As an American committed to cancer surveillance, I’m urging you do all you can to protect essential public health professionals and adequately fund cancer prevention and research. Please work to:

- The CDC's National Program of Cancer Registries (NPCR) is threatened with elimination and The Surveillance, Epidemiology, and End Results (SEER) Program at NCI will be severely impacted by NCI cuts. This alone will severely undermine, if not eliminate, the effectiveness of U.S. cancer surveillance. NPCR and SEER are the foundation of cancer surveillance in the US. The war on cancer cannot be won without cancer surveillance. Both programs need your full support and commitment. Additionally, the recently reinstated National Firefighter Registry housed at CDC’s National Institute for Occupational Safety and Health (NIOSH) is dependent on CDC-NPCR data in order to functionally exist. Please stop these threats to the funding for these programs and adequately fund cancer surveillance functions of the federal government, including the highest possible increases for cancer programs at the CDC, the highest possible increases for cancer research at the NIH and NCI and maintain funding for ARPA-H.

-Lift the moratorium on external communications by federal employees--the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH), including the National Cancer Institute (NCI), have been prevented from conducting the business of their agencies by communicating or engaging on topics of interest, including participating in health conferences to present or learn about public health data and from initiating public health programming.

-Restore and retain our critical federal employees at the Centers for Disease Control and Prevention, the National Institutes of Health/National Cancer Institute and the Department of Veterans Affairs. The cancer surveillance programs at CDC and NCI are integral to our national public health. Without federal personnel in place, we risk incomplete reporting of the nation’s incidences of cancer. The RIFs that have already occurred have been disruptive and we understand more are underway. Staff who were subject to RIFs should be rehired and no further cuts should be made. With last year’s recent congressional mandate to fully report cancer cases among veterans to state central cancer registries beginning to be implemented, now is not the time to eliminate the personnel fulfilling that important function.

-Repeal the administration’s executive orders mandating a return to in-office work for federal employees. While I fully support efforts to increase government efficiency, I strongly urge that these policies do not come at the cost of US cancer surveillance and integrity including cancer among veterans. A blanket return to office policy would disrupt U.S. cancer surveillance by reducing the workforce for this vital component of public health. Cancer registrars are part of a boutique profession—with a recent survey indicating 97% work remotely, with many healthcare facilities not having any registrars available in close geographic proximity. Further, the established protocol for U.S. health systems has been to devote space to patient care rather than in-house cancer registrar staffing. This is impactful to veterans and military health systems where civilian cancer registrars have been routinely hired to work as remote employees. The executive order threatens that protocol.

I look forward to hearing how you will work to support cancer surveillance and the key federal personnel who are waging the fight against cancer.

Sincerely,