes to enhance accuracy, efficiency, and scalability in cancer research;
• Promoting the implementation of decentralized federal government and private sector clinical trials;
• Conducting a comprehensive review of federal initiatives aimed at transforming clinical trials through improved diversity, innovative trial design and data infrastructure;
• Convening key stakeholders to identify barriers and opportunities to responsibly advance AI for drug development; and
• Developing a whole-of-government guide related to AI-enabled clinical decision making.

Advancing groundbreaking new research and delivering innovation to those facing cancer will continue in the work of these agencies and departments-with an emphasis on ensuring that all patients and communities, especially those in underserved communities, receive effective and affordable care for cancer.

SUPPORT: Boosted support and improved access and affordability of cancer care for all Americans

Addressing access and cost:Cancer is one of the costliest diagnoses a person can face in the United States. Thanks to President Biden's leadership, more Americans are able to receive the cancer care they need.

• More Americans than ever before have health insurance thanks to the Administration's efforts to expand the Affordable Care Act and lower premiums by an average of $800 per person per year.

• As a result of the Inflation Reduction Act, millions of Americans have already saved on their medications, and this year, millions of seniors on Medicare will save up to tens of thousands a year with the $2,000 out-of-pocket cap on prescription drugs. This is especially important for those receiving cancer drugs, which are among the most expensive drugs for Medicare beneficiaries.

• To expand care for those in underserved communities, under the leadership of the First Lady the Biden Cancer Moonshot worked to finalize proposals from CMS that, for the first time ever, enable Indian Health Services and Tribal facilities to receive separate payment for high-cost drugs for people with Medicare, increasing clinics' ability to provide certain health care services, like cancer treatment, in Tribal communities.

Boosting support for families facing cancer: With the transformative leadership of President Biden and First Lady Jill Biden to improve the lives of those facing cancer, in November 2023, the Biden Cancer Moonshot made history by ensuring that for the first time ever, cancer navigation services can be reimbursed through Medicare and-with the American Medical Association's updated guidance-through private health care insurers.

• To advance access to these critical navigation services, in 2024, the Biden Cancer Moonshot worked with leading national and regional health insurers, cancer centers, and oncology practices nationwide to make navigation accessible to more than 150 million Americans, including more than 60 million people who are enrolled in Medicare.

• Early data is demonstrating the transformative impact of these newly reimbursable navigation services. Across Centers for Medicare & Medicaid Services (CMS) and commercial health insurers, navigation code utilization has seen a dramatic increase, with tens of thousands of navigation claims being processed since January 1, 2024. Cancer centers are also reporting expanded access to timely, high-quality care and improved outcomes for especially vulnerable populations.

• Additionally, the Department of Labor created new resources to help workers living with cancer, their caregivers, and cancer survivors understand and make use of their rights under the Family and Medical Leave Act.

Delivering support to veterans and families: When President Biden signed the bipartisan Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act, it enacted the most significant expansion of benefits and services for toxic-exposed veterans and their survivors in generations.

• At President Biden's direction, the Department of Veterans Affairs (VA) expedited health care and benefits eligibility under the PACT Act by several years for veterans who were exposed to toxins and other hazards while serving in the military - at home or abroad.

• VA has conducted the largest outreach campaign in the history of the department under the PACT Act, driving all-time record benefits applications and a robust increase in health care enrollments. That means more than 1.4 million veterans and more than 13,000 survivors are now getting monthly disability benefits for toxic exposure-related illnesses, including more than 100 cancers.

• Over 6.0 million veterans have been screened for toxic exposures and more than 860,000 veterans have enrolled in VA health care since the PACT Act was signed into law.

• Furthermore, more than 900,000 veterans have had their priority groups upgraded, making them eligible for care with fewer copays.

• For survivors of veterans who died from a toxic exposure-related illness, the PACT Act provides a pathway to benefits including monthly stipends, access to home loans, as well as education benefits. Surviving veteran spouses with children can qualify for over $2,000 per month and funding toward college tuition.

• Additionally, as part of the Biden Cancer Moonshot, VA has prioritized claims processing for veterans with cancer.

• VA also expanded delivery of high-quality, coordinated cancer care closer to veterans' homes. By the end of FY2025, VA will expand cancer treatment at VA outpatient clinics to an additional 30 health care systems, with the capacity to serve an additional 9,000 veterans each year. VA launched this care delivery model with the first pilot in 2021 and has treated nearly 2000 veterans at 35 VA locations, saving veterans undergoing cancer treatment and their caregivers more than 350,000 traveled miles.

As part of the Cancer Cabinet, the interagency work of the Biden Cancer Moonshot focused on supporting and centering those facing cancer and their caregivers, including by establishing the National Standards for Survivorship Care, a set of recommendations for health systems providing care for cancer survivors that can be used to assess existing care or improve the quality of survivorship care services; expanding VA's National Oncology Programs Close to Me care delivery model to 30 new VA health care systems; and developing an implementation toolkit and complementary manuscript to better integrate patient-reported outcomes related to symptoms and functioning across federal agencies and into routine clinical care.

The ongoing work to support patients and caregivers will ensure that underserved communities are receiving the same high-quality care provided elsewhere, and that those facing cancer are better able to navigate the health care system to achieve the best possible outcome.

GLOBAL CANCER MOONSHOT

While the central goals of the Biden Cancer Moonshot are domestic in focus, the ambitions and impact have extended far beyond our borders. The Biden-Harris Administration officially expanded this focus with the launch of the Global Cancer Moonshot, which has driven transformative progress through the Cancer Cabinet and private sector. The Global Cancer Moonshot has set a particular focus on low- and middle-income countries, which shoulder the burden of 70% of world cancer deaths.

• In the Indo-Pacific, the United States, alongside our partners in the Quad countries-Australia, India, and Japan-launched the Quad Cancer Moonshot, focusing on decreasing or even eliminating the impact of cervical cancer in the region. This initiative will significantly expand HPV vaccination, screening, and treatment in the region which will save hundreds of thousands of lives.

• To decrease the impact of cancer in Africa, the Biden Cancer Moonshot convened the first White House Africa Cancer Care Forum, fostering investment and collaboration across the continent. This effort secured over $100 million in new commitments from government and private sector partners to reduce the burden of cancer, focusing on improving prevention, early detection, screening, treatment and survivorship. This builds on the previous commitment of $300 million announced by First Lady Jill Biden during the U.S.-Africa Leaders' Summit held in 2022.

• The Biden Cancer Moonshot strengthened collaborations between the United States and India through the first ever U.S.-India Cancer Dialogue, prioritizing innovation, equitable care delivery, and expanded clinical trials. Collectively, these global efforts are mobilizing critical resources, enhancing research, and improving access to advanced technologies like imaging, diagnostics, and life-saving treatments, particularly in low- and middle-income countries.

• The International Cancer Proteogenome Consortium (ICPC) fosters enhanced coordination and data sharing among research centers from 14 countries and seeks to deepen our understanding of the biological diversity of cancer. The data generated are made publicly accessible for the scientific community. This model ensures that the data can be widely used to accelerate breakthroughs in cancer research and care.

• Additionally, the Biden Cancer Moonshot strengthened bilateral cooperation between the United States and the United Kingdom through a scientific summit focused on identifying transformative research grand challenges and ways to resolve barriers to progress in cancer research-including prevention and early detection, delivering faster and better new treatments and interventions, and working with patients and their families to deepen the understanding of cancer.

• Recently, the European Union (EU)-U.S. Health Task Force was launched to underscore a shared commitment to advancing cancer research, prevention, and treatment through international collaboration. The Task Force developed two specialized expert-level working groups on Childhood and Young Adult Cancer and Adult Lung Cancer. This transatlantic partnership highlights the importance of uniting global expertise to research cancer more effectively and ensure better outcomes for patients worldwide.

To further mobilize resources and innovation for cancer care, the Biden Cancer Moonshot has supported the creation of a Global Cancer Fund, modeled after successful global health initiatives. The fund aims to address critical gaps in cancer prevention, diagnosis, and treatment in low-and middle-income countries. By leveraging public-private partnerships, the fund will accelerate research, expand clinical trials, and strengthen health care infrastructure in regions most in need.

THE WAY FORWARD

Prevent More Cancers Before They Start

FDA plays a critical role in innovation, education, and supporting research for cancer prevention. To this end, FDA will continue efforts to facilitate the development of new treatments for patients trying to cease use of tobacco products. FDA will also continue to mitigate nutrition-related cancer risks by providing information and tools that help consumers make more informed food choices, and by encouraging industry to make foods healthier.

CDC has consistently made comprehensive, coordinated cancer prevention and control a core part of their work. In the years ahead, CDC will continue to bolster tobacco prevention, control, and surveillance efforts, including addressing tobacco use among youth and encouraging smoking cessation among adults through the successful Tips From Former Smokers^® (Tips^®) campaign. CDC will continue to place Tips^® ads on platforms that reach populations with the highest smoking prevalence, support Tobacco Quitline services, and enhance community-based program efforts to increase awareness of cessation services and coverage options among populations experiencing health disparities. Additionally, CDC will continue to make progress on the Healthy People 2030 goals to increase HPV vaccinations in order to eliminate cervical cancer and prevent seven other HPV-related cancers impacting tens of thousands of Americans each year.

USDA plays a vital role in advancing research and implementing solutions at the intersection of nutrition and disease. The Human Nutrition research program within USDA's Agricultural Research Service will conduct cutting-edge studies in precision nutrition research to identify the factors and mechanisms linking food and diet quality with optimal health and the prevention of diet-related cancers and other diseases. USDA's Economic Research Service will collect data and provide analyses of the relationship of food insecurity rates and the incidence rate of cancer and other diseases among Americans and in different demographic groups. These analyses will raise awareness about the link between diet and the prevention of chronic diseases. Continued efforts will include supporting the HHS-led Federal Food as Medicine Collaborative that recently launched a new website highlighting more than 130 USDA-relevant resources.

Understand and Prevent Toxic and Environmental Exposures

EPA plays a critical role in determining unreasonable risks to human health through environmental exposures. In November 2024, EPA released the final Risk Evaluation for Asbestos Part 2: Supplemental Evaluation Including Legacy Uses and Associated Disposals of Asbestos, conducted under the Toxic Substances Control Act (TSCA), the nation's chemical safety law. Now, EPA will begin the risk management process to address the risks associated with legacy uses and disposal of asbestos. Additionally, EPA will release a proposed rule under TSCA section 6 to protect people from the identified risks. In July 2024, EPA proposed to designate five chemicals as High-Priority Substances for risk evaluation under TSCA. If EPA finalizes these designations as proposed, the agency would immediately move forward with the risk evaluation process, the necessary next step toward imposing restrictions to eliminate unreasonable risks.

To better define and address the risks that people face from toxic exposures, CDC will provide training resources to evaluate publicly available cancer rate and environmental data available through the CDC's Environmental Public Health Tracking Data Explorer. The agency will also provide training and resources to pediatric oncologists through the Pediatric Environmental Health Specialty Units to extend services and support to community organizations and community health workers to address concerns about cancer and environmental exposures. Additionally, CDC will provide training and technical support to state, Tribal, local, and territorial partners on how to implement guidelines for investigating cancer and environmental concerns.

In addition to continuing timely implementation of the PACT Act, VA has intensified efforts to research and address the health conditions affecting veterans, ensuring they receive the benefits and care they have earned. In September 2024, VA initiated a scientific assessment to examine the potential link between PFAS exposure during military service and kidney cancer among veterans. Additionally, VA announced plans for an accelerated review to support rulemaking that would create a presumption for Gulf War deployed veterans, including those who deployed to Karshi-Khanabad (K2) in Uzbekistan and are diagnosed with rare conditions, including cancers, that could be related to the contaminants of concern found at K2, such as jet fuel, particulate matter, and others. This month, VA completed two rulemakings to add urinary bladder, ureter, and related genitourinary cancers and acute and chronic leukemias, multiple myelomas, myelodysplastic syndromes, and myelofibrosis as presumptive conditions associated with fine particulate matter exposure for all eligible toxic-exposed Veterans, including those deployed to Southwest Asia, Somalia, and Afghanistan. These actions underscore commitment to proactively identify and address service-related health issues using the tools and frameworks provided by the PACT Act, particularly for those exposed to unique hazards at K2 and other hazardous deployment sites.

DOD has been engaged in innovative research and care to support the nation's warfighters and veterans, including the Applied Proteogenomics Organizational Learning and Outcomes (APOLLO) research program and the Project for Military Exposures and Toxin History Evaluation in US Service Members (PROMETHEUS), two collaborative programs created as part of the Biden Cancer Moonshot to better understand the causes and effective treatments for cancer in service members. DOD will continue to perform research with active-duty service members and veterans regarding their potential toxic environmental and occupational exposures during service. This research will include analyzing blood specimens for any possible connections to the development of certain cancers, with an aim to proactively screen and prevent cancer development in exposed patients in the future.

Expand Access to Cancer Screenings

Through the Biden Cancer Moonshot and the Accelerating Colorectal Cancer Screening and follow-up through Implementation Science (ACCSIS) Initiative, NCI is working with local partners to improve colorectal cancer screening, follow-up, and referral for care among populations that have low colorectal cancer screening rates. The ACCSIS teams collaborate with communities across the United States who receive care at public and private health care clinics. In each community, the researchers adapt successful programs for the local situations. These projects have worked continually to improve colorectal cancer screening rates and compare their experiences so that future colorectal cancer and other types of cancer screening and follow-up programs are easier to plan and more likely to succeed across the US.

NCI is also evaluating emerging technologies for cancer screening, including the 2025 NCI Vanguard Study on Multi-Cancer Detection, a four-year pilot study with VA and DOD collaboration that will inform the design of a much larger randomized controlled trial that will evaluate whether the benefits of using MCD tests to screen for cancer outweigh the harms, and whether they can detect cancer in a way that reduces deaths. Additionally, NCI continues to generate evidence within its Last Mile Initiative, aimed at increasing access to cervical cancer screening by using self-collection for HPV testing.

In addition to other efforts to evaluate and deliver safe and effective screening tools, FDA will continue efforts to facilitate the development and approval of at-home, self-collected HPV tests to improve access to cervical cancer screening. As evidence is generated, FDA will also continue efforts to facilitate the development and approval of novel single-cancer and MCD tests to address unmet needs, increase the number of cancers for which there are screening tests, and increase the number of safe and effective tests available for cancer screening.

Through its National Breast and Cervical Cancer Early Detection Program, CDC will continue funding 71 awardees across the United States to provide breast and cervical cancer screening and diagnostic services to uninsured and underinsured women recommended to get screening, with the goal of increasing the number of women served by each awardee through the program by 5% per year. In 2023, the program provided breast cancer screening and diagnostic services to nearly 275,000 women and diagnosed 1,970 invasive breast cancers and 688 premalignant breast lesions. Additionally, the program provided cervical cancer screening and diagnostic services to 129,082 women and diagnosed 87 invasive cervical cancers and 6,206 cervical lesions, of which 34% were high-grade.

VA will continue to implement innovations that improve lung and colorectal cancer screenings to ensure that all veterans have access to high-quality cancer screenings.By June 1, 2025, all VA facilities are expected to have high-quality lung cancer screening programs that utilize the Veteran Health Administration's Lung Cancer Screening Platform tracking and reporting tool to better ensure that all veterans who are eligible to receive screening services. By the end of FY2025, all VA facilities that perform colonoscopies will be utilizing a standardized endoscopic reporting system that improves clinical documentation. In combination with the recent deployment of artificial intelligence devices to improve precancerous polyp detection, this system will promote efforts to assure that all veterans have access to high-quality colonoscopies.

Drive New Innovation and Deliver the Latest Progress to Patients and Communities

NCI will include more people from all backgrounds in expanded clinical trials to ensure that new approaches to preventing and treating cancer work for everyone. NCI is modernizing cancer clinical trials through implementation of strategic efforts that envision a flexible, faster, simpler, less expensive, and high-impact clinical trials system that seamlessly integrates with clinical practice. Additionally, the NCI Clinical Trials Innovation Unit was developed to advance innovative science, trial designs, and operational efficiencies for high-priority clinical research needs. NCI continues to increase the pipeline of new cancer drugs by investing in the NCI Experimental Therapeutics program, which moves promising drugs and interventions from early-stage discovery to selection of candidates for clinical trials to FDA review and approval. Additionally, NCI will continue to enhance investment in creating a cancer research workforce that is more representative of the U.S. population through programs like theCancer Moonshot Scholars.

NCI is also launching new efforts to understand and address the rise in early onset cancers-cancers with median age of onset in later adulthood that are increasingly being diagnosed in younger adults, typically in their 20s through 40s. NCI is looking to double the current level of support for these cancers to stimulate relevant studies into the etiology and underlying biology, as well as investigating avenues for prevention, treatment, and post-diagnosis care. This initiative will bring together a broad coalition of experts, including patients and caregivers, to develop focus areas; explore new ways to ensure that accurate and meaningful data are available to researchers and the public share; and to share advances with interested communities.

To facilitate fast, safe, and effective treatments, the FDA will continue to conduct reviews for critically important medical oncology products. FDA will also build and strengthen oncology programs and projects to achieve patient-centric approaches to oncology product development. This work will include collaborating with the international community to promote conduct of multiregional trials to facilitate drug development, including for pediatric and rare cancers; promoting the use of pragmatic and decentralized elements for innovative clinical trials; and patient-centric evidence generation. FDA will continue to work with patient advocacy community, academic investigators, international regulatory agencies, and the pharmaceutical industry to support platform trials to expedite investigation of new targeted therapies.

ARPA-H will continue to seek program managers interested in solving problems in cancer and will actively recruit and engage cancer stakeholder groups to join ARPANET-H, a nationwide health innovation network that connects people, innovators, and institutions across the United States and the world. The agency will also remain in productive engagement with the cancer community to identify opportunities, challenges, and needs to improve health outcomes for all. Central to this engagement is collaborating with patient communities in all existing and future programs to ensure innovation is reaching all those who need it, especially those in underserved populations.

VA cares for more than 480,000 veterans throughout the cancer care continuum and diagnoses approximately 56,000 new cancer cases every year. About 25% of these diagnoses are considered rare cancers. The VA National TeleOncology service will continue to provide subspecialized oncology care across the nation and expand to include critical cancer care components like TeleRadiation Oncology to available services.

DOD will continue to accrue patients into the APOLLO research study, which is open across nine DOD medical centers and enrolls nearly 1,000 cancer patients being treated at DOD hospitals annually. This study provides whole genome (DNA) sequencing of tumors that can inform precision therapy and new biologic insights. DOD will also continue its Return of Genetics Results program, in which consented enrolled patients in DOD medical centers receive germline (blood) DNA sequencing and analysis for over 80 genetic-caused health-related conditions. Once these conditions are identified, patients can take actionable measures to decrease or circumvent the risk of the condition occurring in the future.

NASA and the International Space Station National Laboratory are continuing to expand their collaborations with researchers around the country as they take on cancer and other significant diseases like cardiovascular and neurodegenerative diseases. The two organizations announced a joint solicitation offering up to $4 million in total funding for two to three awards for transformational research and technology development, with a focus on addressing challenges that hinder progress in preventing, diagnosing, and treating cancer and other diseases. This solicitation follows a July 2024 announcement of five projects selected and funded to advance cancer research using the International Space Station to benefit patients on Earth.

Support and Center Patients and Caregivers

To better serve our veterans, VA's Close to Me home, mobile and clinic-based care models will expand to all VA regions across the country and will result in over half a million travel miles saved for veterans. Close to Me has expanded to treat nearly 2,000 veterans at 35 VA locations, saving veterans undergoing cancer treatment and their caregivers over 350,000 traveled miles. In December 2024, VA also proposed rulemaking that would expand eligibility for its Program of Comprehensive Assistance for Family Caregivers which - when finalized - will help more caregivers of veterans with cancer get the support they need. Additionally, DOD will continue to engage with active-duty service members who had or have a cancer diagnosis with access to clinical trials and a unique cancer survivorship program to enable their fullest lives.

NCI is expanding research to better understand and address barriers so all people benefit equitably from cancer research advances, including theNCI Telehealth Research Centers of Excellence, which is focused on developing an evidence base of telehealth approaches across the cancer control continuum and fostering innovation in cancer care delivery.

In 2025, CMS will continue testing the Enhancing Oncology Model to support patients and caregivers living with cancer. In addition, a second cohort of participants will join the model in July 2025, ensuring that more patients undergoing cancer treatment and their families will have access to the enhanced services offered under the model's high quality of care. CMS will also consider comments received through a request for information on the new Principal Illness Navigation services for additional policy refinements through rulemaking. These navigation services support the Biden Cancer Moonshot goal to ensure access to patient navigation services for people with cancer.

MISSION: All Systems GO! is NASA's collaboration with the Fred Hutch Cancer Center and the National Association of Proton Therapy. This collaboration is specifically designed to improve the patient experience of children and young adults undergoing treatments, and it is available for use by medical treatment centers and facilities across the United States.

CONCLUSION

The Biden Cancer Moonshot has had a transformative and catalytic impact to change the course of cancer prevention, detection, treatment, and survivorship and has already improved cancer outcomes for countless Americans. Across all sectors of society, leaders have stepped up with bold commitments in response to President Joe Biden and First Lady Jill Biden's call for action. Sustaining and building on the work of the Biden Cancer Moonshot-through the Cancer Cabinet's actions and through private sector commitments-will be critical to realize a future in which fewer people ever receive a cancer diagnosis; a future in which those diagnoses are no longer devastating; a future in which 4 million cancer deaths are prevented by 2047, and that those impacted by cancer and their loved ones have a much more positive experience; a future in which we have ended cancer as we know it.

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