[Congressional Record Volume 140, Number 67 (Wednesday, May 25, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: May 25, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
SENATE RESOLUTION 216--RELATIVE TO BREAST AND CERVICAL CANCER SCREENING

  Mr. MURKOWSKI (for himself, Mr. Stevens, Mr. Lugar, and Mr. Cochran) 
submitted the following resolution; which was referred to the Committee 
on Labor and Human Resources:

                              S. Res. 216

       Whereas mammography is the most reliable method of 
     detecting the early onset of breast cancer in women;
       Whereas Pap smears are the most reliable method of 
     detecting the onset of cervical and uterine cancers in women;
       Whereas 180,000 women are diagnosed with breast cancer each 
     year and 46,000 die from the disease;
       Whereas 45,500 women are diagnosed with cervical and 
     uterine cancers each year and 10,000 die from these diseases;
       Whereas the American College of Obstetrics and Gynecology 
     recommend that women have annual pelvic exams and Pap smears 
     beginning at the age of 18 or when a woman becomes sexually 
     active; and
       Whereas the American College of Obstetrics and Gynecology, 
     the American Cancer Society, the American Medical 
     Association, and the American Medical Womens' Association 
     recommend that women between the ages of 40 and 50 have 
     mammograms every 1 to 2 years: Now, therefore, be it
       Resolved, That it is the sense of the Senate that any 
     comprehensive health care reform measures passed by the 
     Senate contain provisions that maintain that early detection 
     and preventative screening for breast and cervical cancers 
     not be artificially limited by Federal mandates, but be 
     provided in a manner consistent with sound scientific 
     research, allowing for physician discretion.

 Mr. MURKOWSKI. Mr. President, today, I submit a sense-of-the-
Senate resolution supporting the ability of women to receive, and 
physicians to provide appropriate breast and cervical cancer screening 
under health care reform.
  Every year, 45,500 women are diagnosed with cervical and uterine 
cancers and 10,000 die from these diseases. Breast cancer afflicts even 
greater numbers of women. Each year, 183,000 women are diagnosed with 
breast cancer and 46,000 die from it. One in eight women will develop 
breast cancer in her lifetime--it is the leading cause of death of 
women between the ages of 35 to 54.
  Alaskan women are particularly vulnerable to these diseases. Breast 
cancer is the No. 1 cause of death in Alaskan women, while cancer 
ranked as the second leading cause of death in Alaskan men and second 
for both sexes nationally. In 1986 and 1987, Alaska was ranked 23d 
among all States in breast cancer mortality and, when analyzed by race, 
Alaska tied with New York for the second highest state rate of breast 
cancer mortality in caucasian women. While cervical cancer deaths have 
declined overall in the past 40 years, during the decade 1980 to 1989, 
the rate of cervical cancer for Native Alaskan women was four times 
greater than the non-Native rate. This increase rate in Native Alaskan 
women is suspected to be due to increased rates of undetected and 
untreated sexually transmitted diseases.
  The American College of Obstetrics and Gynecology, the American 
Cancer Society, and other notable physician and scientific 
organizations recommend annual Pap smears and pelvic exams for women 18 
years of age and over, or when they become sexually active. Pap smears 
are inexpensive tests, particularly when compared with other cancer 
screening measures. When there are many cancers that physicians are not 
capable of detecting except through the most expensive tests, it seems 
appropriate that Congress would support, not limit, preventative 
screening measures, like Pap smears, that provide the most effective 
means of early detection.
  I, and many of my colleagues, recently became concerned with the 
National Cancer Institute's change in position regarding mammography 
screening for women between the ages of 40 and 49. The NCI no longer 
recommends that baseline mammography occur at 40, instead they believe 
age 50 is adequate. Yet, just last week, a study conducted at Case 
Western Reserve University found that younger breast cancer victims 
tend to have more aggressive and deadly forms of cancer. Those under 
the age of 45 were determined to have more rapid recurrences of the 
disease and shorter survival time. While there is some controversy 
surrounding age appropriate screening, what is not disputed is that 
mammograms are the only method available to detect breast cancer at the 
earliest stages when it is most curable and that mammography has been 
proven to reduce mortality for women with breast cancer.

  These issues are not partisan issues. We may have our differences 
regarding managing and financing health reform, but I think we all 
endorse accessible and affordable health care that preserves patient 
choice and physician discretion. For years, Democrats and Republicans 
have supported increased funding for research, education and 
preventative screening services for breast and cervical cancers. My 
wife Nancy was the founding director of the Breast Cancer Detection 
Center in Fairbanks, AK, back in 1974, and she and I continue to 
support this centers mission to provide free mammograms to low income 
and underserved women in the Interior of Alaska. Our commitment to 
maintaining these services and expanding them to more remote areas of 
our state remains strong.
  As Congress pursues reforms of the health care system, it is of the 
utmost importance that we ensure appropriate screening for breast and 
cervical cancers is available to women when they want them or when 
their doctor determines they may need them. The purpose of this 
resolution is not to mandate one service at the expense of another, but 
to express the sense of the Senate that it is not the role of the 
Federal Government to place artificial limitations on these services, 
particularly when physicians and scientific organizations do not concur 
with these limitations. This resolution simply states that any 
comprehensive health care reform measures passed by the Senate not 
establish artificial limits on early detection and preventive screening 
for breast and cervical cancers. Rather, screening should be provided 
in a manner consistent with sound scientific research, allowing for 
physician discretion.

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