[Congressional Record Volume 140, Number 75 (Wednesday, June 15, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: June 15, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                  BREAST AND CERVICAL CANCER SCREENING

  Mr. MURKOWSKI. Good morning, Mr. President. I wish you and all of my 
colleagues a very good day.
  Let me share with you a sense-of-the-Senate resolution I introduced 
on May 25, supporting the ability of women to receive and physicians to 
provide appropriate breast cancer and cervical cancer screening under 
health care reform.
  Mr. President, this resolution simply states that any comprehensive 
health care reform measures passed by the Senate shall not establish 
artificial limits on early detection and preventive screening for 
breast and cervical cancer. Rather, screening should be provided in a 
manner consistent with sound scientific research, allowing for a 
physician's discretion.
  Mr. President, every year 45,500 women are diagnosed with cervical 
and uterine cancers, and approximately 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, and it 
is now the leading cause of death in women between the ages of 35 and 
54.
  In my State of Alaska, we have a high incidence of 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, we tied with New York for the second highest rate of breast 
cancer mortality in Caucasian women.
  While cervical cancer deaths have declined overall in the past 40 
years, during the decade of 1980 to 1989, the rate of cervical cancer 
for Native Alaskan women was four times greater than the non-Native 
rate.
  The American College of Obstetrics and Gynecology, the American 
Cancer Society, and other notable physician and scientific 
organizations, recommend annual Pap smears and pelvic examinations for 
women who are 18 years of age and older.
  Further, 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 National Cancer 
Institute no longer recommends that baseline mammography occur at age 
40. Instead they believe age 50 is adequate. Yet, just last month, 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 when breast 
cancer occurs.
  Mr. President, of course, these are not partisan issues. We may have 
our differences regarding the managing and financing of health care 
reform, but I think we all endorse accessible and affordable health 
care that preserves the patient's choice and the physician's 
discretion. For years, Members of both parties have supported increased 
funding for research, education, and preventative screening services 
for breast cancer and cervical cancer. My wife Nancy was the founding 
director of the Breast Cancer Detection Center in Fairbanks, AK, back 
in 1974, and both she and I continue to support this center's mission 
to provide free mammograms to low-income and underserved women in the 
interior part of Alaska. Our commitment to maintaining these services 
and expanding them to more remote areas of our State remains strong and 
is our objective.
  As Congress pursues reforms on the health care system, it is of the 
utmost importance that we ensure appropriate screening for breast and 
cervical cancers and make it available to women when they want them or 
when their doctor determines they may need them.
  So the purpose of this resolution, Mr. President, is not to mandate 
one service at the expense of another, but to simply 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.
  Again, the resolution simply states that any comprehensive health 
care reform measure 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.
  I am pleased to include Senators Cochran, Lugar, and Stevens among 
the original cosponsors of this resolution.

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