[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 994 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 994

  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.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 7, 2009

 Ms. Klobuchar (for herself, Ms. Snowe, Mrs. Gillibrand, Mr. Sanders, 
    Mr. Bayh, Mr. Nelson of Florida, Mr. Martinez, Mrs. Hagan, Mrs. 
 Feinstein, Ms. Stabenow, Ms. Landrieu, Mrs. Murray, Ms. Mikulski, and 
  Mr. Vitter) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 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.

    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 Education and 
Awareness Requires Learning Young Act of 2009'' or ``EARLY Act''.

SEC. 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:

              ``PART S--PROGRAMS RELATING TO BREAST CANCER

``SEC. 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 
                racial, ethnic, and cultural backgrounds, including the 
                particular risks faced by certain racial, 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 45;
                            ``(iii) identifying methods for increasing 
                        early detection, including clinical breast 
                        exams;
                            ``(iv) encouraging genetic counseling and 
                        testing for appropriate individuals, in order 
                        to facilitate early diagnosis or prevention;
                            ``(v) supporting imaging-based screening 
                        for individuals with a genetic mutation or who 
                        have a high risk of early onset breast cancer 
                        based on family history or other pertinent 
                        factors;
                            ``(vi) consistent with the most recent 
                        version of the National Comprehensive Cancer 
                        Network (NCCN) guidelines, identifying methods, 
                        such as breast self exams and knowing the signs 
                        of breast malignancies, for increasing breast 
                        self awareness;
                            ``(vii) identifying evidence-based methods 
                        to lower the risk of breast cancer through 
                        changes in lifestyle, including diet, exercise, 
                        and environmental factors;
                            ``(viii) identifying available treatment 
                        options for breast cancer; and
                            ``(ix) 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 45 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;
                            ``(iii) genetic counseling and testing for 
                        appropriate individuals, in order to facilitate 
                        early diagnosis or prevention;
                            ``(iv) imaging-based screening for 
                        individuals with a genetic mutation or who have 
                        a high risk of early onset breast cancer based 
                        on family history or other pertinent factors;
                            ``(v) consistent with the most recent 
                        version of the National Comprehensive Cancer 
                        Network (NCCN) guidelines, identifying methods, 
                        such as breast self exams and knowing the signs 
                        of breast malignancies, for increasing breast 
                        self awareness;
                            ``(vi) evidence-based preventative 
                        lifestyle changes, including eating healthily 
                        and maintaining a healthy weight; and
                            ``(vii) 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 
                45 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 45 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, 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) Definition.--In this section, the term `young women' means 
women 15 to 44 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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