[Congressional Record Volume 141, Number 28 (Monday, February 13, 1995)]
[Extensions of Remarks]
[Page E332]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


       THE COLON CANCER SCREENING AND PREVENTION ACT--INTRODUCED

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                        HON. BENJAMIN L. CARDIN

                              of maryland

                    in the house of representatives

                        Monday, February 13, 1995
  Mr. CARDIN. Mr. Speaker, today I am introducing the Colon Cancer 
Screening and Prevention Act. This legislation provides for Medicare 
coverage of preventive services to enhance the early detection and 
treatment of colorectal cancer--the second deadliest cancer in America.
  Colorectal cancer is more common than either breast or prostate 
cancer, and strikes men and women in almost equal numbers. This year 
alone it is estimated that over 138,000 new cases will be diagnosed and 
more than 55,000 lives lost.
  If colorectal cancer is not found early, less than 60 percent of 
persons diagnosed will survive for 5 years. Early detection, however, 
can boost the 5-year survival rate to 91 percent. That is an 
astonishing difference which can be appreciated in terms of both lives 
and dollars saved.
  With well documented and highly effective detection and prevention 
strategies, colorectal cancers have become almost completely 
preventable. Every major Federal employee health plan recognizes the 
importance of colorectal screening measures and provides coverage for 
these services. Yet--although the average age at the time of diagnosis 
is 71--Medicare does not provide coverage of screening and preventive 
services for colorectal cancers.
  With this legislation Medicare beneficiaries are eligible for two 
screening services at specified intervals. For those at high risk of 
developing colorectal cancer--due to previous experience of cancer or 
precursor polyps, a history of a chronic digestive disease condition, 
the presence of recognized gene markers, or other predisposing 
factors--a more comprehensive and invasive procedure is also covered.
  Specifically, the Colon Cancer Screening and Prevention Act first 
enables early detection of colorectal cancers by providing for an 
annual fecal occult blood test [FOBT]. This is a non-invasive test that 
checks for blood in a stool sample, at an average cost of only $5. 
Research shows that this simple test, with follow-up examination of a 
positive result, reduces the risk of death from colorectal cancer by 
between 33 and 43 percent.
  Second, this legislation includes benefit coverage of a flexible 
sigmoidoscopy examination, which enables a doctor to inspect the lower 
part of the colon where 50 to 60 percent of polyps and cancers occur. 
This preventive service would be available no more than once every 4 
years.
  Third, the Colon Cancer Screening and Prevention Act allows 
individuals at high risk for developing colorectal cancer to receive a 
screening colonoscopy exam no more than once every 2 years. This 
procedure allows examination of the entire colon and, if necessary, 
biopsy and removal of suspicious polyps, which are the precursors to 
almost all colon cancers.
  The preventive screening services in the Colon Cancer Screening and 
Prevention Act are standard medical procedures recommended by the 
American Cancer Society, the National Cancer Institute, the American 
College of Gastroenterology, the American Gastroenterological 
Association, and the American College of Physicians. Among the many 
professionals who have provided the scientific and technical 
information underlying this legislation, I particularly appreciate the 
efforts of Marvin Schuster, M.D. of Johns Hopkins University, who 
serves as treasurer of the American College of Gastroenterology.
  The ACG worked closely with me last year in developing this 
legislation and documenting the need for this benefit. The Colon Cancer 
Screening and Prevention Act has been endorsed by many consumer groups, 
including the Crohn's and Colitis Foundation, the United Ostomy 
Association and the Digestive Diseases National Coalition, as well as 
professional societies such as the American Medical Association and the 
American Nurses Association.
  In an environment of rising health care costs, this amendment will 
save Medicare dollars. Screening to detect colorectal cancers and 
providing necessary treatments early in the course of the disease not 
only improves the quality of life for patients but is much cheaper than 
providing intensive, expensive medical treatment to individuals in the 
late stages of colorectal cancer.
  Many of my colleagues recognize the gap in Medicare coverage 
resulting from the failure to provide sensible, preventive colorectal 
screening benefits. This legislation, which received strong bipartisan 
support during the 103d Congress, closes that gap, providing Medicare 
beneficiaries with necessary, cost-effective services. I urge my 
colleagues to join me in 


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