Authorizing Legislation

106 STAT. 3372

PUBLIC LAW 102–515—OCT. 24, 1992

Public Law 102-515
102d Congress
Oct. 24, 1992
[S. 3312]
Cancer
Registries
Amendment
Act.
Diseases.
Health and
health care.
42 USC 201 note.
42 USC 280e
note.

An Act

Entitled the “Cancer Registries Amendment Act”.

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the “Cancer Registries Amendment
Act”.

SEC. 2. FINDINGS AND PURPOSE.

(a) FINDINGS.—Congress finds that—
(1) cancer control efforts, including prevention and early
detection, are best addressed locally by State health departments that can identify unique needs;
(2) cancer control programs and existing statewide population-based cancer registries have identified cancer incidence
and cancer mortality rates that indicate the burden of cancer for
Americans is substantial and varies widely by geographic location and by ethnicity;
(3) statewide cancer incidence and cancer mortality data,
can be used to identify cancer trends, patterns, and variation for
directing cancer control intervention;
(4) the American Association of Central Cancer Registries
(AACCR) cites that of the 50 States, approximately 38 have
established cancer registries, many are not statewide and 10
have no cancer registry; and
(5) AACCR also cites that of the 50 States, 39 collect data on
less than 100 percent of their population, and less than half
have adequate resources for insuring minimum standards for
quality and for completeness of case information.
(b) PURPOSE.—It is the purpose of this Act to establish a national
program of cancer registries.

SEC. 3. NATIONAL PROGRAM OF CANCER REGISTRIES.

42 USC 280e.

Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following new part:
“PART M—NATIONAL PROGRAM OF CANCER REGISTRIES

“SEC. 399H. NATIONAL PROGRAM OF CANCER REGISTRIES.

“(a) IN GENERAL.—The Secretary, acting through the Director of
the Centers for Disease Control, may make grants to States, or may
make grants or enter into contracts with academic or nonprofit
organizations designated by the State to operate the State’s cancer
registry in lieu of making a grant directly to the State, to support
the operation of population-based, statewide cancer registries in
order to collect, for each form of in-situ and invasive cancer (with
the exception of basal cell and squamous cell carcinoma of the skin),
data concerning—





















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PUBLIC LAW 102–515—OCT. 24, 1992

106 STAT. 3373

“(1) demographic information about each case of cancer;
“(2) information on the industrial or occupational history of
the individuals with the cancers, to the extent such information
is available from the same record;
“(3) administrative information, including date of diagnosis
and source of information;
“(4) pathological data characterizing the cancer, including
the cancer site, stage of disease (pursuant to Staging Guide),
incidence, and type of treatment; and
“(5) other elements determined appropriate by the
Secretary.
“(b) MATCHING FUNDS.—
“(1) IN GENERAL.—The Secretary may make a grant under
subsection (a) only if the State, or the academic or nonprofit private organization designated by the State to operate the cancer
registry of the State, involved agrees, with respect to the costs
of the program, to make available (directly or through donations
from public or private entities) non-Federal contributions
toward such costs in an amount that is not less than 25 percent
of such costs or $1 for every $3 of Federal funds provided in the
grant.
“(2) DETERMINATION OF AMOUNT OF NON-FEDERAL CONTRIBUTION; MAINTENANCE OF EFFORT.—
“(A) Non-Federal contributions required in paragraph
(1) may be in cash or in kind, fairly evaluated, including
plant, equipment, or services. Amounts provided by the
Federal Government, or services assisted or subsidized to
any significant extent by the Federal Government, may not
be included in determining the amount of such non-Federal
contributions.
“(B) With respect to a State in which the purpose
described in subsection (a) is to be carried out, the Secretary,
in making a determination of the amount of non-Federal
contributions provided under paragraph (1), may include
only such contributions as are in excess of the amount of
such contributions made by the State toward the collection
of data on cancer for the fiscal year preceding the first year
for which a grant under subsection (a) is made with respect
to the State. The Secretary may decrease the amount of nonFederal contributions that otherwise would have been
required by this subsection in those cases in which the State
can demonstrate that decreasing such amount is appropriate
because of financial hardship.
“(c) ELIGIBILITY FOR GRANTS.—
“(1) IN GENERAL.—No grant shall be made by the Secretary
under subsection (a) unless an application has been submitted
to, and approved by, the Secretary. Such application shall be in
such form, submitted in such a manner, and be accompanied by
such information, as the Secretary may specify. No such application may be approved unless it contains assurances that the
applicant will use the funds provided only for the purposes specified in the approved application and in accordance with the
requirements of this section, that the application will establish
such fiscal control and fund accounting procedures as may be
necessary to assure proper disbursement and accounting of
Federal funds paid to the applicant under subsection (a) of this

106 STAT. 3374

PUBLIC LAW 102–515—OCT. 24, 1992
section, and that the applicant will comply with the peer review
requirements under sections 491 and 492.
“(2) ASSURANCES.—Each applicant, prior to receiving Federal
funds under subsection (a), shall provide assurances satisfactory
to the Secretary that the applicant will—
“(A) provide for the establishment of a registry in accordance with subsection (a);
“(B) comply with appropriate standards of completeness,
timeliness, and quality of population-based cancer registry
data;
“(C) provide for the annual publication of reports of cancer data under subsection (a); and
“(D) provide for the authorization under State law of the
statewide cancer registry, including promulgation of regulations providing—
“(i) a means to assure complete reporting of cancer
cases (as described in subsection (a)) to the statewide
cancer registry by hospitals or other facilities providing
screening, diagnostic or therapeutic services to patients
with respect to cancer;
“(ii) a means to assure the complete reporting of cancer cases (as defined in subsection (a)) to the statewide
cancer registry by physicians, surgeons, and all other
health care practitioners diagnosing or providing treatment for cancer patients, except for cases directly
referred to or previously admitted to a hospital or other
facility providing screening, diagnostic or therapeutic
services to patients in that State and reported by those
facilities;
“(iii) a means for the statewide cancer registry to
access all records of physicians and surgeons, hospitals,
outpatient clinics, nursing homes, and all other facilities,
individuals, or agencies providing such services to
patients which would identify cases of cancer or would
establish characteristics of the cancer, treatment of the
cancer, or medical status of any identified patient;
“(iv) for the reporting of cancer case data to the
statewide cancer registry in such a format, with such
data elements, and in accordance with such standards of
quality timeliness and completeness, as may be established by the Secretary;
“(v) for the protection of the confidentiality of all cancer case data reported to the statewide cancer registry,
including a prohibition on disclosure to any person of
information reported to the statewide cancer registry
that identifies, or could lead to the identification of, an
individual cancer patient, except for disclosure to other
State cancer registries and local and State health officers;
“(vi) for a means by which confidential case data may
in accordance with State law be disclosed to cancer
researchers for the purposes of cancer prevention, control
and research;
“(vii) for the authorization or the conduct, by the
statewide cancer registry or other persons and organizations, of studies utilizing statewide cancer registry data,

PUBLIC LAW 102–515—OCT. 24, 1992

106 STAT. 3375

including studies of the sources and causes of cancer,
evaluations of the cost, quality, efficacy, and appropriateness of diagnostic, therapeutic, rehabilitative, and preventative services and programs relating to cancer, and
any other clinical, epidemiological, or other cancer
research; and
“(viii) for protection for individuals complying with
the law, including provisions specifying that no person
shall be held liable in any civil action with respect to a
cancer case report provided to the statewide cancer registry, or with respect to access to cancer case information
provided to the statewide cancer registry.
“(d) RELATIONSHIP TO CERTAIN PROGRAMS.—
“(1) IN GENERAL.—This section may not be construed to act as
a replacement for or diminishment of the program carried out
by the Director of the National Cancer Institute and designated
by such Director as the Surveillance, Epidemiology, and End
Results Program (SEER).
“(2) SUPPLANTING OF ACTIVITIES.—In areas where both such
programs exist, the Secretary shall ensure that SEER support is
not supplanted and that any additional activities are consistent
with the guidelines provided for in subsection (c)(2) (C) and (D)
and are appropriately coordinated with the existing SEER program.
“(3) TRANSFER OF RESPONSIBILITY.—The Secretary may not
transfer administration responsibility for such SEER program
from such Director.
“(4) COORDINATION.—To encourage the greatest possible efficiency and effectiveness of Federally supported efforts with
respect to the activities described in this subsection, the
Secretary shall take steps to assure the appropriate coordination of programs supported under this part with existing
Federally supported cancer registry programs.
“(e) R EQUIREMENT R EGARDING C ERTAIN S TUDY ON B REAST
CANCER.—In the case of a grant under subsection (a) to any State
specified in section 399K(b), the Secretary may establish such
conditions regarding the receipt of the grant as the Secretary determines are necessary to facilitate the collection of data for the study
carried out under section 399C.
“SEC. 399I. PLANNING GRANTS REGARDING REGISTRIES.

“(a) IN GENERAL.—
“(1) STATES.—The Secretary, acting through the Director of
the Centers for Disease Control, may make grants to States for
the purpose of developing plans that meet the assurances
required by the Secretary under section 399B(c)(2).
“(2) OTHER ENTITIES.—For the purpose described in paragraph (1), the Secretary may make grants to public entities
other than States and to nonprofit private entities. Such a grant
may be made to an entity only if the State in which the purpose
is to be carried out has certified that the State approves the
entity as qualified to carry out the purpose.
“(b) APPLICATION.—The Secretary may make a grant under subsection (a) only if an application for the grant is submitted to the
Secretary, the application contains the certification required in subsection (a)(2) (if the application is for a grant under such subsec-

42 USC 280e–1.

106 STAT. 3376

42 USC 280e–2.

42 USC 280e–3.

42 USC 280e–4.

PUBLIC LAW 102–515—OCT. 24, 1992

tion), and the application is in such form, is made in such manner,
and contains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this section.

“SEC. 399J. TECHNICAL ASSISTANCE IN OPERATIONS OF STATEWIDE
CANCER REGISTRIES.

“The Secretary, acting through the Director of the Centers for
Disease Control, may, directly or through grants and contracts, or
both, provide technical assistance to the States in the establishment and operation of statewide registries, including assistance in
the development of model legislation for statewide cancer registries
and assistance in establishing a computerized reporting and data
processing system.

“SEC. 399K. STUDY IN CERTAIN STATES TO DETERMINE THE FAC
TORS CONTRIBUTING TO THE ELEVATED BREAST CANCER MORTALITY RATES.

“(a) IN GENERAL.—Subject to subsections (c) and (d), the Secretary, acting through the Director of the National Cancer Institute,
shall conduct a study for the purpose of determining the factors
contributing to the fact that breast cancer mortality rates in the
States specified in subsection (b) are elevated compared to rates in
other States.
“(b) RELEVANT STATES.—The States referred to in subsection (a)
are Connecticut, Delaware, Maryland, Massachusetts, New
Hampshire, New Jersey, New York, Rhode Island, Vermont, and the
District of Columbia.
“(c) COOPERATION OF STATE.—The Secretary may conduct the
study required in subsection (a) in a State only if the State agrees
to cooperate with the Secretary in the conduct of the study, including providing information from any registry operated by the State
pursuant to section 399H(a).
“(d) PLANNING, COMMENCEMENT, AND DURATION.—The Secretary
shall, during each of the fiscal years 1993 and 1994, develop a plan
for conducting the study required in subsection (a). The study shall
be initiated by the Secretary not later than fiscal year 1994, and
the collection of data under the study may continue through fiscal
year 1998.
“(e) REPORT.—Not later than September 30, 1999, the Secretary
shall complete the study required in subsection (a) and submit to
the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources
of the Senate, a report describing the findings and recommendations made as a result of the study.

“SEC. 399L. AUTHORIZATION OF APPROPRIATIONS.

“(a) REGISTRIES.—For the purpose of carrying out this part, the
Secretary may use $30,000,000 for each of the fiscal years 1993
through 1997. Out of any amounts used for any such fiscal year, the
Secretary may obligate not more than 25 percent for carrying out
section 399I, and not more than 10 percent may be expended for
assessing the accuracy, completeness and quality of data collected,
and not more than 10 percent of which is to be expended under subsection 399J.

PUBLIC LAW 102–515—OCT. 24, 1992

106 STAT. 3377

“(b) BREAST CANCER STUDY.—Of the amounts appropriated for
the National Cancer Institute under subpart 1 of part C of title IV
for any fiscal year in which the study required in section 399K is
being carried out, the Secretary shall expend not less than
$1,000,000 for the study.”.
Approved October 24, 1992.
Authorization extended through 1998.

LEGISLATIVE HISTORY–S. 3312:
CONGRESSIONAL RECORD, Vol. 138 (1992):
Oct. 2, considered and passed Senate.
Oct. 5, considered and passed House, amended.
Oct. 7, Senate concurred in House amendment.