I 111th CONGRESS 1st Session H. R. 1740 IN THE HOUSE OF REPRESENTATIVES March 26, 2009 Ms. Wasserman Schultz (for herself, Mrs. Myrick, Ms. DeLauro, Mrs. Christensen, Ms. Bean, Ms. Pelosi, Ms. Bordallo, Mr. Serrano, Mrs. Capps, Mr. Weiner, Mr. Wexler, Mr. Tonko, Mr. Davis of Alabama, Mr. Sablan, Ms. McCollum, Mr. Berman, Ms. Ros-Lehtinen, Mr. Baca, Mr. Hastings of Florida, Mr. Meek of Florida, Ms. Castor of Florida, Mr. Lincoln Diaz-Balart of Florida, Mr. Klein of Florida, Ms. Fudge, Ms. Schakowsky, Ms. Jackson-Lee of Texas, Mr. Maffei, Mr. Larson of Connecticut, Ms. Sutton, Mr. Cummings, Mr. Burton of Indiana, Mr. Poe of Texas, Ms. Lee of California, Mr. Moore of Kansas, Mr. Mario Diaz-Balart of Florida, Ms. Markey of Colorado, Ms. Clarke, Mr. Perriello, Ms. Kosmas, Ms. Matsui, Mr. Gene Green of Texas, Ms. Hirono, Mrs. McCarthy of New York, Mr. Boren, Mrs. Davis of California, Mr. Nadler of New York, Mrs. Dahlkemper, Ms. Schwartz, Ms. Edwards of Maryland, Ms. Kilpatrick of Michigan, Mr. Murtha, Ms. Baldwin, Ms. Harman, Mrs. Emerson, Mr. Hodes, Mr. Hall of New York, Mr. Fattah, Mrs. Tauscher, Ms. Norton, Mr. Conyers, Mr. Ryan of Ohio, Mr. Jones, Mr. Braley of Iowa, Ms. Titus, Mr. Van Hollen, Mr. Arcuri, Mr. Welch, Ms. Herseth Sandlin, Mr. Nye, Mr. Carney, Mrs. Kirkpatrick of Arizona, Mr. Doggett, Ms. Kilroy, Mr. Barrow, Ms. Linda T. Sánchez of California, Mr. Walz, Mr. Donnelly of Indiana, Mr. Becerra, Mr. Schiff, Mr. Schauer, Mr. Hinchey, Mrs. Lowey, Mr. Perlmutter, Mr. Ellison, Mr. Teague, Mr. Cohen, Mr. Doyle, Mr. Mitchell, Mr. Sestak, Mr. McMahon, Mr. Olver, Mr. Shuler, Mr. Thompson of California, Ms. Kaptur, Mr. Massa, Mr. Reyes, Mrs. Maloney, Mr. Waxman, Ms. Shea-Porter, Mr. Boyd, Mr. Dicks, Mr. LaTourette, Mr. Obey, Mr. Wamp, Mr. Price of North Carolina, Mr. Manzullo, Mrs. Bono Mack, Mr. Posey, Mr. Stearns, Mr. Tierney, Mr. Issa, Mr. Mack, Mr. Scott of Georgia, Mr. Clyburn, Mr. Childers, Mr. Cleaver, Mr. Luján, Mr. Foster, Mr. Kanjorski, Ms. Speier, Mr. Hoyer, Ms. Richardson, Mr. Patrick J. Murphy of Pennsylvania, Mr. Murphy of Connecticut, Mr. Boccieri, Mr. Wilson of Ohio, Mr. Neal of Massachusetts, Mr. Pallone, Mr. Kratovil, Mr. Al Green of Texas, Mr. Putnam, Mrs. Halvorson, Mr. Kind, Mr. Kildee, Mr. Kennedy, Mr. Boozman, Mrs. Biggert, Mr. Lance, Mrs. McMorris Rodgers, Mr. Yarmuth, Mr. Shimkus, Mr. Carnahan, Mr. Loebsack, Mr. Rehberg, Mr. Alexander, Mr. Heinrich, Mr. Sires, Mr. Ellsworth, Mr. Matheson, Mr. Taylor, Mr. Burgess, Mrs. Blackburn, Ms. Ginny Brown-Waite of Florida, Mr. Barton of Texas, Mr. Clay, Mr. Honda, Mr. Frank of Massachusetts, Ms. Woolsey, Mr. Fortenberry, Mr. Crenshaw, Mr. Sam Johnson of Texas, Mr. Culberson, Mr. Marchant, Mr. Lucas, Mr. Smith of Texas, Mr. Kirk, Mrs. Capito, Mr. Gonzalez, Mr. Faleomavaega, Mr. Latham, Mr. Cantor, Ms. Fallin, Ms. Waters, Mr. Melancon, Ms. Zoe Lofgren of California, Mr. Oberstar, Mr. Rahall, Mr. Pastor of Arizona, Mr. Himes, Mr. Buyer, Mr. Payne, Mr. Costello, Mr. Turner, and Mr. Price of Georgia) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to increase awareness of the risks of breast cancer in young women and provide support for young women diagnosed with breast cancer.

1.

Short title

This Act may be cited as the Breast Cancer Education and Awareness Requires Learning Young Act of 2009 or EARLY Act.

2.

Young women’s breast cancer awareness and support

Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the following: S

Programs relating to breast cancer

399HH.

Young women’s breast cancer awareness and support

(a)

Public education campaign

(1)

In general

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall conduct a national evidence-based education campaign— (A)to increase public awareness regarding the threats posed by breast cancer to young women of all ethnic and cultural backgrounds, including the particular risks faced by certain ethnic and cultural groups; and (B)focusing on awareness of risk factors of breast cancer among young women and achieving early detection of breast cancer among young women through community-centered informational forums, public service advertisements, and media campaigns. (2)

Authorized activities

In conducting the education campaign under paragraph (1), the Secretary may— (A)make public announcements targeted towards young women with the goal of educating them that breast cancer occurs in young women and the steps they can take to recognize their individual risk factors and ensure early detection of breast cancer, ensuring that such messaging is age-appropriate; (B)provide education, through written materials, identifying evidence based methods to lower the risk of breast cancer in young women through changes in lifestyle including diet, exercise, and environmental factors; (C)conduct other activities determined by the Secretary to promote educational awareness, early detection, and risk-reducing practices among young women and increase the number of young women with breast cancer warning signs who seek immediate care; (D)award grants, contracts, or cooperative agreements to appropriate State agencies to carry out secondary school and university education campaigns, focusing on breast cancer awareness among young women; (E)develop and distribute to young women, physicians, and other appropriate health care professionals, educational materials— (i)designed for young women; (ii)relating to particular risk factors for breast cancer in women under the age of 40; (iii)identifying methods for increasing early detection, including clinical breast exams, blood component analysis, and where there is a increased risk of breast cancer due to ethnic background, genetic mutations, or other risk factors, other predictive tools such as genetic counseling and testing; (iv)identifying methods for increasing self awareness, including breast self exams, learning how to perform such exams, and knowing the signs of breast malignancies; (v)identifying evidenced based methods to lower the risk of breast cancer through changes in lifestyle, including diet, exercise, and environmental factors; (vi)identifying available treatment options for breast cancer; and (vii)for young women who have been diagnosed with breast cancer, health information from credible sources that provides information on— (I)fertility preservation; (II)support, including social, emotional, psychosocial, financial, lifestyle, and caregiver support; (III)familial risk factors; and (IV)risk reduction strategies to reduce recurrence or metastasis; and (F)carry out a health education program targeted to specific higher-risk populations of young women based on race, ethnicity, level of acculturation, and family history, including the African-American and Ashkenazi Jewish populations under 40 years of age. (3)

Media campaign

In conducting the education campaign under paragraph (1), the Secretary shall award grants to entities to establish national multimedia campaigns oriented to young women that— (A)will encourage young women to be aware of— (i)their personal risk factors, including by talking to their medical practitioner about those risks; (ii)strategies for increasing early detection, including clinical breast exams, and where there is a increased risk of breast cancer due to ethnic background, genetic mutations, or other risk factors, other predictive tools such as genetic counseling and testing; (iii)strategies for increasing self awareness, including doing breast self exams, learning how to perform such exams, and knowing the signs of breast malignancies; (iv)evidence based preventative lifestyle changes, including eating healthily and maintaining a healthy weight; and (v)other breast cancer early detection and risk reduction strategies determined appropriate by the Secretary; (B)will encourage young women of specific higher-risk populations based on race, ethnicity, level of acculturation, and family history, including the African-American and Ashkenazi Jewish populations under 40 years of age to talk to their medical practitioners about those risks and methods for appropriate screening and surveillance, including available genetic testing and counseling; and (C)may include advertising through television, radio, print media, billboards, posters, all forms of existing and emerging social networking media, other Internet media, and any other media determined appropriate by the Secretary. (4)

Advisory committee

. (A)

Establishment

Not later than 60 days after the date of the enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish an advisory committee to assist in creating and conducting the education campaign under paragraph (1). (B)

Membership

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall appoint to the advisory committee under subparagraph (A) such members as deemed necessary to properly advise the Secretary, and shall include organizations and individuals with expertise in breast cancer prevention, diagnosis, genetic screening and counseling, treatment, and rehabilitation in young women. (b)

Health care professional education campaign

(1)

In general

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, and in consultation with the Administrator of the Health Resources and Services Administration, shall conduct an education campaign to increase awareness among physicians and other health care professionals— (A)relating to the risk factors, risk reduction strategies, early diagnosis and treatment of breast cancer in young women; (B)on when to refer patients to a health care provider with genetics expertise; and (C)on how to provide counseling that addresses long-term survivorship and health concerns of young women diagnosed with breast cancer. (2)

Materials

The education campaign under paragraph (1) may include the distribution of print, video, and Web-based materials on assisting physicians and other health care professionals in— (A)identifying generally the risk factors and early warning signs and symptoms of breast cancer specific to women under the age of 40 and the specific risk factors that would require increased monitoring; (B)counseling patients on the benefits of evidence based healthy lifestyles which reduce the risks of breast cancer; (C)counseling patients on the importance of consistent breast self exams to facilitate breast self awareness and teaching patients how to perform such exams; (D)understanding the importance of early diagnosis, including teaching young women the symptoms of breast cancer and early detection practices, including clinical breast exams, blood component analysis, genetic counseling and testing where appropriate, and other strategies determined to be appropriate by the Secretary; and (E)the unique long-term effects faced by young women with breast cancer that will need to be addressed over their lifetimes, including— (i)re-entry into the workforce or school; (ii)infertility as a result of treatment; (iii)neuro-cognitive effects; (iv)important effects of cardiac, vascular, muscle, and skeletal complications; and (v)secondary malignancies. (c)

Prevention research activities

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall conduct prevention research on breast cancer in younger women, including the following: (1)Behavioral and other research on the impact of breast cancer diagnosis on young women. (2)Formative research to assist with the development of educational messages and information for the public, targeted populations, and their families about breast cancer. (3)Surveys of physician and public knowledge, attitudes, and practices about breast cancer prevention and control in high-risk populations. (d)

Support for young women diagnosed with breast cancer

(1)

In general

The Secretary shall award grants to organizations and institutions to provide health information from credible sources and substantive assistance directed to young women diagnosed with breast cancer on— (A)education and counseling regarding fertility preservation; (B)support, including social, emotional, psychosocial, financial, lifestyle, and caregiver support; (C)familial risk factors; and (D)risk reduction strategies to reduce recurrence or metastasis. (2)

Priority

In making grants under paragraph (1), the Secretary shall give priority to applicants that deal specifically with young women and breast cancer. (e)

No duplication of effort

In conducting an education campaign or other program under subsections (a), (b), (c), or (d), the Secretary shall avoid duplicating other existing Federal breast cancer education efforts. (f)

Measurement; reporting

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall— (1)measure young women’s awareness regarding breast cancer, including knowledge of specific risk factors and early warning signs, and young women’s proactive efforts at early detection, including seeking out information on risk-reducing lifestyle choices, the number or percentage of young women receiving regular clinical breast exams, the number or percentage of young women who perform breast self exams, and the frequency of such exams, before the implementation of this section; (2)establish quantitative benchmarks to measure the impact of activities under this section; (3)not less than every 3 years, measure the impact of such activities; and (4)submit reports to the Congress on the results of such measurements. (g)

Definitions

In this section— (1)the term State means each of the several States, the District of Columbia, the Commonwealth of Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the United States Virgin Islands; and (2)the term young women means women 15 to 39 years of age. (h)

Authorization of appropriations

To carry out this section, there are authorized to be appropriated $9,000,000 for each of the fiscal years 2010 through 2014.

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