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The 2026 NCCN Fall Policy Summit explored the current state of cancer screening and prevention services in the US, barriers that still drive disparities in screening uptake, and strategies to shift the paradigm of preventive cancer care.
The 2026 National Comprehensive Cancer Network (NCCN) Fall Policy Summit convened on October 5-6 in Washington, DC, to bring together patients, providers, advocates, and industry leaders to discuss the current landscape of cancer screening and prevention services. Speakers and attendees explored advancements in screening at the population level, as well as the opportunities and challenges that still exist in cancer prevention and early detection.
To kick off the two-day event, CAPT Jacqueline Miller, MD, Acting Division Director of the Centers for Disease Control and Prevention (CDC) Division of Cancer Prevention and Control, gave a keynote address on the current state of cancer screening and prevention nationally. Dr. Miller shared that although cancer death rates have decreased for more than 20 years, incidence has increased slightly each year from 2018 to 2022, and costs continue to rise year over year—with an estimated $198 billion spent annually on cancer care.
Although evidence-based population screening is recommended for breast, cervical, colorectal, and lung cancers, certain populations are consistently screened less frequently. Insurance status, income, geography, disability, language, and health literacy all contribute to disparities in screening.
Across populations, lung cancer screening rates remain startlingly low, with only 18.7% of eligible adults screened in 2024. In part, this low rate is due to the fragmented nature of screening. “Lung cancer screening is not as embedded in our health system as it is for other cancers,” Dr. Miller commented. Furthermore, the screening process is often halted by patients’ shame about tobacco use. Even having the initial conversation about smoking history to determine patient eligibility for lung cancer screening is a struggle for many providers during clinical visits.
Dr. Miller also identified a disparity in human papillomavirus (HPV) vaccination rates between adolescents aged 13 to 17 years living in rural (52%) and nonrural (63%) regions. “The HPV vaccine is an underused prevention lever,” she emphasized.
On the topic of barriers to prevention and screening, Dr. Miller outlined the five largest obstacles faced by the CDC: fragmentation across the healthcare system, workforce and capacity constraints, incomplete data for appropriate risk identification, financial and nonfinancial costs that stand in the way of care, and mistrust from misinformation and historical harms.
To counter these challenges, she introduced the following opportunities to shift the paradigm:
To close her address, Dr. Miller urged attendees to sustain community partnerships and patient navigation as core infrastructure to take the next step beyond average-risk assessment to risk stratification. To effect population-level change, screening must be routine rather than episodic, risk-informed, and available to all communities.
“Behind every single statistic is a person,” said Dr. Miller. “The measure of our success will be when fewer people develop cancers, cancers are diagnosed earlier, and all communities share in these outcomes.”
“Many folks think of screening as a single event, but it is a pathway. Just because screening is offered, that is not when the process ends. We need to measure the whole continuum to ensure it is followed.” — Darcie Green
Following the keynote, a panel moderated by Clifford Goodman, PhD, Consultant in Healthcare Technology and Policy, opened the discussion to broader issues in screening and prevention, equity and disparities, and clinical guidelines.
Quickly, a clear theme emerged: Screening is a pathway, not a single event. “If we did everything right, we’d prevent about 50% of cancer deaths,” said Chyke Doubeni, MD, MPH, Chief Health Equity Officer at The Ohio State University Wexner Medical Center. “There are only a few cancers for which screening is found to be effective, but even for those with higher rates, the disparities between different populations are vast.” He emphasized that following through after the initial test is paramount; for screening to be effective, patients need to get to the next phase of treatment when cancer is detected.
Darcie Green, Executive Director of Latinas Contra Cancer, expounded on the significant disparities in cancer screening. “We know so much in oncology today, but so many people are not benefiting from this knowledge. Some people disproportionately do not benefitall of the time, in a way that is extremely predictable,” she stated.
To that end, Misha McKinney, MHA, RN, OCN, Vice President of Clinical Programs at Kaiser Foundation Health Plan Inc and Hospitals, emphasized the need for intentional system design that makes screening easy to do, rather than an extra step for an already busy clinician: “The question isn’t, ‘Why didn’t that patient get screened?’ It’s, ‘Why did we make it so hard?’”
Kate Mevis, Executive Director of US Federal and State Vaccine Policy at Merck, built on this idea, applying it to vaccination rates. “How do we make sure we’re not making it harder for people to get vaccinated?” she posed. Although the cost of vaccines is typically covered by health insurance, Medicare, and Medicaid, access barriers still exist—from clinic hours to pharmacy availability to whether a clinic location is within reasonable driving distance. “We need to take a broader brush when we think about vaccine policies to make sure the broader cancer community is protected from infectious diseases,” said Mevis.
Shifting to the notably low national lung cancer screening rate, panelists agreed that all members of the healthcare team need to take every opportunity to discuss screening with patients who may be eligible. “Assure patients that this is not something they need to feel guilty about. Rather, it’s an opportunity to take control of their health,” said Brandon Leonard, MA, Vice President of Government Affairs at the LUNGevity Foundation.
Dr. Doubeni agreed, adding that lung cancer screening often occurs in specialized places because of the technology required. “There are so few centers available in rural areas, and those are the regions where smoking is most common,” he said.
Inconsistent coverage for follow-up care is another hurdle that prevents many patients from receiving necessary care. Leonard shared that in his experience, most patients have insurance coverage for the initial lung cancer screening test, but not necessarily for the subsequent tests that are necessary to complete a diagnosis. “We’re losing patients at so many different points in the [screening] process,” he said. “Many patients think, ‘If I know I can’t afford follow-up appointments, why get screened in the first place?’”
In closing, McKinney emphasized the importance of recruiting the entire healthcare system to raise the bar for cancer prevention and screening. “When you rely on a single provider or nurse to do prevention measures, that’s not reliable,” she said. “Make it a high-reliability process where there are multiple points of contact. You can’t rely on the [primary care provider] to meet every patient need in a 15-minute consultation.”
Read Part 2 on the ACCCBuzz Blog for coverage of Day 2 of the 2026 NCCN Fall Policy Summit.
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