President's Cancer Panel

Closing Gaps in Cancer Screening:

Connecting People, Communities, and Systems to Improve Equity and Access


Letter to President Biden

Dear President Biden,

The President’s Cancer Panel is most appreciative of your ongoing dedication to ending cancer as we know it. We know that cancer is a deeply personal issue for you and your family, as it is for too many Americans. As we conclude the year-long observance of the National Cancer Act’s 50th anniversary, we applaud the investments in research and cancer control over the past five decades that have led to tremendous progress against cancer, including substantial declines in cancer mortality. At the same time, we are keenly aware that there remains so much more to be done. In this report, the Panel focuses on one area requiring urgent attention: improving the uptake of cancer screening.

Throughout much of 2020, as the United States and the rest of the world focused on combatting the COVID-19 pandemic, our country experienced an alarming drop in cancer screenings. The postponement and cancellation of cancer screening is projected to result in thousands of excess cancer-related deaths. This sobering figure highlights the life-saving power of cancer screening and the need to correct the misperception that it is “elective.” Underutilization of screening before, during, and beyond the pandemic is a problem that must be addressed. We know that cancer screening saves lives. The challenge at hand is to ensure that screening is prioritized and easily accessible to all Americans, now and in the future.

Gaps in cancer screening uptake—both before and during the pandemic—mean that too many Americans are enduring aggressive treatment for or dying from cancers that could have been prevented or detected at earlier stages. These gaps exacerbate the already heavy burden of cancer experienced by many communities of color, socially and economically disadvantaged populations, and families with hereditary cancers.

In 2020–2021, the President’s Cancer Panel chose to investigate and identify opportunities to address these gaps in cancer screening. To this end, the Panel convened a series of meetings on cancer screening, gleaning insights from noted experts in the fields of breast, cervical, colorectal, and lung cancers. Informed by these experts, the Panel concluded that more effective and equitable implementation of existing evidence-based cancer screening modalities and guidelines represents a significant opportunity to reduce the burden of cancer and accelerate the decline in cancer deaths. In this report, we share with you recommendations to achieve four critical goals for connecting people, communities, and systems to improve equity and access in cancer screening. Implementation of the Panel’s recommendations by stakeholders across the National Cancer Program will improve communication, facilitate equitable access, promote team-based care, and harness technology to support patients and providers.

Mr. President, the time to stem this tide is now. Your Cancer Panel respectfully shares this report and our recommendations for your urgent consideration, as a catalyst for action across the cancer enterprise at this critical time. We can and must improve uptake of cancer screening for all Americans, and we must effect meaningful change well before the next milestone anniversary of the National Cancer Act. Too many American lives depend on it.


John P. Williams, MD, FACS
Edith P. Mitchell, MD, MACP, FCPP, FRCP
Robert A. Ingram