Future Direction: Evidence-based Cancer Control Policy Research

Selected Examples of Progress

Tobacco Control Strategies Reduce Cancer Mortality Rates

The Tobacco Control Research Branch (TCRB) leads and collaborates on research and disseminates evidence-based findings to prevent, treat, and control tobacco use in order to create a world free of tobacco use, related cancer, and suffering. NCI has published funding opportunities focused on tobacco control policies, with the long-term goal of reducing disparities in tobacco-related cancers, and, in doing so, promoting health equity. Under these funding opportunities, DCCPS has funded 13 awards (three R21s, eight R01s, and two R37s). Beyond these activities, NCI continues to participate in the partnership between NIH and the Food and Drug Administration's Center for Tobacco Products to fund research to inform tobacco regulatory activities. TCRB also funds other grants focused on state and local tobacco control policy research. This funded research will advance tobacco control policies in the United States to impact cancer morbidity and mortality. DCCPS has also been actively engaged with the US Department of Health and Human Services (HHS) and the White House in Cancer Moonshot^SM efforts, including, for example, involvement in the White House Cancer Moonshot Smoking Cessation Forum held on June 7, 2023.

DCCPS has also been actively engaged with the US Department of Health and Human Services (HHS) and the White House in Cancer Moonshot^SM efforts.

Reconvening the HPV Cancer Center Consortium

In response to the 2012–2013 President’s Cancer Panel report “Accelerating HPV Vaccination Uptake: Urgency for Action to Prevent Cancer,” DCCPS funded three rounds of grant supplements to NCI-Designated Cancer Centers to support the development of expertise related to increasing HPV vaccine uptake. As a result of these supplements, NCI-Designated Cancer Centers formed the HPV Cancer Center Consortium, which focused on increasing HPV vaccine uptake and highlighting local issues around HPV vaccination.

Consortium efforts helped boost the two-dose completion rate for the HPV vaccine from only 28% (girls only) in 2012 to its current level of 54%, including boys and girls. Following a COVID-19 pandemic-related hiatus, the HPV Cancer Center Consortium reconvened and is planning a 2-day, in-person event hosted by the University of Kentucky, where cancer centers, researchers, and practitioners will reconnect in a collaborative environment to discuss the increasing uptake of the HPV vaccine, reducing HPV-related cancers, and highlighting local issues surrounding HPV vaccination. A webinar series launched in September 2023 as part of the consortium’s efforts to support the goal of providing the vaccine to 80% of eligible adolescents and coming closer to eliminating death from cervical cancer.

CCIS Action Group and Awards

The Consortium for Cancer Implementation Science (CCIS) was founded in 2019 as a public effort in which Cancer Moonshot investigators, as well as other researchers and practitioners, work together to address key challenges and advance the implementation science (IS) agenda in cancer. The Policy and IS action group has seven subgroups and supports the IS community by (1) analyzing and advancing policies related to cancer prevention and control, (2) identifying resources to support IS policy development and implementation, and (3) connecting investigators working in this space. During the 2022 CCIS annual meeting, the Policy and IS action group prioritized equity, capacity, and funding as well as devising a shared language for use with policymakers. To accomplish these priorities, the action group set out to

Use an equity-focused approach to policy implementation and analysis
Create an online platform for training
Develop a best practices document

Supplemented by the CCIS awards program, which awards personal service contracts to individuals willing to dedicate time to develop and deliver specific tools and resources prioritized by the action groups, seven policy public goods have been developed to move the action group priorities forward. The action group reconvened in October 2023 to identify priorities for fiscal year 2024 and continues to move policy-related IS priorities forward.

Administrative Supplement to Support Health Policy Research in Cancer Prevention and Control

In early 2023, DCCPS solicited applications via NOT-CA-23-044 encouraging currently funded NCI extramural investigators to apply for administrative supplements to support cancer-related policy research to

Generate new or utilize secondary data that operationalize policies hypothesized to affect cancer control at the geographic, provider, patient, and/or temporal level
Examine the effects of existing policies and/or simulate the potential effects of new policies, with an emphasis on understanding health disparities by examining differential impacts on disadvantaged groups
Identify effective community-engaged strategies for dissemination or implementation of evidence to inform policymaking

The administrative supplement yielded a robust response, resulting in nine funded projects. The funded projects focus on (1) incorporating the effects of economic policy and price shocks on treatment, spending, and survival outcomes for multiple myeloma; (2) evaluating the dissemination of state legislation to providers and patients by payors; (3) examining whether implementation of the national policy for next-generation sequencing testing for patients with advanced or metastatic cancer influenced disparities in the use of genomically targeted therapies; (4) exploring the impact of mergers between health insurers/plans and pharmacy chains on the quality of oncology care; (5) studying the implementation of expanding genetic risk assessment, per the National Comprehensive Cancer Network guidelines, among Black and rural individuals; (6) exploring organizational-level policymaking for hospital community benefits to inform development of a simulation tool that can be used for more equitable policymaking; (7) studying payment reform for delivery of radiotherapy and implications for disparities; (8) understanding how state immunization information systems policies and features can guide providers’ HPV vaccine recommendations; and (9) studying the effects of Medicare coverage for telehealth on cancer-related care.

Obesity, Diet, Physical Activity, and Cancer

Obesity and its proximal determinants, diet and physical activity, together constitute the second most important modifiable risk factor for cancer, after smoking. DCCPS has invested significantly in supporting policy-related research and efforts in these areas. NCI has funded a substantial body of grants addressing policy influences on obesity via Notice of Special Interest (NOSI): Obesity Policy Evaluation Research (NOT-DK-20-035) and the innovative Time-Sensitive Obesity and Policy Evaluation (PAR-21-305) PAR led by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NCI is also part of a broader time-sensitive Notice of Funding Opportunity (NOFO) (PAR-22-233) led by the NIH Office of Behavioral and Social Sciences Research (OBSSR), with significant NCI staff contributions that support policy evaluation on a range of factors influencing outcomes across the cancer continuum. In addition, NCI has collaborated on NOSI: Stimulating Research to Understand and Address Hunger, Food and Nutrition Insecurity (NOT-OD-22-135) to support research addressing food and nutrition insecurity, including the contextual examination of policy interventions at organizational through federal levels to support healthy food environments and promote cancer prevention and control. Critical examples of other recent, ongoing efforts by DCCPS staff include leadership of the National Collaborative on Childhood Obesity Research (NCCOR), recently updating and promoting data and policy evaluation-related resources such as the NCCOR Catalogue of Surveillance Systems, Measures Registry, and a toolkit to help communities create thriving and active communities; development of the Classification of Laws Associated with School Students (CLASS) resource; supporting the Dietary Guidelines for Americans, including participating on the Data Analysis Team; serving on the federal committee and writing team for the Physical Activity Guidelines for Americans Midcourse Report on Implementation Strategies for Older Adults (PDF, 52.5MB); hosting the 2023 Active Living Conference, highlighting research, policies, and practices based on a multilevel perspective; and the publication of several papers addressing policies related to physical activity from elementary school to college settings. Efforts to normalize community and multilevel research, policy evaluation, and stakeholder engagement are vital to fulfilling the promise of cancer prevention via a life course approach that addresses critical modifiable risk factors.

We will focus on evaluating existing policies and studying new policy approaches to improve cancer outcomes and health equity.

Planning for the Future

DCCPS has a long history (PDF, 1.2MB) of supporting science that informs policies and programs to prevent, detect, and treat cancer and improve outcomes for cancer survivors. As we look toward the future, we recognize the central role that policy plays in shaping health and health care. DCCPS is committed to sustaining the innovations and interventions that come from research. While our work has a broad influence on policy, we will focus on evaluating existing policies and studying new policy approaches to improve cancer outcomes and health equity. By identifying methodological approaches for studying different policy types and levels and focusing on structural issues affecting health equity, policy research can move the field forward to determine the impact of those policies and inform existing frameworks and strategies to promote population health.

For information about alcohol and cancer, please see the Modifiable Risk Factors section below. Information about telehealth can be found in the Digital Health section.

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