Cancer touches nearly every American family. Despite progress in preventing, screening for, and treating cancer, it remains the second leading cause of death in the United States, claiming more than 600,000 American lives each year. In February 2022, President Joe Biden and First Lady Jill Biden reignited the Cancer Moonshot, setting ambitious, achievable goals: to reduce the death rate from cancer by at least 50 percent over the next 25 years, and to improve the experience of people and families living with and surviving cancer, ultimately ending cancer as we know it today.

The President’s FY 2024 Budget makes strategic investments in the Cancer Moonshot as part of the President’s Unity Agenda to deliver new ways to prevent, detect, and treat cancer and to ensure that the tools we have and those we develop along the way equitably reach all Americans. It builds on the strong progress the Cancer Moonshot made last year, with nearly 30 new programs, policies, and resources in five key priority areas: (1) closing the screening gap, (2) understanding and addressing environmental exposure, (3) decreasing the impact of preventable cancers, (4) bringing cutting-edge research through the pipeline to patients and communities, and (5) supporting patients and caregivers.

The President’s Budget’s robust investments in the Cancer Moonshot include: 

  • $1.7 billion at the Department of Health and Human Services (HHS) to support dedicated Cancer Moonshot activities at the National Cancer Institute (NCI), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and Health Resources and Services Administration (HRSA), and Indian Health Service (IHS). The Budget includes a total investment of $7.8 billion for NCI, plus expected critical contributions from $2.5 billion for ARPA-H to help deliver on Moonshot goals; 
  • $680 million at the Environmental Protection Agency (EPA) for programs to reduce environmental and toxic exposures as part of cancer prevention and a commitment to environmental justice;
  • $360 million at the Department of Veterans Affairs (VA) for research to expand knowledge on the biological understanding, diagnosis, prognosis, treatment, and prevention of cancer, as well as to support healthcare utilization, delivery of care to cancer patients, and the delivery, efficacy, and effectiveness of therapies;
  • $40 million at the U.S. Department of Agriculture (USDA) for the National Institute of Food Agriculture and the Agricultural Research Service and a new program aimed at preventing nutrition-related diseases;
  • $47 million for the Department of Defense (DoD) Murtha Cancer Center to support the tri-agency Applied Proteogenomics Organizational Learning and Outcomes (APOLLO) project and its related research initiatives; and investment in a new DoD program, PROject for Military Exposures and Toxin History Evaluation in U.S. Service Members (PROMETHEUS), to understand and address cancer in exposed service members; and
  • $5 million at the National Aeronautics and Space Administration (NASA) to pursue cancer-related research on the International Space Station National Lab. 

Key investments to drive progress across the Cancer Moonshot priority actions:

Close the Screening Gap:
To reduce the deficit in cancer screenings and to expand equitable access to effective early detection, the Budget supports the development and deployment of innovative approaches to screening and early detection, including more precise, less invasive, and even at-home methods.

  • $394.5 million total investment in the following three CDC programs: National Comprehensive Cancer Control Program, including the Cancer Genomics program to increase the number of individuals who are appropriately referred to genetic counseling and testing; the National Breast and Cervical Cancer Early Detection Programs to enhance breast and cervical cancer screening and diagnostic services for uninsured and underinsured American women; and the Colorectal Cancer Control Program to increase colorectal cancer screening rates among people age 45 to 75.
  • Investments at NCI include a large national trial that, if successful, will identify effective blood tests for the detection of one or more cancers, providing the opportunity for additional tools for early detection.
  • $108 million for IHS to develop a nationwide coordinated public health and clinical cancer prevention initiative to implement best practices and prevention strategies to address incidence of cancer and mortality among the American Indian and Alaska Native (AI/AN) population.
  • $20 million for HRSA to expand partnerships between federally funded health centers and NCI-Designated Cancer Centers to facilitate access to lifesaving cancer screenings and early detection services for medically underserved populations.

Understand and Address Environmental and Toxic Exposures: To better prevent and mitigate potential health impacts, the Budget invests in a robust agenda to enable increased understanding and reduction of the impact of environmental and toxic exposures.

  • Approximately $356 million for the EPA’s Superfund program to continue cleaning up some of the Nation’s most contaminated land. In addition, an estimated $2.5 billion in Superfund tax revenue will be available to EPA in 2024.
  • Funding for EPA to continue investments in a variety of tools for evaluating the health hazards posed by chemicals, including the Integrated Risk Information System, Provisional Peer-Reviewed Toxicity Values Program, and Integrated Science Assessments.
  • Support for EPA to implement programs to improve air toxics data, characterize potential cancer risk, and issue regulations that result in lower emissions and reduced health risk for people across America.
  • $4 billion for EPA to upgrade drinking water and wastewater infrastructure nationwide, including $219 million to remediate lead contamination in water, $593 million, plus approximately $2.5 billion in Superfund tax revenue, to continue cleaning up some of the Nation’s most contaminated land, and $170 million for EPA to tackle per- and polyfluoroalkyl substances (PFAS) pollution. These steps will help address contaminants that lead to greater cancer risk.
  • $70 million for military and environmental exposures research, including $46 million in the Toxic Exposures Fund to support research required under the PACT Act, which stands as the most significant expansion of benefits and services for toxic exposed veterans in more than 30 years.
  • $8.3 billion for the Department of Energy’s Environmental Management program to support the cleanup of communities used for nuclear weapons production.
  • Investments at CDC to enhance funding for state public health laboratories for biomonitoring programs to increase their capability and capacity to assess human exposure to environmental chemicals of concern and conduct investigations into unusual patterns of cancer.
  • Funding for PROMETHEUS at DoD, which will bring together agency and private sector innovators to understand and address cancer in exposed service members. This includes the DoD Serum Repository, which contains blood samples for all service members; the Individual Longitudinal Exposure Record (ILER), which tracks potential toxic exposures; the DoD Tumor Registry, which tracks cancer diagnoses in active duty; DoD Framingham, which analyzes blood proteins in active duty with cancer; the Joint Pathology Center, which is the DoD pathology Center of Excellence; and the APOLLO Network, which was created in response to the Cancer Moonshot in 2016—now with a network of 13 hospitals to carry out military-specific research. 

Decrease the Impact of Preventable Cancers: The Budget supports evidence-based implementation efforts to decrease the impact of preventable cancers—including tobacco- and nutrition-related cancers—and research efforts focused on fully understanding and developing additional approaches to reach people with cancer prevention tools.

  • $257.5 million in tobacco prevention and control efforts at CDC, including tobacco cessation activities to support Americans in their efforts to quit. Smoking is the single biggest driver of cancer deaths in the nation.
  • $15 million total CDC investment to prevent and detect HPV-related cancers which include cervical, head, neck, anal, and other cancers that impact nearly 40,000 Americans each year but can mostly or wholly be prevented through HPV vaccination and early detection.
  • A new mandatory proposal for a national hepatitis C elimination program to increase access to curative medications, and expand implementation of complementary efforts such as screening, testing, and provider capacity with a specific focus on high-risk populations. Hepatitis C is a major risk factor for liver cancer.
  • The Budget supports EPA continuing its efforts to address radon as a health equity challenge and prioritize new strategies to reduce radon risk in underserved communities, including communities of color.
  • $13 million for USDA’s Agriculture Science Center of Excellence for Nutrition and Diet for Better Health (ASCEND for Better Health) to understand diet-related chronic diseases, including cancer. ASCEND will accelerate research through partnerships with Texas A&M University and six human nutrition research centers, enable research through big data, and translate research through engagement with extension and community leaders. 

Bring Cutting Edge Research Through the Pipeline to Patients and Communities: The Budget invests in the development and deployment of new ways to prevent, detect, and treat cancer to save and extend lives.

  • $2.5 billion in ARPA-H, a $1 billion increase over FY 2023 for this agency launched by the President to deliver new ways to prevent, detect, and treat cancer and other diseases.
  • $7.8 billion for NCI, an increase of $500 million above FY 2023, with investments to support precision medicine, target effective treatments to patients, improve cancer prevention, early detection, and survivorship, and speed progress on some of the deadliest and rare cancers, including childhood cancers. The Budget also proposes to reauthorize the 21st Century Cures Act Cancer Moonshot through 2026.
  • $50 million for the Oncology Center of Excellence at the FDA to unite experts to conduct expedited review of medical cancer-related products and execute a number of research and educational outreach projects and programs to advance the development and regulation of medical products for patients with cancer. 

Support Patients and Caregivers: To make the experience around cancer—from screening, to getting a diagnosis, to treatment, care, and surviving—easier on those living with cancer and their caregivers, the Budget supports evidence-based and scientifically sound approaches to care.  

  • $1 million investment in CDC’s Cancer Survivorship Resource Center, which provides information and support to cancer survivors, their families and caregivers, along with physicians.
  • $94 million within VA research programs, together with $266 million within the VA Medical Care program, for precision oncology to provide access to the best possible cancer care for veterans. Funds also support research and programs that address cancer care, rare cancers, and cancers in women, as well as genetic counseling and consultation that advance tele-oncology and precision oncology care.
  • A new mandatory proposal to require a pay for cancer care quality data reporting program for all Medicare providers to drive improvements in the quality of cancer care, and simplify the process for patients to identify high value care.
  • The Budget builds upon the Inflation Reduction Act to continue lowering the cost of prescription drugs, including those for cancer. For Medicare, this includes further strengthening its newly established negotiation power by negotiating more drugs and bringing drugs into negotiation sooner after they launch.


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