Authorizing Legislation: Cancer Registries Amendment Act

106 STAT. 3372

PUBLIC LAW 102-515—OCT. 24, 1992

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

Entitled the "Cancer Registries Amendment Act".

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

of

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 CEincer 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 quahty 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.

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
42 u s e 280e.

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

"(a) I N GENERAL.—^The Secretary, acting through the Director
of the Centers for Disease Control, may make grsuits 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—

PUBLIC LAW 102-515—OCT. 24, 1992
"(1) demographic iikformation 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) I N 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 pubhc 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 OP 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 (Jovemment, or services assisted or subsidized to
any significant extent by the Federal (Jovemment, may
not be included in determining the amount of such nonFederal 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 nonFederal contributions provided imder 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 non-Federal 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 luiless it contains assurances that
the applicant will use the funds provided only for the purposes
specified in the approved appUcation and in accordance with
the requirements of this section, that the appHcation will estabUsh 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)

106 STAT. 3373

106 STAT. 3374

PUBLIC LAW 102-515—OCT. 24, 1992
of this 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 estabhshment of a registry in
accordance with subsection (a);
"(B) comply with appropriate standards of completeness, timeliness, and qusdity 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 meguis 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
faciUties, 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 reg-

PUBLIC LAW 102-515—OCT. 24, 1992

106 STAT. 3375

istry data, 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 cUnical, epidemiological, or
other cancer research; and
"(viii) for protection for individuals complying with
the law, including provisions specifying that no person
shall be held Uable 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) I N 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) £uid are appropriately coordinated with the existing
SEER program.
"(3) TRANSFER OF RESPONSIBILITY.—The Secretary may not

transfer administration responsibiUty 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) REQUIREMENT REGARDING CERTAIN STUDY ON BREAST CAN-

CER.—In the case of a grant under subsection (a) to any State
specified in section 399K(ib), 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 imder section 399C.
"SEC. 3991. PLANNING GRANTS REGARDING REGISTRIES.
"(a) I N GENERAL.—

"(1) STATES.—^The Secretary, acting through the Director
of the Centers for Disease Control, may make grsuits 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 para-

graph (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) onlv if an application for the grant is submitted
to the Secretary, the application contains the certification required
in subsection (a)(2) (if the appUcation is for a grant imder such
subsection), and the application is in such form, is made in such

42 USC 280e-l.

106 STAT. 3376

PUBLIC LAW 102-515—OCT. 24,1992

manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out
this section.
42 u s e 280e-2.

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