Reducing Overscreening for Breast, Cervical, and Colorectal Cancers among Older Adults (R21 Clinical Trial Optional) | PA 18 015

Opportunity Information: Apply for PA 18 015

The National Institutes of Health (NIH) funding opportunity titled "Reducing Overscreening for Breast, Cervical, and Colorectal Cancers among Older Adults (R21 Clinical Trial Optional)" (Funding Opportunity Number PA-18-015) supports research aimed at cutting back on unnecessary cancer screening in average-risk older adults. The core idea behind the announcement is that public health and healthcare systems have made real progress increasing screening, but that success has also created a new problem: some older adults continue to receive breast, cervical, or colorectal cancer screening even when the likely benefits are small and the potential harms become more significant. This FOA is focused on the "overscreening" side of the equation, where tests can lead to avoidable follow-up procedures, complications, anxiety, and other burdens that may reduce quality of life rather than improve it.

This opportunity specifically calls for healthcare-setting-based interventions, meaning the work should be grounded in real clinical delivery environments such as primary care practices, health systems, specialty clinics, or integrated care networks. The FOA recognizes that overscreening is rarely caused by a single factor; instead, it can be driven by influences at multiple levels, including patient beliefs and preferences, clinician habits and communication practices, care team workflows, system-level reminders or performance measures, organizational policies, and even community or advocacy norms. Because of that complexity, proposed projects are expected to intervene at two or more levels (for example, combining patient-facing decision support with clinician training and changes to electronic health record prompts), and also to measure outcomes at two or more levels (such as patient knowledge and decisional conflict, clinician ordering behavior, and system-level screening rates). Importantly, applicants are expected to account for the way these levels interact, rather than treating them as isolated targets.

The intent is not only to test strategies that reduce overuse, but also to deepen understanding of why overscreening happens and what consequences it has for older adults, particularly as they balance multiple chronic conditions, functional limitations, and personal priorities. The FOA emphasizes outcomes that matter to older adults, including health, independence, and quality of life, which signals interest in patient-centered endpoints and real-world impacts, not just whether a test was ordered or completed. Clinical trials are optional under this R21 mechanism, so applicants can propose early-stage intervention development, feasibility studies, pilot trials, pragmatic experiments, or other rigorous designs appropriate for exploratory research, as long as the work meaningfully advances knowledge and practice around reducing overscreening.

From an administrative standpoint, this is a discretionary NIH grant using the R21 activity code, which typically supports exploratory and developmental research. The listed award ceiling is $200,000. The CFDA numbers associated with the opportunity are 93.394 and 93.866, and the FOA falls under the education and health activity categories. The original closing date shown in the source information is 2020-01-07, and the opportunity record was created on 2017-11-03.

Eligibility is broad and includes many types of domestic applicants such as state, county, city or township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations other than federally recognized tribal governments; public housing authorities/Indian housing authorities; nonprofit organizations with and without 501(c)(3) status; for-profit organizations other than small businesses; and small businesses. In addition, the FOA explicitly notes other eligible applicants that include Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISISs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, tribal governments other than federally recognized entities, and even non-U.S. organizations (foreign entities). This wide eligibility reflects an interest in reaching diverse healthcare settings and populations, including groups that may experience distinct patterns of screening, care access, or healthcare communication.

Overall, the FOA is aimed at shifting cancer control research to include not only increasing appropriate screening, but also reducing inappropriate screening in older adults. It seeks multi-level, healthcare-embedded interventions that can be evaluated in ways that capture patient, clinician, and system dynamics, with the end goal of minimizing harm from unnecessary testing while supporting healthier aging, preserved function, and better quality of life.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Reducing Overscreening for Breast, Cervical, and Colorectal Cancers among Older Adults (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.394, 93.866.
• This funding opportunity was created on 2017-11-03.
• Applicants must submit their applications by 2020-01-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for PA 18 015

[Watch] Creating a grant proposal using the step-by-step wizard inside the applicant portal: