[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 752 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                 S. 752

To establish a comprehensive interagency response to reduce lung cancer 
                     mortality in a timely manner.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                April 6 (legislative day, April 5), 2011

Mrs. Feinstein (for herself, Mr. Isakson, and Mr. Kerry) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To establish a comprehensive interagency response to reduce lung cancer 
                     mortality in a timely manner.

    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 ``Lung Cancer Mortality Reduction Act 
of 2011''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Lung cancer is the leading cause of cancer death for 
        both men and women, accounting for 28 percent of all cancer 
        deaths.
            (2) The National Cancer Institute estimates that in 2010, 
        there were 222,520 new diagnosis of lung cancer and 157,300 
        deaths attributed to the disease.
            (3) According to projections published in the Journal of 
        Clinical Oncology in 2009, between 2010 and 2030, the incidence 
        of lung cancer will increase by 46 percent for women and by 58 
        percent for men. The increase in the incidence of lung cancer 
        among minority communities during that time period will range 
        from 74 percent to 191 percent.
            (4) Lung cancer causes more deaths annually than the next 4 
        leading causes of cancer deaths, colon cancer, breast cancer, 
        prostate cancer, and pancreatic cancer, combined.
            (5) The 5-year survival rate for lung cancer is only 15 
        percent, while the 5-year survival rate for breast cancer is 89 
        percent, for prostate cancer 99 percent, and for colon cancer 
        65 percent. Yet in research dollars per death, lung cancer is 
        the least funded of the major cancers.
            (6) In 2001, the Lung Cancer Progress Review Group of the 
        National Cancer Institute stated that funding for lung cancer 
        research was ``far below the levels characterized for other 
        common malignancies and far out of proportion to its massive 
        health impact'' and it gave the ``highest priority'' to the 
        creation of an integrated multidisciplinary, multi-
        institutional research program. No comprehensive plan has been 
        developed.
            (7) While smoking is the leading risk factor for lung 
        cancer, the President's National Cancer Advisory Board Report 
        of 2010 identified radon as the second leading cause of lung 
        cancer and listed 15 other environmental contaminants strongly 
        association with lung cancer, and there is accumulating 
        evidence that hormonal and genetic factors may influence the 
        onset.
            (8) Lung cancer is the most stigmatized of all the cancers 
        and the only cancer blamed on patients, whether they smoked or 
        not.
            (9) Nearly 20 percent of lung cancer patients have never 
        smoked. Sixty percent of individuals diagnosed with lung cancer 
        are former smokers who quit, often decades ago.
            (10) Lung cancer in men and women who never smoked is the 
        sixth leading cause of cancer death. Of individuals diagnosed 
        with lung cancer who have never smoked, \2/3\ of are women.
            (11) Lung cancer is the leading cause of cancer death in 
        the overall population and in every major ethnic grouping, 
        including White, African-American, Hispanic, Asian and Pacific 
        Islander, American Indian, and Alaskan Native, with an even 
        disproportionately higher impact on African-American males that 
        has not been addressed.
            (12) Military personnel, veterans, and munitions workers 
        exposed to carcinogens such as Agent Orange, crystalline forms 
        of silica, arsenic, uranium, beryllium, and battlefield fuel 
        emissions have increased risk for lung cancer.
            (13) Only 16 percent of lung cancer is being diagnosed at 
        an early stage and there were no targets for the early 
        detection or treatment of lung cancer included in the 
        Department of Health and Human Services's ``Healthy People 
        2010'' or ``Healthy People 2020''.
            (14) An actuarial analysis carried out by Milliman Inc. and 
        published in Population Health Management Journal in 2009 
        indicated that early detection of lung cancer could save more 
        than 70,000 lives a year in the United States.
            (15) A National Cancer Institute study in 2009 indicated 
        that while the value of life lost to lung cancer will exceed 
        $433,000,000,000 a year by 2020, a 4 percent annual decline in 
        lung cancer mortality would reduce that amount by more than 
        half.
            (16) In 2010, the National Cancer Institute released 
        initial results from the National Lung Screening Trial, a 
        large-scale randomized national trial that compared the effect 
        of low-dose helical computed tomography (``CT'') and a standard 
        chest x-ray on lung cancer mortality. The study found 20 
        percent fewer lung cancer deaths among study participants 
        screened with the CT scan.

SEC. 3. SENSE OF THE SENATE CONCERNING INVESTMENT IN LUNG CANCER 
              RESEARCH.

    It is the sense of the Senate that--
            (1) lung cancer mortality reduction should be made a 
        national public health priority; and
            (2) a comprehensive mortality reduction program coordinated 
        by the Secretary of Health and Human Services is justified and 
        necessary to adequately address all aspects of lung cancer and 
        reduce lung cancer mortality among current smokers, former 
        smokers, and non-smokers.

SEC. 4. LUNG CANCER MORTALITY REDUCTION PROGRAM.

    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. 399V-6. LUNG CANCER MORTALITY REDUCTION PROGRAM.

    ``(a) In General.--Not later than 180 days after the date of 
enactment of the Lung Cancer Mortality Reduction Act of 2011, the 
Secretary, in consultation with the Secretary of Defense, the Secretary 
of Veterans Affairs, the Director of the National Institutes of Health, 
the Director of the Centers for Disease Control and Prevention, the 
Commissioner of Food and Drugs, the Administrator of the Centers for 
Medicare & Medicaid Services, the Director of the National Center on 
Minority Health and Health Disparities, and other members of the Lung 
Cancer Advisory Board established under section 7 of the Lung Cancer 
Mortality Reduction Act of 2011, shall implement a comprehensive 
program to achieve a 50 percent reduction in the mortality rate of lung 
cancer by 2020.
    ``(b) Requirements.--The program implemented under subsection (a) 
shall include at least the following:
            ``(1) With respect to the National Institutes of Health--
                    ``(A) a strategic review and prioritization by the 
                National Cancer Institute of research grants to achieve 
                the goal of the lung cancer mortality reduction program 
                in reducing lung cancer mortality;
                    ``(B) the provision of funds to enable the Airway 
                Biology and Disease Branch of the National Heart, Lung, 
                and Blood Institute to expand its research programs to 
                include predispositions to lung cancer, the 
                interrelationship between lung cancer and other 
                pulmonary and cardiac disease, and the diagnosis and 
                treatment of these interrelationships;
                    ``(C) the provision of funds to enable the National 
                Institute of Biomedical Imaging and Bioengineering to 
                expedite the development of screening, diagnostic, 
                surgical, treatment, and drug testing innovations to 
                facilitate the potential of imaging as a biomarker and 
                reduce lung cancer mortality, such as through expansion 
                of the Quantum Grant Program and Image-Guided 
                Interventions programs of the National Institute of 
                Biomedical Imaging and Bioengineering;
                    ``(D) the provision of funds to enable the National 
                Institute of Environmental Health Sciences to implement 
                research programs relative to lung cancer incidence; 
                and
                    ``(E) the provision of funds to enable the National 
                Institute on Minority Health and Health Disparities to 
                collaborate on prevention, early detection, and disease 
                management research, and to conduct outreach programs 
                in order to address the impact of lung cancer on 
                minority populations.
            ``(2) With respect to the Food and Drug Administration, the 
        provision of funds to enable the Center for Devices and 
        Radiologic Health to--
                    ``(A) establish quality standards and guidelines 
                for hospitals, outpatient departments, clinics, 
                radiology practices, mobile units, physician offices, 
                or other facilities that conduct computed tomography 
                screening for lung cancer;
                    ``(B) provide for the expedited revision of 
                standards and guidelines, as required to accommodate 
                technological advances in imaging; and
                    ``(C) conduct an annual random sample survey to 
                review compliance and evaluate dose and accuracy 
                performance.
            ``(3) With respect to the Centers for Disease Control and 
        Prevention--
                    ``(A) the provision of funds to establish a Lung 
                Cancer Early Detection Program that provides low-
                income, uninsured, and underserved populations that are 
                at high risk for lung cancer access to early detection 
                services;
                    ``(B) the provision of funds to enable the National 
                Institute for Occupational Safety and Health to conduct 
                research on environmental contaminants strongly 
                associated with lung cancer in the workplace and 
                implement measures to reduce lung cancer risk and 
                provide for an early detection program; and
                    ``(C) a requirement that State, tribal, and 
                territorial plans developed under the National 
                Comprehensive Cancer Control Program include lung 
                cancer mortality reduction measures commensurate with 
                the public health impact of lung cancer.
            ``(4) With respect to the Agency for Healthcare Research 
        and Quality, the annual review of lung cancer early detection 
        methods, diagnostic and treatment protocols, and the issuance 
        of updated guidelines.
            ``(5) The cooperation and coordination of all programs for 
        women, minorities, and health disparities within the Department 
        of Health and Human Services to ensure that all aspects of the 
        Lung Cancer Mortality Reduction Program adequately address the 
        burden of lung cancer on women and minority, rural, and 
        underserved populations.
            ``(6) The cooperation and coordination of all tobacco 
        control and cessation programs within agencies of the 
        Department of Health and Human Services to achieve the goals of 
        the Lung Cancer Mortality Reduction Program with particular 
        emphasis on the coordination of drug and other cessation 
        treatments with early detection protocols.''.

SEC. 5. DEPARTMENT OF DEFENSE AND THE DEPARTMENT OF VETERANS AFFAIRS.

    The Secretary of Defense and the Secretary of Veterans Affairs 
shall coordinate with the Secretary of Health and Human Services--
            (1) in developing the Lung Cancer Mortality Reduction 
        Program under section 399V-6 of the Public Health Service Act, 
        as added by section 4;
            (2) in implementing the demonstration project under section 
        6 within the Department of Defense and the Department of 
        Veterans Affairs with respect to military personnel and 
        veterans whose smoking history and exposure to carcinogens 
        during active duty service has increased their risk for lung 
        cancer; and
            (3) in implementing coordinated care programs for military 
        personnel and veterans diagnosed with lung cancer.

SEC. 6. LUNG CANCER SCREENING DEMONSTRATION PROJECT.

    (a) Sense of the Senate.--It is the sense of the Senate that a 
national computed tomography lung cancer screening demonstration 
project should be carried out expeditiously in order to assess the 
public health infrastructure needs and to develop the most effective, 
safe, equitable, and efficient process that will maximize the public 
health benefits of screening.
    (b) Demonstration Project in General.--Not later than 1 year after 
the date of enactment of this Act, the Secretary of Health and Human 
Services (referred to in this Act as the ``Secretary''), in 
consultation with the Secretary of Defense, the Secretary of Veterans 
Affairs, the Director of the National Institutes of Health, the 
Director of the Centers for Disease Control and Prevention, the 
Commissioner of Food and Drugs, the Administrator of the Centers for 
Medicare & Medicaid Services, and the other members of the Lung Cancer 
Advisory Board established under section 7 of the Lung Cancer Mortality 
Reduction Act of 2011, shall establish a demonstration project, to be 
known as the Lung Cancer Computed Tomography Screening and Treatment 
Demonstration Project (referred to in this section as the 
``demonstration project'').
    (c) Program Requirements.--The Secretary shall ensure that the 
demonstration project--
            (1) identifies the optimal risk populations that would 
        benefit from screening;
            (2) develops the most effective, safe, equitable and cost-
        efficient process for screening and early disease management;
            (3) allows for continuous improvements in quality controls 
        for the process; and
            (4) serves as a model for the integration of health 
        information technology and the concept of a rapid learning into 
        the health care system.
    (d) Participation.--The Secretary shall select not less than 5 
National Cancer Institute Centers, 5 Department of Defense Medical 
Treatment Centers, 5 sites within the Veterans Affairs Healthcare 
Network, 5 International Early Lung Cancer Action Program sites, 10 
community health centers for minority and underserved populations, and 
additional sites as the Secretary determines appropriate, as sites to 
carry out the demonstration project described under this section.
    (e) Quality Standards and Guidelines for Licensing of Tomography 
Screening Facilities.--The Secretary shall establish quality standards 
and guidelines for the licensing of hospitals, outpatient departments, 
clinics, radiology practices, mobile units, physician offices, or other 
facilities that conduct computed tomography screening for lung cancer 
through the demonstration project, that will require the establishment 
and maintenance of a quality assurance and quality control program at 
each such facility that is adequate and appropriate to ensure the 
reliability, clarity, and accuracy of the equipment and interpretation 
of the screening scan and set appropriate standards to control the 
levels of radiation dose.
    (f) Timeframe.--The Secretary shall conduct the demonstration 
project under this section for a 5-year period.
    (g) Report.--Not later than 180 days after the date of enactment of 
this Act, the Secretary shall submit a report to Congress on the 
projected cost of the demonstration project, and shall submit annual 
reports to Congress thereafter on the progress of the demonstration 
project and preliminary findings.

SEC. 7. LUNG CANCER ADVISORY BOARD.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a Lung Cancer Advisory Board (referred to in this section as 
the ``Board'') to monitor the programs established under this Act (and 
the amendments made by this Act), and provide annual reports to 
Congress concerning benchmarks, expenditures, lung cancer statistics, 
and the public health impact of such programs.
    (b) Composition.--The Board shall be composed of--
            (1) the Secretary of Health and Human Services;
            (2) the Secretary of Defense;
            (3) the Secretary of Veterans Affairs;
            (4) the Director of the Occupational Safety and Health 
        Administration;
            (5) the Director of the National Institute of Standards and 
        Technology; and
            (6) one representative each from the fields of clinical 
        medicine focused on lung cancer, lung cancer research, 
        radiology, imaging research, drug development, minority health 
        advocacy, veterans service organizations, lung cancer advocacy, 
        and occupational medicine to be appointed by the Secretary of 
        Health and Human Services.

SEC. 8. AUTHORIZATION OF APPROPRIATIONS.

    To carry out this Act (and the amendments made by this Act), there 
are authorized to be appropriated such sums as may be necessary for 
each of fiscal years 2012 through 2016.
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