The 21st Century Cures Act supports the Cancer Moonshot

What the law set aside

The 21st Century Cures Act became Public Law 114-255 on December 13, 2016.

Among many other things, it set up an NIH Innovation Account in the Treasury. Money would move into it each year from 2017 through 2026. The total comes to about $4.8 billion.

The law then divided that money among four named projects, each with a ceiling. The Precision Medicine Initiative could draw up to $1.455 billion. The BRAIN Initiative up to $1.511 billion. Adult stem cell regenerative medicine research up to $30 million.

Cancer research got the largest single share: up to $1.8 billion.

What the cancer money was for

The law is unusually specific about the purpose. It names cancer vaccines, more sensitive tests to find cancer, immunotherapy, and combination therapies. It also names research that could transform the field, carries higher risk, and takes on major challenges in cancer.

The schedule runs longer than most summaries suggest: $300 million in fiscal 2017, $300 million in 2018, $400 million in 2019, $195 million in 2020, $195 million in 2021, $194 million in 2022, and $216 million in 2023.

One word in the law matters more than the numbers. These are authorizations, not appropriations. The money still had to be appropriated each year, and the law says so.

What the Moonshot did with it

NCI says the Cancer Moonshot launched in 2016 and was set up again in 2022. The goal was a decade's worth of progress in cancer prevention, diagnosis, and treatment in five years. A panel of experts made 12 broad recommendations, and NCI built its goals around them.

By NCI's own count, the Moonshot has supported 250 research projects and more than 70 programs and consortia. Some of what came out of it is now visible in ordinary care and in trials people can join:

• A network to turn immune science into treatment and prevention for adults, and a second one for childhood cancers, where immunotherapy has been harder to build. Our page on immunotherapy covers how these treatments work.
• The Human Tumor Atlas Network, which maps the gene changes and cell behavior in single tumors as they move from a precancerous patch to advanced cancer.
• The NCI Cancer Research Data Commons, a shared national store where researchers, clinicians, and patients can add data and analyze it.
• Work on why cancers stop responding to treatment that once worked.
• Faster guidelines for tracking and managing the symptoms patients report themselves, to cut the burden of side effects.
• The Cancer Screening Research Network, which runs the Vanguard Study. That study asks whether multi-cancer blood tests can be tested in larger trials, and whether their benefits beat their harms. Our page on multi-cancer early detection blood tests covers what is still unknown.
• Telehealth research centers, testing whether care at a distance improves cancer outcomes.

Why this is not a patient benefit

This is research funding. It changes what gets studied. It does not change what any individual is entitled to receive, and it does not create coverage, a benefit, or eligibility for anything.

The route from this kind of money to a person's care is long. A funded network builds a resource. A trial opens. Results arrive years later. Guidelines change. Only then does a clinic do something differently. Several items on the list above are still at the first step.

What this does and doesn't change

• No individual gains coverage, treatment access, or eligibility from this law.
• The $1.8 billion was a ceiling through fiscal 2023, not a permanent budget. Each year's money still had to be appropriated.
• The Vanguard Study is asking whether multi-cancer blood tests should be studied further. It is not a recommendation to have one.
• NCI's list describes programs set up, not results proven. A research network is a means, not an end.
• Funding law changes. Check the current NCI and congressional sources rather than relying on figures from 2016.

When to get checked

Research funding is not something anyone can act on. Two things are.

The first is the screening that already has evidence behind it, and where the schedules currently stand:

• Colorectal cancer screening from age 45 to 75 at average risk
• A mammogram every two years from age 40 to 74
• Cervical screening every three years from age 21, with HPV-based options every five years from age 30
• A yearly low-dose CT if you are 50 to 80 with a 20 pack-year smoking history and still smoke or quit within 15 years

The second is a symptom that has not settled. Whatever research is funded, cancers are still mostly found because someone reported a change. A lump, unexplained bleeding, a cough or a change in bowel habit lasting more than three weeks, or weight loss you did not intend all need a doctor.

And if you are already in treatment, asking whether a clinical trial fits your situation is reasonable at any point. Our page on finding a clinical trial covers how to look.

Sources

• govinfo, Public Law 114-255, 21st Century Cures Act — https://www.govinfo.gov/content/pkg/PLAW-114publ255/pdf/PLAW-114publ255.pdf
• NCI, The Cancer Moonshot — https://www.cancer.gov/research/key-initiatives/moonshot-cancer-initiative
• White House archive, Remarks at the 21st Century Cures Act Bill Signing — https://obamawhitehouse.archives.gov/the-press-office/2016/12/13/remarks-president-and-vice-president-21st-century-cures-act-bill-signing/

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

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