[Congressional Record Volume 140, Number 57 (Wednesday, May 11, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: May 11, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                         EARLY CANCER SCREENING

  Mr. STEVENS. Mr. President, I have spoken before here on the floor of 
the Senate about my experience with prostate cancer, and Senators have 
listened to my plea and that of minority leader, Senator Dole, to seek 
early screening and diagnosis of what is a largely ignored disease for 
men.
  It has been almost 3 years now since that early screening detected my 
prostate cancer. I then elected to have surgery, which was a complete 
success. And I have had annual physical checkups. The results this 
year, as they have been every year, have confirmed that there is 
absolutely no trace of prostate cancer now in my system, and my 
physician has given me a clean bill of health in this regard.
  Incidentally, also, I had very successful recovery from back surgery.
  But I come to the floor today to introduce legislation which I think 
is necessary to improve research opportunities and screening for 
breast, cervical, and prostate cancer because I think all Americans 
ought to have available the routine screening tests which can discover 
cancers early, giving them the same chance that I had to bring about 
early health care and to have a prolonged life because of it.
  During the months and years since my own diagnosis, a number of 
Senators have come to talk to me. Senator Dole and I have participated 
in a number of meetings about symptoms and signs of prostate cancer. We 
have had meetings, at the request of individual Members of the 
Congress, with family members who may have been worried about this 
subject.
  As I learn more about the subject of cancer, I learn more about these 
other reproductive cancers, particularly breast and cervical cancer, 
and the populations who are at the highest risk for these cancers. It 
is no accident that the breast cancer support group called Why Me? 
stimulated the growth of a prostate cancer group called Us Too. With 
respect to prostate cancer, one of the highest risk groups is African-
American men.
  The incidence of cancer in that group is at a significantly younger 
age than that of the average Caucasian or Asian-American man's 
experience with the disease. A higher percentage of African-American 
men die from this disease, solely because they are not screened.
  There are several possible reasons why African-American men are not 
screened: By choice, because the basic digital exam is not a 
comfortable one; because they do not have access to screening services; 
or because many are low-income African-American men, who rarely have 
access to the services. Most African-American men do not have access to 
Medicare at the age of the most frequent incidence of prostate cancer, 
between the thirties and fifties; and many veterans, for instance, had 
their last exam when it was required during military service. For my 
age, that is many years ago.
  Medicare can pay for an examination to evaluate the suspect symptoms 
but is generally not able to cover annual screening exams or PSA blood 
tests on a routine basis before there is some incidence, some symptom 
that demonstrates a cancerous presence.
  Another high risk population is our own sons. I had the difficult job 
of telling my three sons after my surgery, on the advice of my surgeon, 
that they were at increased risk because they were sons of one who had 
been diagnosed with prostate cancer, and that the probability was that 
they might have an exposure to the disease at an earlier age than I 
did.
  For breast cancer, we know that in some cases there are indications 
that it runs in families. Recently, my own sister had a diagnostic 
procedure for breast cancer. She did have access to insurance, and she 
had access to facilities for screening.
  But the vast majority of women diagnosed with the disease each year 
are among those with limited access to both insurance coverage and the 
needed preventive services. There are extremely high rates of breast 
cancer among African-American women. In addition, our knowledge base 
about early diagnosis among younger women is very limited.
  I am sad to say one of the groups which is strongly represented among 
my constituency, the Alaskan Native women, have a very high rate of 
cervical cancer. Alaskan Native women's rates of invasive cervical 
cancer occur at a much earlier age than the national population. We do 
not know all of the reasons for that, but we do know they share with 
African-American women a lack of access to screening services and to 
treatment when a problem is identified.
  Many of our Alaskan Native women live in communities where it is 
accessible only by air. They see skilled screening technicians very 
infrequently. Others live in communities accessible by our ferry 
system, which we call the ``Alaskan Marine Highway.'' Planes and 
ferries get them to regional hubs, which do have services availability, 
but that is a very expensive proposition.
  I am introducing legislation which, I hope, will get the attention of 
the Senate. The Senate will notice that many of the cosponsors of this 
legislation are Appropriations Committee members, and that is no 
accident, since I serve on that committee and have served there for a 
long time. The Appropriations Committee members, I feel, are keenly 
aware that funds included in authorizations are not available for 
appropriations. Often we authorize appropriations far beyond our 
ability to make money available. The Appropriations Committee also 
understands the need to expand the resources that we have, wherever 
possible, through obtaining matching funds from State and local 
governments or other sources.
  The bill we are introducing today seeks to do that by matching 
Federal resources with the resources of nonprofit entities, which agree 
to prioritize their investment in screening facilities and make those 
facilities available to low-income women and men. This would double the 
total resources available to combat the problem, provide for early 
screening for cancer detection for a whole group of people in our 
country, who have no access to such screening.
  Three years ago, I sought a specialized project of research 
excellence, which we then called ``SPORE,'' for prostate cancer, and 
the Senate endorsed my request for projects which would bring the 
science from the laboratory to the patient in as short a time as 
possible. The approach that I am asking the Senate to take this day is 
to ask for a partnership between nonprofit organizations and the 
Federal Government in financing the facilities that would make 
available early screening and detection of cancers to rural areas in 
particular, and through the use of Federal funds in constructing the 
facilities, and nonprofit funds to take those facilities out to the 
rural areas Having early screening and detection of cancers, I hope, 
will help us fight this terrible disease.
  I send the bill to the desk for proper referral.
  The ACTING PRESIDENT pro tempore. The bill will be received and 
appropriately referred.
  Mr. STEVENS. Mr. President, I ask unanimous consent to have printed 
in the Record a summary and background of the Family Cancer Screening 
Research Partnership Act, which is introduced today by myself and 
Senators Inouye, Dole, Mack, and Dorgan.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

          Family Cancer Screening and Research Partnership Act

    (Introduced by Senators Stevens, Inouye, Dole, Mack, and Dorgan)


                               background

       The ``Family Cancer Screening and Research Partnership Act 
     of 1994'' provides for the creation of federal partnerships 
     with non-profit organizations to facilitate breast, cervical 
     and prostate screening activities, and to expedite the 
     development of effective treatments for breast, cervical and 
     prostate cancer by combining resources to finance research 
     efforts.


                federal/non-profit research partnerships

       The Act authorizes the Director of the National Cancer 
     Institute to enter into agreements with non-profit 
     organizations to make matching grant awards for breast, 
     cervical, and prostate cancer research of up to $250,000 
     each. The legislation includes appropriate protections for 
     the federal expenditure. It also calls on the Director to 
     expedite, where possible, the use of the federal funds. The 
     federal share of funds may only be used for direct research 
     activities.


                leveraging federal research expenditures

       By creating a partnership non-profit organizations will be 
     encouraged to match federal research spending dollar for 
     dollar, thus increasing the amount of funding available.


    encouraging increases in research programs funded by non-profit 
                             organizations

       With the availability of federal matching funds, non-profit 
     organizations can speed up the process of researching 
     effective treatments for breast, cervical and prostate 
     cancer.


             complements other federal research activities

       A matching grant program does not replace other federal 
     cancer research priorities and programs. Rather, a federal 
     matching program is intended to complement the existing 
     federal programs. It will hopefully encourage more 
     researchers to focus there attention on these three diseases. 
     And, importantly, it recognizes the need that to be 
     successful, a war on cancer requires cooperation and 
     coordination among the entire research infrastructure.


      breast, cervical, and prostate cancer screening partnerships

       The Act authorizes the Secretary of Health and Human 
     Services, acting through the Director of the Centers for 
     Disease Control, to award grants to nonprofit entities for 
     the purpose of acquiring mobile vehicles and for properly 
     equipping them for the purpose of conducting breast, cervical 
     and prostate cancer screening procedures. Such vehicles will 
     be used by organizations for the purpose of conducting free 
     examinations. Priority for these grants will be given to non-
     profit organziations for efforts to screen low-income or 
     geographically isolated women and men. An eligible use of 
     these funds may be to outfit airplanes or boats where that is 
     the best way to promote access to screening services.


         effective screening reduces future health expenditures

       Breast, cervical and prostate cancer curability is directly 
     proportional to its early diagnosis. Early detection of all 
     three diseases reduces future health care costs associated 
     with treatment, possible surgery, and after-care necessary 
     for those diagnosed with one of these diseases.


     cancer screening is a family issue--not a male or female issue

       An effective screening effort requires outreach to those 
     who are unable to afford regular examinations by a family 
     physician or who do not otherwise have access to screening 
     services. By making screening available at convenient 
     locations for both husbands and wives, spouses are given the 
     means of encouraging each other to undertake appropriate 
     screening procedures.


  a small federal investment in equipment will enable the non-profit 
     sector and corporate community to undertake screening programs

       Mobile vehicles equipped for breast, cervical and prostate 
     cancer screening programs cost approximately $400,000 each. 
     This initial capital outlay makes it prohibitively expensive 
     for nonprofit organizations to undertake screening 
     initiatives for short periods during a year. By providing 
     grants for the equipment the federal government would 
     encourage such groups to make arrangements to staff the 
     vehicles and otherwise defray the cost of screening programs.


 screening programs should focus on underserved and at-risk communities

       Mobile vehicles equipped to conduct cancer screening 
     services will enable organizations to reach otherwise 
     underserved communities.

  Mr. KERRY addressed the Chair.
  The ACTING PRESIDENT pro tempore. The Senator from Massachusetts [Mr. 
Kerry] is recognized.

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