S. 4717

[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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