[Congressional Record Volume 140, Number 38 (Tuesday, April 12, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: April 12, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
       THE COLON CANCER SCREENING AND PREVENTION ACT--INTRODUCED

                                 ______


                        HON. BENJAMIN L. CARDIN

                              of maryland

                    in the house of representatives

                        Tuesday, April 12, 1994

  Mr. CARDIN. Mr. Speaker, today I am introducing the Colon Cancer 
Screening and Prevention Act. This legislation would enhance the early 
detection and treatment of colorectal cancer--the second most frequent 
type of cancer in America.
  Each year there are 160,000 new cases of colorectal cancer reported. 
Furthermore, each year colorectal cancer claims 57,000 lives--more than 
either breast or prostate cancer. The death rate from a diagnosis of 
colorectal cancer is approaching a devastating 60 percent, yet Medicare 
does not provide coverage for colorectal cancer screening and 
preventive services.
  Outcome research has recently shown decreases in mortality rates 
attributable to prompt and preventive colorectal screening measures. 
The evidence from these studies was not yet available when the OTA 
published a 1990 report on the costs/benefits of colorectal screening. 
Colorectal cancer screening measures have come of age. We can no longer 
ignore the advancement of this preventive service for the elderly. In 
recent years preventive services such as screening mammography and flu 
shots have been added to Medicare. This is the next logical step in 
expanding Medicare's preventive services.
  This legislation delegates authority to the Secretary to define those 
individuals who are at high risk for colorectal cancer, allowing for 
expert consideration of recent advances in prevention research. The 
Colon Cancer Screening and Prevention Act provides a specific example 
of what may be considered a high risk individual for colon cancer, 
therefore, providing additional clarity of those possibly eligible for 
cancer screening services.
  This legislation provides a strategy for decreasing cancer deaths. 
Specifically, Medicare recipients would be eligible for--
  A fecal occult blood test [FOBT] which is an inexpensive noninvasive 
screening test that checks for blood in stool. The average cost of the 
test is $5 and it would be available on an annual basis. This quick and 
efficient test allows for the detection of cancer in early and still 
curable stages.
  A flexible sigmoidoscopy exam allows for inspection of the lower part 
of the colon within which 50 to 60 percent of polyps and cancers occur. 
This exam would be available no more than every 4 years.
  A colonoscopy exam allows for the inspection of the entire colon and 
has the advantage of allowing biopsy and removal of highly suspicious 
polyps which are the precursors to almost all colon cancers. This exam 
would be available no more than every 2 years.
  Only those individuals who are determined by the Secretary to be at 
high risk for colon cancer, are eligible for the more invasive 
colonoscopy.
  High risk criteria, as a stated in the bill, includes prior 
experience of cancer or digestive diseases, Crohn's disease, ulcerative 
colitis, and inflammatory bowel disease, highly suspicious polyps, 
significant family history of colon cancer, or presence of a gene 
marker for colon cancer.
  Endorsement for this legislation has been received by multiple 
patient groups such as the Crohn's Colitis Foundation, the Digestive 
Disease National Coalition, and the United Ostomy Association. Support 
for this legislation is also given by well respected professional 
associations such as the American College of Gastroenterologists and 
the American Gastroenterological Association.
  With the national focus on preventive services, we can no longer 
afford to ignore the advancement in colorectal screening services for 
the elderly. President Clinton's Health Security Act provides for the 
inclusion of colorectal screening in the standard benefit package--an 
example of what is to come. This legislation provides Medicare 
recipients with the urgently needed services to detect and prevent 
colorectal cancer without being overly aggressive.
  I look forward to the constructive comments and suggestions of my 
colleagues and other interested parties regarding this legislation. I 
urge my colleagues to join me in cosponsoring the Colon Cancer 
Screening and Prevention Act.

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