Anne Moyer Ph.D.

Beyond Treatment

How Does Public Policy Relate to Cancer?

Regulations, legislation, funding, and other decisions can help save lives.

Posted May 03, 2019

This entry written in collaboration with Jennifer Bowers, M.A.

Public policy—or action taken by the government to solve critical problems—may take many forms, and can have profound effects on cancer prevention and cancer care. Regulations, legislation, funding, and other decisions can help to save lives and improve the lives of cancer survivors. Here are some examples of the ways public policy influences cancer prevention and care in the US, and suggestions for how to learn more or get involved.

Public Policy and Cancer Prevention

The incidence of cancer in the population can be reduced. The required insurance coverage of certain preventive services can aid in cancer prevention, including cancer screenings (e.g., breast or lung) and HPV vaccinations, which can reduce susceptibility to cervical cancer. Government grants and insurance (i.e., Medicaid) support cancer screenings around the country at facilities such as Planned Parenthood.

Cigarette warning labels, smoking bans for public indoor spaces, and restriction of tobacco advertising are all examples of successful regulations that have limited smoking and harm from second-hand smoke.1 Age restrictions also have been a key component for smoking prevention among young people, and the US Senate Majority leader plans to soon introduce a bill to raise the age for purchases smoking and vaping products to age 21,2 a move which would be expected to save lives because many people begin smoking at an early age.

Indoor tanning is another cancer risk behavior relevant for young people.3 Recently, most states in the US have implemented restrictions or bans on indoor tanning for those under 184 and there is evidence that indoor tanning among those under 18 has decreased as a result,5 which is great news for potential reductions in melanoma and non-melanoma skin cancers in the future.

Public Policy and Cancer Care

Public policy dictates funding for cancer research and treatments. The federal budget allocates funds for publicly funded research, such as by the National Cancer Institute (NCI), which accounts for much of the cancer research ongoing in the US. The NCI’s Cancer Moonshot program, which supports research for innovative cancer therapies, recently received a $100 million increase in the 2019 spending bill.6 The Food and Drug Administration regulates cancer drugs and therapies and requires clinical trials for the safety and effectiveness of cancer drugs.

For cancer patients and survivors, public policy on healthcare is important toward the goal of affordable healthcare coverage. Although the majority of insured Americans are currently covered by their employers, those who use Medicare and Medicaid to cover their cancer treatments, and those who are uninsured or seeking additional coverage through government funding, may follow healthcare policy debates with much interest. Additionally, the Cancer Care Planning and Communications Act has recently been introduced.7 It seeks to develop personalized cancer care plans for Medicare beneficiaries.

Finally, public policy is involved in regulating environmental health concerns that may affect cancer survivors in particular. For example, the Environmental Protection Agency’s Clean Air Act protects the air from harmful toxins and pollutants. However, the work to keep our air clean is far from done and more public policy work is needed, especially for vulnerable populations. A recent study from the Huntsman Cancer Institute found that air pollution increases childhood cancer survivors’ risk of hospitalizations from acute breathing problems about twofold compared to other children.8

How to Learn More About Cancer-Related Public Policy

Many important steps have been taken to prevent cancer and promote better cancer care, but this work is ongoing and ever-evolving. Several organizations advocate for better public policy related to cancer, including: the National Coalition for Cancer Survivorship (www.canceradvocacy.org), the American Cancer Society (www.cancer.org), and the Prevent Cancer Foundation (preventcancer.org).

References

1.  Centers for Disease Control and Prevention. (2018). Smoking and Tobacco Use: Policy and Legislation. Retrieved from https://www.cdc.gov/tobacco/data_statistics/by_topic/policy/index.htm

2.  CNBC. (2019). Sen. Majority Leader McConnell to introduce bill to raise the minimum age to buy tobacco to 21. Retrieved from https://www.cnbc.com/2019/04/18/mcconnell-to-introduce-bill-for-a-minimum-age-to-buy-tobacco-of-21.html

3.  Cust, A. E., Armstrong, B. K., Goumas, C., et al. (2011). Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma. International Journal of Cancer, 128, 2425-2435.

4.  National Conference of State Legislatures. (2018). Indoor Tanning Restrictions for Minors: A State By State Comparison. Retrieved from http://www.ncsl.org/research/health/indoor-tanning-restrictions.aspx

5.  Reimann, J., McWhirter, J. E., Cimino, A., Papadopoulos, A., Dewey, C. (2019). Impact of legislation on youth indoor tanning behaviour: A systematic review. Preventive Medicine, 123, 299-307.

6. Science Magazine. (2018). NIH gets $2 billion boost in final 2019 spending bill. Retrieved from https://www.sciencemag.org/news/2018/09/nih-gets-2-billion-boost-final-2019-spending-bill

7.  115th Congress. (2018). H.R.5160: Cancer Care Planning and Communications Act of 2018. Retrieved from https://www.congress.gov/bill/115th-congress/house-bill/5160

8.  Ou, J. Y., Hanson, H. A., Ramsay, J. M., et al. (2019). Fine particulate matter and respiratory healthcare encounters among survivors of childhood cancers. International Journal of Environmental Respiratrory Public Health, 16.