[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1899 Introduced in Senate (IS)]
108th CONGRESS
1st Session
S. 1899
To improve data collection and dissemination, treatment, and research
relating to cancer, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 20, 2003
Mr. Brownback (for himself and Mr. Gregg) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To improve data collection and dissemination, treatment, and research
relating to cancer, and for other purposes.
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 ``National Cancer Act of 2003''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) In 2003, an estimated 1,334,100 Americans will be
diagnosed with some form of cancer.
(2) In 2003, an estimated 556,500 Americans will die of
cancer. In the United States, 1 in every 4 deaths results from
cancer.
(3) In 2002, the National Institutes of Health estimated
the overall cost of cancer at $171,600,000,000.
(4) In 2003, an estimated 211,300 American women and 1,300
men will be diagnosed with breast cancer, and 40,200 will die
of the disease. A mammogram every 1-2 years can reduce the risk
of dying by about 16 percent for women 40 years of age and
older.
(5) In 2003, an estimated 40,100 women will be newly
diagnosed with cancer of the uterine corpus and 6,800 women
will die of the disease.
(6) In 2003, an estimated 147,500 Americans will be
diagnosed with colorectal cancer and 57,100 will die of the
disease.
(7) Incidence rates of colorectal cancer stabilized between
1995 and 1999. Research suggests that declines may be in part
due to increased screening and polyp removal.
(8) The Chronic Disease Prevention Department found that
screening for colorectal cancer can reduce the number of deaths
by at least 30 percent.
(9) Regular screening examinations by a health care
professional can result in early detection of cancers of the
breast, colon, rectum, prostate, testis, oral cavity, and skin.
If all these cancers were diagnosed at a localized stage
through regular examinations, the 5-year survival rate would
increase from 82 percent to 95 percent.
(10) Cancers of the lung, mouth, larynx, bladder, kidney,
cervix, esophagus, and pancreas are related to tobacco use. The
American Cancer Society estimates that in 2003 more than
180,000 cancer deaths will be caused by tobacco use. Smoking
alone causes \1/3\ of all cancer deaths.
(11) More than 1,000,000 skin cancers expected to be
diagnosed in 2003 could have been prevented by protection from
the sun's rays.
(12) An estimated 9,000 new cases of childhood cancer are
expected to occur in 2003.
(13) Cancer is the chief cause of death by disease in
children between the ages of 1 and 14.
(14) The American Cancer Society estimates that
approximately \1/3\ of the 556,500 cancer deaths expected in
2003 will be related to nutrition, physical inactivity,
obesity, and other lifestyle factors that could be prevented.
(15) About 77 percent of all cancers are diagnosed at age
55 and older. In order to ensure high quality cancer care for
American seniors, medicare reimbursements must reflect the true
cost of treatment in every treatment setting and medicare
payments should accurately reflect the cost of drug and
biologics as well as the cost of administering drugs and
supportive care therapies.
(16) Despite an aging population, death rates for the most
common cancers, lung, colorectal, breast, and prostate continue
to drop at an average of 1.7 percent per year.
(17) In May 2001, Gleevec, the first in what is expected to
be a number of cancer treatments, was approved for use by the
Food and Drug Administration as it appeared to be effective in
stopping the growth of deadly Chronic Myeloid Leukemia cells
within 3 months of use. In 2002, Gleevec showed ability to stop
growth of gastrointestinal stromal tumors.
(18) In early 2003, researchers used gene chips to
accurately predict whether or not breast cancer tumors would
spread in the future. If the findings are validated, doctors
will be able to determine which patients are likely to relapse
and need chemotherapy, while sparing those with a favorable
prognosis from additional treatment.
(19) The Lance Armstrong Foundation, a leading national
organization providing services and support for cancer
survivors, defines cancer survivorship as living with, through,
and beyond cancer.
(20) In 2001, there were 9,600,000 cancer survivors in the
United States.
(21) Sixty percent of adults diagnosed with cancer survive
at least 5 years.
(22) While nearly every childhood cancer diagnosis 20 years
ago was fatal, today more than 80 percent of children diagnosed
with cancer survive at least 5 years.
SEC. 3. SENSE OF THE SENATE.
It is the sense of the Senate that the United States is at a point
in history in which we must take the proper steps to reach the goal of
making cancer survivorship the rule and cancer deaths rare by the year
2015.
TITLE I--PUBLIC HEALTH PROVISIONS
SEC. 101. NATIONAL PROGRAM OF CANCER REGISTRIES.
Part M of title III of the Public Health Service Act (42 U.S.C.
280e et seq.) is amended by inserting after section 399B the following:
``SEC. 399B-1. ENHANCING CANCER REGISTRIES AND PREPARING FOR THE
FUTURE.
``(a) Strategic Plan.--Not later than 1 year after the date of
enactment of the National Cancer Act of 2003 the Secretary shall
develop a plan and submit a report to Congress that outlines strategies
by which the State cancer registries funded with grants under section
399B and the Surveillance, Epidemiology, and End Results program of the
National Cancer Institute (in this section referred to as the `SEER
program') can share information to ensure more comprehensive cancer
data. The report shall include ways in which the Secretary will--
``(1) standardize data between State cancer registries and
the SEER program;
``(2) increase the portability and usability of data files
from each registry for researchers and public health planners;
``(3) ensure data collection from the greatest number of
health care facilities possible;
``(4) maximize the use of State registry data and data from
the SEER program in State and regional public health planning
processes; and
``(5) promote the use of data to--
``(A) improve the health status of cancer
survivors; and
``(B) research quality of cancer care and access to
that care.''.
SEC. 102. ENHANCING EXISTING SCREENING EFFORTS.
(a) Grant and Contract Authority of States.--Section 1501(b)(2) of
the Public Health Service Act (42 U.S.C. 300k(b)(2)) is amended to read
as follows:
``(2) Certain applications.--
``(A) Strategies for colorectal cancer screening.--
If any entity submits an application to a State to
receive an award of a grant or contract pursuant to
paragraph (1) that includes strategies for colorectal
cancer screening and outreach, the State may give
priority to the application submitted by that entity in
any case in which the State determines that the quality
of such application is equivalent to the quality of the
application submitted by the other entities.
``(B) Women diagnosed with cancer.--If any entity
submits an application to a State to receive an award
of a grant or contract pursuant to paragraph (1) that
includes strategies for the provision of treatment for
uninsured women diagnosed with cancer discovered in the
course of the screening, the State may give priority to
the application submitted by that entity in any case in
which the State determines that the quality of such
application is equivalent to the quality of the
application submitted by the other entities.''.
(b) Requirements With Respect to Type and Quality of Services.--
Section 1503 of the Public Health Service Act (42 U.S.C. 300m) is
amended by adding at the end the following:
``(d) Waiver of Direct Services Requirement.--The Secretary may
waive the requirement under subsection (a)(1) if--
``(1) the State involved will use the grant under this
section for a demonstration project that will leverage private
funds to supplement program efforts; or
``(2) such requirement would cause a barrier to the
enrollment of qualifying women.''.
(c) Authorization of Appropriations.--Section 1510(a) of the Public
Health Service Act (42 U.S.C. 300n-5(a)) is amended by striking
``$50,000,000'' and all that follows and inserting ``such sums as may
be necessary for each of fiscal years 2004 through 2008.''.
(d) Report on the Comprehensive Colorectal Cancer Initiative.--Not
later than 6 months after the date of enactment of this Act, the
Director of the Centers for Disease Control and Prevention shall submit
to the appropriate committees of Congress a report containing an
assessment of the success of the Comprehensive Colorectal Cancer
Initiative (within the Centers for Disease Control and Prevention) in--
(1) increasing public awareness of colorectal cancer;
(2) increasing awareness of screening guidelines among
health care providers;
(3) monitoring national colorectal cancer screening rates;
(4) promoting increased patient-provider communication
about colorectal cancer screening;
(5) supporting quantitative and qualitative research
efforts; and
(6) providing funding to State programs to implement
colorectal cancer priorities.
SEC. 103. ENHANCED PATIENT EDUCATION.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by adding at the end the following:
``SEC. 399O. ENHANCED PATIENT EDUCATION.
``(a) Grants Authorized.--The Secretary is authorized to award
grants to eligible entities to implement programs to educate patients
and their families about--
``(1) the availability and options of effective medical
techniques and pain management technology therapies to reduce
and prevent pain and suffering for those with cancer upon
diagnosis;
``(2) the unique health challenges associated with cancer
survivorship, including--
``(A) the role of followup care and monitoring to
support and improve the long-term quality of life for
cancer survivors;
``(B) physical activity and healthy lifestyles; and
``(C) the availability of peer and mentor support
programs; and
``(3) community resources available to increase access to
quality cancer care.
``(b) Application.--An eligible entity desiring a grant under this
section shall submit to the Secretary an application at such time, in
such manner, and containing such information as the Secretary may
require.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be
necessary.''.
SEC. 104. PRACTITIONER EDUCATION PROGRAM.
Section 414 of the Public Health Service Act (42 U.S.C. 285a-3) is
amended by adding at the end the following:
``(d) In order to receive funding under this section, a center
described under subsection (a) shall maintain a program for
disseminating to patients and research participants, as well as their
caregivers, the latest information about--
``(1) pain and symptom management and palliative care; and
``(2) the unique clinical and research challenges
associated with cancer survivorship.
``(e) The Secretary may provide additional amounts to fund centers
under subsection (a) that develop innovative relationships with
community cancer centers, community health centers, rural hospitals,
and other community-based health care providers who target medically
underserved populations for the purpose of increasing access to quality
cancer care.''.
SEC. 105. ELEVATING THE IMPORTANCE OF PAIN MANAGEMENT AND CANCER
SURVIVORSHIP THROUGHOUT THE NATION'S CANCER PROGRAMS.
(a) National Cancer Program.--Section 411 of the Public Health
Service Act (42 U.S.C. 285a) is amended to read as follows:
``Sec. 411. The National Cancer Program shall consist of--
``(1) an expanded, intensified, and coordinated cancer
research program encompassing the research programs conducted
and supported by the Institute and the related research
programs of the other national research institutes, including
research programs for--
``(A) pain and symptom management;
``(B) survivorship; and
``(C) the prevention of cancer caused by
occupational or environmental exposure to carcinogens;
and
``(2) the other programs and activities of the Institute,
including research on populations with both uniquely diverse
genetic variation and geographic isolation.''.
(b) Cancer Control Programs.--Section 412(2) of the Public Health
Service Act (42 U.S.C. 285a-1(2)) is amended--
(1) in subparagraph (A), by striking ``, and'' and
inserting a semicolon; and
(2) by adding at the end the following:
``(C) appropriate methods of pain and symptom
management for individuals with cancer, including end-
of-life care and cancer survivorship; and''.
(c) Special Authorities of the Director.--Section 413(a)(2) of the
Public Health Service Act (42 U.S.C. 285a-2(a)(2)) is amended--
(1) in subparagraph (D), by striking ``and'' at the end;
(2) in subparagraph (E), by striking the period and
inserting ``; and''; and
(3) by adding at the end the following:
``(F) assess and improve pain and symptom management of
cancer throughout the course of treatment and cancer
survivorship.''.
(d) Breast and Gynecological Cancers.--Section 417 of the Public
Health Service Act (42 U.S.C. 285a-6) is amended--
(1) in subsection (c)(1)--
(A) in subparagraph (D), by striking ``and'' at the
end;
(B) in subparagraph (E), by striking the period and
inserting ``; and''; and
(C) by inserting after subparagraph (E) the
following:
``(F) basic, clinical, and applied research
concerning pain and symptom management and cancer
survivorship.''; and
(2) in subsection (d)--
(A) in paragraph (4), by striking ``and'' at the
end;
(B) in paragraph (5), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(6) basic, clinical, and applied research concerning pain
and symptom management and cancer survivorship.''.
(e) Prostate Cancer.--Section 417A(c)(1) of the Public Health
Service Act (42 U.S.C. 285a-7(c)(1)) is amended--
(1) in subparagraph (F), by striking ``and'' at the end;
(2) in subparagraph (G), by striking the period and
inserting ``; and''; and
(3) by inserting after subparagraph (G) the following:
``(H) basic and clinical research concerning pain
and symptom management and cancer survivorship.''.
SEC. 106. SURVIVORSHIP RESEARCH PROGRAM.
Subpart 1 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285 et seq.) is amended by adding at the end the following:
``SEC. 417D. SURVIVORSHIP RESEARCH PROGRAM.
``(a) Establishment.--There is established, within the Institute,
an Office on Cancer Survivorship (in this section referred to as the
`Office'), which may be headed by an Associate Director, to implement
and direct the expansion and coordination of the activities of the
Institute with respect to cancer survivorship research.
``(b) Collaboration Among Agencies.--In carrying out the activities
described in subsection (a), the Office shall collaborate with other
institutes, centers, and offices within the National Institutes of
Health that are determined appropriate by the Office.
``(c) Report.--Not later than 1 year after the date of enactment of
this section, the Secretary shall prepare and submit to the appropriate
committees of Congress a report providing a description of the
survivorship activities of the Office and strategies for future
activities.''.
TITLE II--RESEARCH PROVISIONS
SEC. 201. NATIONAL CANCER INSTITUTE.
(a) Other Transactions Authority.--Subpart 1 of part C of title IV
of the Public Health Service Act (42 U.S.C. 285 et seq.), as amended by
section 106, is further amended by adding at the end the following:
``SEC. 417E. OTHER TRANSACTIONS AUTHORITY.
``Notwithstanding any other provision of this subpart, the Director
of the National Cancer Institute may cofund grant projects with private
entities for any purpose described in this subpart.''.
(b) Sense of the Senate on a Central Institutional Review Board.--
It is the sense of the Senate that--
(1) the current procedure of sending 1 clinical trial
through multiple local institutional review boards may not be
the most efficient method for the protection of patients
enrolled in the trial and may delay the process of bringing
lifesaving treatment to cancer patients;
(2) the National Cancer Institute should be commended for
its work in centralizing the institutional review board
process; and
(3) the research community should continue to streamline
the institutional review board process in order to bring
lifesaving treatments to patients as quickly as possible.
(c) Patient and Provider Outreach Opportunities With Experimental
Therapies.--For the purpose of enhancing patient access to experimental
therapies, the National Cancer Institute shall conduct the following
activities:
(1) Integrate, to the maximum extent practicable, trials
being conducted by private manufacturers into the National
Cancer Institute's clinical trials online database. Such
integration may require specific awareness-raising and outreach
activities by the National Cancer Institute to private
industry.
(2) Establish an education program which provides patients
and providers with--
(A) information about how to access and use the
National Cancer Institute clinical trials database
online; and
(B) information about the Food and Drug
Administration process for approving the use of drugs
and biologics for a single patient.
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