1.This Act may be cited as
the Lung Cancer Mortality Reduction
Act of 2011
.
2.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.
3.Sense of the
Senate concerning investment in lung cancer researchIt 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.
4.Lung cancer
mortality reduction programPart 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:
399V–6.Lung cancer
mortality reduction program
(a)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)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.
.
5.Department of
defense and the department of veterans affairsThe 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.
6.Lung cancer
screening demonstration project
(a)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 generalNot 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)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)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
facilitiesThe 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)The
Secretary shall conduct the demonstration project under this section for a
5-year period.
(g)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.
7.Lung Cancer
Advisory Board
(a)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)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.
8.Authorization of
appropriationsTo 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.