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On Day 2 of the 2026 NCCN Fall Policy Summit, speakers and panelists discussed the greatest operational hurdles preventing personalized cancer screening, offered proven best practices in five real-world case studies, and explored policy solutions to modernize screening systems.
On October 5-6, patients, providers, advocates, policymakers, and other key stakeholders gathered in Washington, DC, for the 2026 National Comprehensive Cancer Network (NCCN) Fall Policy Summit. For a recap of Day 1, read the previous blog on ACCCBuzz.
Day 2 of the summit opened with a keynote address from Anthony Letai, MD, PhD, Director of the National Cancer Institute (NCI), who shared that his priority in this role is to keep national guidelines rooted in clear scientific evidence.
According to Dr. Letai, cancer-related deaths have decreased by about 33% since 1991, in large part due to preventive measures. “Prevention and screening save more lives than all treatment advances combined,” he stated. “That is our greatest opportunity to reduce suffering.”
Building on an underlying theme from the previous day’s content, Dr. Letai affirmed that the key to improving screening uptake is to make the process easier for patients and providers alike. He pointed to several examples, including the use of at-home cervical cancer screening kits and a study that found that one dose of the human papillomavirus (HPV) vaccine is as effective as two. Making screening and preventive care as accessible to patients as possible is central to their utilization.
Dr. Letai also noted that major gaps remain—both due to a lack of proven screening strategies for many cancers and because screening uptake is highly uneven, depending on social drivers of health such as geography, income, and insurance status. “We need better tools where none exist, and wider use of existing tools,” he said.
The address concluded with a clear call to action: No institution can shift the paradigm of cancer screening and prevention alone. Progress requires collaboration among clinicians, industry, the NCI, the NCCN, and others, and these groups must work together to shorten the path from scientific questions to definitive answers. “It is time to build on our foundation and advance the next generation of prevention and screening science,” said Dr. Letai.
Following the keynote, a multidisciplinary panel of experts explored the greatest operational hurdles preventing personalized screening, gaps in screening data, and actionable steps to overcome these barriers.
One challenge identified by Tuya Pal, MD, a Professor at Vanderbilt University Medical Center and a Clinical Geneticist at Vanderbilt-Ingram Cancer Center, was that cancer screening data come from populations of predominantly White/European ancestry, thus leaving large gaps in research. “Screening measures work differently in different populations,” she said. “If we’re not calibrated across all populations, we’re not going to see the same effectiveness across all populations. The data we have and the world population are not proportional.”
For John M. Kirkwood, MD, Distinguished Professor of Medicine in Dermatology and Translational Science, Sandra and Thomas Usher Chair in Melanoma Research, and Co-Director of the Melanoma and Skin Cancer Program at the University of Pittsburgh and UPMC Hillman Cancer Center, one of the greatest hurdles in prevention and early detection is the fragmented nature of the health system—particularly for patients receiving care in the community. “Patients shouldn’t have to go to different places to be screened for breast, cervical, lung, and skin cancer,” he argued. “We need to consolidate these offerings.”
Another gap noted by the panel was a lack of data on drivers of early-onset cancer. “We don’t know why there’s been a sudden rise in the last 20 years,” said Ernest Hawk, MD, MPH, T. Boone Pickens Distinguished Chair for Early Prevention of Cancer and Vice President and Division Head of Cancer Prevention and Population Sciences at the University of Texas MD Anderson Cancer Center. “It’s crucial that we capture family history data.”
In the realm of policy, Dr. Pal noted that Medicare does not cover genetic testing or enhanced screening for individuals at high genetic risk unless they have a cancer diagnosis. “This is a clear gap in policy. Medicare was established in 1965, long before the age of genomics. It needs to be updated,” she said.
As the panel concluded, Scout, PhD, Executive Director of the LGBTQIA+ Cancer Network, stressed the importance of keeping equity at the forefront of oncology: “We have to include all underserved populations [in research] so that we don’t develop even larger disparity gaps.”
The next session highlighted five real-world case studies of successful preventive practices in cancer care. All initiatives focused heavily on the power of community involvement, comprehensive education, and cooperative policymaking in improving access to and the use of screening services.
West Virginia is a rural state that experiences multidimensional barriers to cancer care, from rugged terrain that makes transportation difficult to an aging population living in medically underserved areas, according to Jenny R. Ostien, MS, Assistant Director of Mobile Outreach for the Department of Cancer Prevention and Control at the West Virginia University Cancer Institute. The state also has an above-average incidence rate of several cancer types, including lung cancer. Only 25% of lung cancer cases in the state are diagnosed at the localized stage, which means most cases are detected after the disease has already spread.
In the first case study, Ostien demonstrated a working solution to combat these rates: mobile screening buses for breast cancer and lung cancer named Bonnie and LUCAS, respectively. These buses supply their own power and meet patients where they are, even in rural locations. Each bus is staffed by two team members: One drives the bus and handles registration, and the other is the computed tomography technologist. “The goal is to increase access for those with the least resources and provide the same high level of care as in the clinic,” Ostien said.
The success of these buses is evident in the data: LUCAS was launched in 2021 and now provides more than 1,000 screenings each year, and through early breast cancer detection, Bonnie’s work has added an estimated 174 years of life for screened patients.
In the second case study, Erika Ninoyu, Director for Federal Advocacy at the American Cancer Society Cancer Action Network (ACS CAN), presented on the importance of the National Breast and Cervical Cancer Early Detection Program, run by the Centers for Disease Control and Prevention, for which ACS CAN is lobbying Congress to extend funding. Since 1991, the program has reached more than 6.8 million women who are uninsured or who live below the federal poverty level, providing education, diagnostics, and treatment guidance to those who may not have been reached before.
“Despite the program’s impact, we are not reaching all eligible patients,” Ninoyu said. At a recent Capitol Hill Day, ACS CAN advocated for the reauthorization of the SCREENS for Cancer Act to provide funding through 2030, as well as the Breast Cancer Education and Awareness Requires Learning Young (EARLY) Act, which helps address the rising incidence of breast cancer in young women.
ACS CAN continues to advocate for evidence-based policies in cancer care and adequate funding for research and treatment. “When we [collaborate], we can work toward ending cancer for everyone as we know it,” Ninoyu said.
In the third case study, Dr. Hawk shared that approximately 40% of cancer cases in the US could be avoided if individuals followed healthy living guidelines. That potential is why MD Anderson Cancer Center’s Office of Community Health prioritizes community outreach and engagement alongside clinical care and research.
The Be Well Community Initiative, a program designed by the Office of Community Health to assess cancer prevention and population health strategy, is built upon more than 100 years of healthy community best practices and data. The program’s goal is to foster and facilitate healthy behaviors and build other community organizations’ capacity to provide resources and serve as important cancer prevention pillars. “It’s our view that healthy living needs to begin early and continue across the lifespan,” Dr. Hawk said.
So far, the initiative has reached four ethnically diverse Texas communities with a population-based healthy living model. It offers courses for students and reshapes the physical environment to support prevention, adding everything from shade structures in public spaces to community gardens and food banks stocked with fresh produce. These programs are funded by MD Anderson and private-sector investors, with communities continuing to invest through their own channels after funding ends to maintain the programs.
Since 2017, the initiative has provided nearly 10,000 cancer screenings and thousands of immunizations and tobacco cessation resources, aligning with its holistic healthy living model. Read more about the Be Well Community Initiative in this case study from NCI.
Because lung cancer outcomes have been persistently poor in Appalachian communities, the fourth case study of the day centered on the Appalachian Community Cancer Alliance launched in 2021 by ACCC. This initiative partners with multiple institutions and their leaders, including Mary Reid, PhD, MSPH, Distinguished Professor of Oncology and Chief of Cancer Screening and Survivorship at Roswell Park Comprehensive Cancer Center. “You have to be invested for a long time to make systemic change [in this community],” Dr. Reid said.
The initiative aims to improve screening and early detection rates by identifying the barriers that have kept levels low and creating patient-centered approaches to improve access to life-saving resources. In the presentation, Dr. Reid highlighted successes of the program thus far, from the screening van EDDIE on the New York–Pennsylvania border to the building of efficient and accessible screening and treatment workflows in rural communities such as Pikeville, Kentucky.
“You can’t [offer] lung cancer screening as a single event,” Dr. Reid said. “It goes back to building strong relationships with trust. ACCC put us in front of them, and we helped them build an infrastructure. It’s the sustainability that is important.”
The fifth case study came from Juny Simpson, Head of Population Health and Customer Engagementat Genentech, who described the company’s integrated approach to population health, which draws on science and evidence, policy, and community partnerships. In recent years, Genentech has focusedon underserved or overlooked communities, such as rural populations, Veterans, and women.
Genentech recently formed its Population Health Center of Excellence to support community outreach programs that address low literacy and low health literacy in the US. “Championing health literacy is core to how we approach population health,” Simpson said.
Genentech also recently launched the Love Letters Cancer Screening Campaign across all five boroughs of New York City to increase awareness and prompt women of color to seek preventive care. The initial data on the campaign’s effectiveness paint an encouraging picture: More than 80% of survey respondents said they would take action to get screened after seeing the campaign. “We must catalyze action to close the gaps [in screening and preventive care],” Simpson urged.
In the final panel of the summit, the conversation turned to experts in academia, research, and policy to address the current state of healthcare policy in the US and the need to modernize current screening infrastructure to close coverage gaps and address out-of-pocket barriers.
A. Mark Fendrick, MD, Professor of Internal Medicine and of Health Management and Policy at the University of Michigan and Director of the Center for Value-Based Insurance Design, spoke to Section 2713 of the Patient Protection and Affordable Care Act (ACA), which requires private insurers to cover preventive screening services for breast, colorectal, cervical, and lung cancer at no out-of-pocket cost to the patient.
“Policy solutions are really hard, and we have to not let perfect get in the way of good,” Dr. Fendrick said. He emphasized that while he does not believe the ACA is perfect, more than 250 million individuals have benefited from accessible preventive screenings through the law.
Across the board, panelists expressed a desire for reform now that the ACA has been in effect for more than a decade, citing the rapidly evolving understanding of cancer, technological advances, and common loopholes that mean coverage does not necessarily equate to access.
“We have so many innovations in cancer treatment, and as those innovations are increasingly expensive, we have more pressure for the modernization of infrastructure,” said Robin Yabroff, PhD, MBA, Scientific Vice President of Health Services Research at the American Cancer Society. “The problem is even bigger than we realize. People who are diagnosed with cancer also need to be able to access and afford their cancer treatment.”
Lisa Schlager, Vice President of Public Policy at FORCE: Facing Our Risk of Cancer Empowered, described the difficulty that many primary care providers and patients with genetic variants have in meeting criteria for preventive screening. “Risk is a spectrum, and our systems have been set up to accommodate what the average person needs and to not take those with an increased risk or less risk into consideration,” Schlager said.
Looking to the federal level, Susan G. Komen works regularly to establish state-level models and believes that valuable lessons could be applied on a larger scale. Several systemic barriers to equitable preventive care remain, which lends urgency to the call for reform beyond screening. Some patients fail to receive diagnostic care and treatment because of follow-up costs, patients with Medicare still face limitations on care, and recent federal cuts to safety-net programs that address social drivers of health—such as the Special Supplemental Nutrition Program for Women, Infants, and Children—further fuel disparities.
“All people regardless of condition deserve to get guideline-recommended screening at no cost without administrative barriers,” said Molly Guthrie, Vice President of Policy and Advocacy at Susan G. Komen.
Across the two-day summit, speakers kept returning to one point: Tools to prevent and detect cancer early already exist, but the systems built to deliver them have not kept up. Barriers in policy—such as limited screening criteria and inconsistent coverage—remain, as well as persistent social drivers of health, ranging from socioeconomic status to geography.
Making screening easier, more equitable, and more personalized will take sustained collaboration among clinicians, researchers, advocates, industry, and policymakers, because no single institution can do this work alone. But with deliberate investment in both the science and the infrastructure that supports it, the next generation of prevention and screening could reach every patient who needs it.
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