[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 90 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 90

To require studies and guidelines for breast cancer screening for women 
                  ages 40-49, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 21, 1997

   Ms. Snowe introduced the following bill; which was read twice and 
         referred to the Committee on Labor and Human Resources

_______________________________________________________________________

                                 A BILL


 
To require studies and guidelines for breast cancer screening for women 
                  ages 40-49, 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 ``Breast Cancer Screening Act of 
1997''.

SEC. 2. FINDINGS.

    Congress finds that--
            (1) the National Cancer Institute is the lead Federal 
        agency for research on the causes, prevention, diagnosis, and 
        treatment of cancer;
            (2) health professionals and consumers throughout the 
        Nation regard the guidelines of the National Cancer Institute 
        as reliable scientific and medical advice;
            (3) it has been proven that intervention with routine 
        screening for breast cancer through mammography can save 
        women's lives at a time when medical science is unable to 
        prevent this disease;
            (4) there are statistical limitations to evaluating the 
        efficacy of mammography in a 5-10 year age range of women, 
        using existing studies designed to test the efficacy of 
        mammography in a 25-30 year age range of women;
            (5) there were numerous shortcomings identified in a 
        Canadian study designed to address reduction of mortality from 
        breast cancer in the 40-49 age range;
            (6) to date, it is not possible to have the same degree of 
        scientific confidence about the benefit of mammography for 
        women ages 40-49 as exists for women ages 50-69 due to inherent 
        limitations in the studies that have been conducted;
            (7) meta-analysis (combining the results of several 
        studies) is sometimes useful, and the studies used to reach the 
        National Cancer Institute's conclusions were not easily 
        combined because of variations in design, technology, screening 
        interval, the inclusion or exclusion of clinical breast 
        examination, and quality;
            (8) the existing clinical trial data are inadequate to 
        provide a definite answer to the efficacy of early detection in 
        the 40-49 age group and there has been a dramatic change in 
        technology during the 30-year period since the initiation of 
        the first study of breast cancer screening;
            (9) the majority, approximately 80 percent, of women who 
        are diagnosed with breast cancer have no identifiable risk for 
        this disease;
            (10) breast cancer is the leading cause of cancer death 
        among women in the age group 15-54;
            (11) the American Cancer Society and 21 other national 
        medical organizations and health and consumer groups are at 
        variance with the decision of the National Cancer Institute to 
        rescind the guideline of the Institute for mammography for 
        women ages 40-49;
            (12) Swedish researchers, analyzing studies involving more 
        than 150,000 women, recently found a 24 percent lower death 
        rate among women who received mammograms in their forties; and
            (13) the statement of scientific fact on breast cancer 
        screening issued by the National Cancer Institute on December 
        3, 1993, caused widespread confusion and concern among women 
        and physicians, eroded confidence in mammography, and 
        reinforced barriers and negative attitudes that keep women of 
        all ages from being screened.

SEC. 3. STUDIES AND GUIDELINES.

    The Director of the National Cancer Institute shall--
            (1) conduct adequately designed studies to determine the 
        benefit of screening women ages 40-49 through mammography and 
        other emerging technologies; and
            (2)(A) reissue the guideline rescinded in 1993 for 
        mammography for women ages 40-49; or
            (B)(i) amend the Institute statement of scientific fact on 
        breast cancer screening to clearly state that the uncertainty 
        of evidence for women in this age group is due to the 
        limitations of existing studies (as of the date of issuance of 
        the statement); and
            (ii) direct the public to consider guidelines issued by 
        other organizations.
                                 <all>