[Congressional Record Volume 146, Number 121 (Tuesday, October 3, 2000)]
[House]
[Pages H8638-H8640]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              CERVICAL CANCER PUBLIC AWARENESS RESOLUTION

  Mr. COBURN. Mr. Speaker, I move to suspend the rules and agree to the 
concurrent resolution (H. Con. Res. 64) recognizing the severity of the 
issue of cervical health, and for other purposes.
  The Clerk read as follows:

                            H. Con. Res. 64

       Whereas cervical cancer annually strikes an estimated 
     15,000 women in the United States;
       Whereas during an average woman's lifetime cervical cancer 
     strikes one out of every 50 American women;
       Whereas it is estimated that during this decade more than 
     150,000 women will be diagnosed with cervical cancer in the 
     United States;
       Whereas according to the Surveillance, Epidemiology, and 
     End Results Program of the National Cancer Institute, when 
     cervical cancer is detected at an early stage, the five-year 
     survival rate is 91 percent;
       Whereas in most cases cervical cancer is a preventable 
     disease yet is one of the leading causes of death among women 
     worldwide;
       Whereas according to the Centers for Disease Control and 
     Prevention, the mortality rate among American women with 
     cervical cancer declined during the period 1960 through 1997, 
     but now has begun to rise;
       Whereas clinical studies have confirmed that the human 
     papillomavirus (HPV) is a major cause of cervical cancer and 
     unknown precursor lesions; and
       Whereas cervical cancer survivors have shown tremendous 
     courage and determination in the face of adversity: Now, 
     therefore, be it
       Resolved by the House of Representatives (the Senate 
     concurring),

     SECTION 1. SHORT TITLE.

       This resolution may be cited as the ``Cervical Cancer 
     Public Awareness Resolution''.

     SEC. 2. RECOGNIZING THE SEVERITY OF CERVICAL CANCER.

       The Congress--
       (1) recognizes the severity of the issue of cervical 
     health;
       (2) calls on the United States as a whole to support both 
     the individuals with cervical cancer as well as the family 
     and loved ones of individuals with cervical cancer through 
     public awareness and education;
       (3) calls on the people of the United States to take this 
     opportunity to learn about cervical cancer and the improved 
     detection methods available;
       (4) recognizes through education and early detection, women 
     can lower their likelihood for developing cervical cancer;
       (5) recognizes the importance of federally funded programs 
     that provide cervical cancer screenings and follow-up 
     services to medically underserved individuals; and
       (6) encourages all women to have regular Pap smear tests.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oklahoma (Mr. Coburn) and the gentleman from Ohio (Mr. Brown) each will 
control 20 minutes.
  The Chair recognizes the gentleman from Oklahoma (Mr. Coburn).

                              {time}  1130

  Mr. COBURN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, prior to coming to Congress, I had a full-time practice 
in obstetrics and family medicine; and it was not uncommon that 50 to 
200 times a year I would diagnose cervical cancer, and over the 15 
years in practice prior to coming here, what I saw was an ever-
increasing number of people who were being diagnosed with either cancer 
or pre-cancer of their cervix.
  What we have come to know on the science of this is this is all 
caused by one virus, different strains of the same virus. Squamous 
carcinoma of the cervix is rarely caused by anything other than human 
papilloma virus. What we have today is a bill to make awareness of this 
issue for women in our country.
  I want to thank the gentlewoman from California (Ms. Millender-
McDonald) for her work in this area, and also in the area of HIV and 
her care for those most affected by this. Raising the awareness of the 
high risk of cervical cancer is important not just to the more mature 
women in our country, but also to the young women in our country.
  Along with that comes the very sad fact that our institutions that we 
should be trusting in this area have failed us. The Center for Disease 
Control has failed, because the full name of the Center for Disease 
Control is the Center for Disease Control and Prevention. The NIH has 
released a statement, as well as NCI, and on their Web site you can 
find that this disease is caused by human papilloma virus and that a 
condom fails to protect. We are so sold on this concept of ``safe sex'' 
in this country that we refuse to accept the etiology and pathogenesis 
of this disease, and we refuse to be honest with the American public in 
that a condom cannot protect them from this.
  The thing that is exciting to me about this resolution coming up is 
it perhaps will have some honesty coming

[[Page H8639]]

out of the institutions that are funded with the taxpayers' money in 
this country, both the NIH and the NCI, as well as the CDC.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, it is tragic that this year alone 15,000 women will be 
diagnosed with cervical cancer. More than 4,500 women will lose their 
lives to it. It is tragic that cervical cancer remains such a virulent 
killer when it is within our power to prevent it. In my own State of 
Ohio, over 200 deaths each year are attributable to cervical cancer.
  Experts believe that cervical cancer deaths can be virtually 
eliminated through behavioral changes, early detection, and timely 
access to treatment, all of which hinge on public awareness.
  The public needs to know that safe behaviors and proper screening can 
reduce cervical cancer death rates dramatically. The public needs the 
facts about screening test accuracy, new detection methods and about 
treatment breakthroughs so that all of us can play an active role in 
prevention and in treatment decisions.
  The public needs to know about initiatives like the CDC's breast and 
cervical cancer early detection program, which has reached millions of 
uninsured women with free screening tests. Public awareness can help us 
garner the resources needed for CDC and its State and local partners to 
do more than scratch the surface of this problem.
  As currently funded, the CDC program can only reach 15 percent of 
uninsured women. Unfortunately, because of congressional inaction, we 
make the early detection almost a cruel hoax on uninsured women, 
because we have not funded well enough the treatment for these women if 
early detection actually shows cervical cancer. We can do much better 
than that.
  Mr. Speaker, knowledge fuels advocacy, and in the case of cervical 
cancer, advocacy can save countless lives. I am proud to be a cosponsor 
of the resolution offered by the gentlewoman from California (Ms. 
Millender-McDonald) affirming that principle. I thank my colleague from 
California for her excellent work on this issue.
  Mr. Speaker, I would add that I would hope that Congress, while 
passing this resolution, would do its job and move forward on other 
health care legislation that has the force of law, that sends money 
where it is needed, that changes laws where they are needed, that can 
help with prescription drugs, that can help with the Patients' Bill of 
Rights, that can help with Ryan White, that can do all the things that 
this Congress in the health care areas all too unfortunately bottled 
up.
  Mr. Speaker, I reserve the balance of my time.
  Mr. COBURN. Mr. Speaker, I yield 3 minutes to the gentleman from 
Florida (Mr. Shaw).
  Mr. SHAW. Mr. Speaker, I thank the gentleman for yielding me time. I 
would like to say the gentleman is certainly going to be missed next 
year. I wish he were coming back.
  Mr. Speaker, today I rise in strong support of H. Con. Res. 64, the 
Cervical Cancer Public Awareness Resolution. Educating women of all 
ages on risk factors associated with cervical cancer and the importance 
of early diagnosis is imperative in reducing the number of women who 
are diagnosed and die of the disease each year.
  I have been a long-standing supporter of efforts to raise the 
public's awareness of cervical cancer, and I strongly believe education 
is a critical first step in our fight against this dreadful disease 
that strikes one out of every 50 American women.
  A real tragedy exists, because in many cases, cervical cancer is a 
disease that, if detected in its initial stage, can be successfully 
treated. We have a proven and effective screening tool in the Pap test, 
and we have the medical advances necessary to treat and save women's 
lives. Yet, unfortunately, cervical cancer remains a leading cause of 
death among women.
  Increasing public awareness about cervical cancer will help educate 
women about the need to seek preventive care. It is a vital part of our 
fight against this disease.
  Also vital to our fight is to make certain that women have access to 
and coverage for appropriate preventive care that will reduce cervical 
cancer deaths. That is why I, along with my colleague, the gentlewoman 
from Florida (Mrs. Thurman), have introduced the Providing Annual Pap 
Test to Save Women's Lives Act of 2000, which would require Medicare to 
cover Pap tests and pelvic exams.
  Medicare generally only covers Pap tests for women every 3 years. 
Since the Pap test's introduction shortly after World War II, death 
rates from cervical cancer have decreased 70 percent in the United 
States. However, despite the Pap test's unparalleled record of success, 
studies show of those women who die of cervical cancer, 80 percent had 
not had a Pap test in 5 years preceding their death. A January 1999 
report on cervical cancer by the Agency for Health Care Research and 
Quality showed that cancer deaths and cancer cases are reduced with 
annual screening.
  Fighting cervical cancer should be a national priority. Without 
question, we need to promote public awareness about the severity of 
cervical cancer and the risk factors associated with the disease. At 
the same time, we must promote a health care policy that allows women 
to be routinely covered for screening Pap tests. Therefore, Mr. 
Speaker, I urge my colleagues to take this important step in the battle 
against cervical cancer and support H. Con. Res. 64.
  I look forward to continuing to work to improve coverage policies so 
that women across this country can get the life-saving care that they 
need and they deserve.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 5 minutes to the gentlewoman 
from California (Ms. Millender-McDonald), the sponsor of the 
resolution.
  Ms. MILLENDER-McDONALD. Mr. Speaker, I would like to thank all of 
those Members, the gentleman from Oklahoma (Mr. Coburn) for his 
leadership in helping me with this resolution and the input for the 
language, as well the ranking member and the chairman.
  Mr. Speaker, I am proud to sponsor the Cervical Cancer Public 
Awareness Resolution with the gentleman from Oklahoma (Mr. Coburn). 
Together we have worked to raise awareness of cervical cancer 
throughout the past 2 years. Our work began with the Committee on 
Commerce, which held an eye-opening hearing on cervical cancer in early 
1999.
  I appreciate all of the support the gentleman from Virginia (Chairman 
Bliley), the ranking member, the gentleman from Michigan (Mr. Dingell), 
the gentleman from Florida (Mr. Bilirakis), and the gentleman from Ohio 
(Mr. Brown) have given to this cause, and especially the gentleman from 
Ohio (Mr. Brown). He has been most helpful.
  More than 50 years ago, Dr. George Papanicolaou developed what is 
considered the most effective cancer screen in the history of medicine, 
the Pap smear test. This test is still one of the most effective tools 
in saving lives and preventing invasive cervical cancer.
  When cervical cancer is detected at an early stage, the 5-year 
survival rate is 91 percent, according to the National Cancer 
Institute. The CDC reports that the mortality rate among American women 
with cervical cancer declined from 1960 to 1997 in large part because 
of the extensive use of the Pap smear test.
  However, in 1997, the number of women with cervical cancer began to 
rise. An estimated 15,000 women in the United States develop cervical 
cancer each year, and far too many of these women do not get annual 
screenings.
  In October of 1997, a Gallup survey found that almost 87 percent of 
the women surveyed know they should have a Pap smear every year. Nearly 
40 percent of these same women failed to do so in the previous year. 
One in four of the women who had not had an annual Pap smear test said 
they did not have the time. Other reasons include the belief that they 
are too old, feel embarrassed, are afraid of the results, or think it 
is too expensive. While all of these reasons are valid, they are not 
acceptable, when one considers that 80 percent of the women who die of 
cervical cancer have not had a Pap smear test in the past 5 years or 
more.
  Women must understand what cervical cancer is, what steps they can

[[Page H8640]]

take to reduce the likelihood of getting cervical cancer, how it can be 
detected early, and what all of their treatment options are when facing 
this disease.
  While it is encouraging that women seem to know of the Pap smear 
test, many women do not understand just how life-saving this annual 
screening can be. That is why I sponsored this resolution, Mr. Speaker, 
with the gentleman from Oklahoma (Mr. Coburn).
  Our resolution is part of a national campaign to raise awareness and 
increase annual screenings among women. I want to end the confusion, 
discomfort, and misunderstanding that form an unnecessary barrier to 
too many women, and particularly low-income and minority women. One out 
of every three Hispanic women reported in an HHS study that they failed 
to get a Pap smear test in the preceding 3 years, compared with about 
one-quarter of all American women. In addition, another survey by HHS 
found that 87 percent of employed women had a recent Pap test within 
the past three years, while 73 percent of women who were not in the 
labor force had done so.
  More disturbing than the gap in lack of screening is that more women 
of color are dying from this disease. The rate of mortality for African 
American women is nearly twice that of Caucasian women, according to 
HHS. Equally disturbing is the high rate of STD transmission within 
this community. The World Health Organization and the National 
Institutes of Health report that the principal cause of cervical cancer 
is HPV infection, which is also the most common STD.
  In my own district of South-Central Los Angeles, including Watts, the 
County Health Department reports that the rates of STD among African 
Americans are up to 20 percent higher than among Caucasians. The main 
reason is lack of information on how to prevent this transmission, 
which undetected years later, can lead to cervical cancer.
  Although the risk factors for cervical cancer can vary, the cultural, 
financial and even geographical areas that complicate the fluid 
delivery of quality health care linger as a dangerous indication of the 
need for more dialogue on this issue.
  Mr. Speaker, let me thank my colleagues, the gentleman from Oklahoma 
(Mr. Coburn) first for his leadership in joining me on this resolution 
and all of the national effort in raising the awareness of this deadly 
disease. I applaud the thousands of persons who are out there helping 
to make this awareness possible.
  Mr. COBURN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I want to read some literature from experts at the 
National Cancer Institute and the American Cancer Society, their 
published statements, and I will include them for the record. This is a 
quote from the National Cancer Institute:
  ``Condoms are ineffective against human papilloma virus because the 
virus is present not only in the mucosal tissue, but also on dry skin 
of the surrounding abdomen and groin, and it can migrate from those 
areas into other areas into the vagina and the cervix. Additional 
research efforts by NCI on the effectiveness of virus transmission are 
not warranted.''

                              {time}  1145

  The American Cancer Society recent research shows that condoms cannot 
protect against infection with HPV. The absence of visible signs of 
this disease cannot be used to decide whether caution is warranted 
since this disease can be passed on to another person when there are no 
visible signs of the disease externally. That is the American Cancer 
Society and the National Institutes of Health.
  National Institutes of Health, April 3, 1996, the data on the use of 
barrier methods of contraception condoms to prevent the spread of human 
papilloma virus is controversial but does not support it as an 
effective method of prevention.
  I include for the Record the following information:

Do Condoms Protect Against HPV Infection?--According to the Scientific 
       Experts, the Answer Is a Resounding and Conclusive ``NO''.


                       national cancer institute

       ``Condoms are ineffective against HPV because the virus is 
     prevalent not only in mucosal tissue (genitalia) but also on 
     dry skin of the surrounding abdomen and groin, and it can 
     migrate from those areas into the vagina and the cervix. 
     Additional research efforts by NCI on the effectiveness of 
     condoms in preventing HPV transmission are not warranted.''--
     Excerpt from a February 19, 1999 letter to House Commerce 
     Committee Chairman Tom Bliley from Dr. Richard D. Klausner, 
     Director of the National Cancer Institute at the National 
     Institutes of Health.


                        american cancer society

       ``Recent research shows that condoms (``rubbers'') cannot 
     protect against infection with HPV. This is because HPV can 
     be passed from person to person with any skin-to-skin contact 
     with any HPV-infected area of the body, such as skin of the 
     genital or anal area not covered by the condom. The absence 
     of visible warts cannot be used to decide whether caution is 
     warranted, since HPV can be passed on to another person even 
     when there are no visible warts or other symptoms. HPV can be 
     present for years with no symptoms.''--Excerpt from the 
     American Cancer Society website (www.cancer.org).


                     national institutes of health

       ``The data on the use of barrier methods of contraception 
     to prevent the spread of HPV is controversial but does not 
     support this as an effective method of prevention. . . . 
     Reducing the rate of HPV infection by encouraging changes in 
     the sexual behavior of young people and/or through developing 
     an effective HPV vaccine would reduce the incidence of this 
     disease.''--National Institutes of Health Consensus 
     Development Conference Statement on Cervical Cancer, April 1-
     3, 1996.

  Mr. Speaker, the reason that is important is we have a breast and 
cervical cancer treatment bill by the gentleman from New York (Mr. 
Lazio) and the gentlewoman from North Carolina (Mrs. Myrick) that is 
being held up at this time on the basis of the Senate conferees not 
wanting to agree to the language in that in regards to HPV and cervical 
cancer.
  Mr. Speaker, I would like to ask the body that they would put 
pressure on their fellow Senators that they might accede to this. The 
fact is, the reason we have this awareness up is we want women to get 
treated. This is a disease that is absolutely curable. It is not like 
breast cancer; we cannot always cure breast cancer.
  This disease, if diagnosed properly and treated, is 100 percent 
curable. Knowledge and the fact that we are allowing a safe sex message 
of condoms preventing this disease to continue will do nothing but harm 
women. It will not undermine anybody's position on sexuality or 
abortion or any other issue. The fact is, it is harmful to women to let 
that lie continue.
  Mr. Speaker, I would ask that as we support this, that we remember 
what we are really talking about is our sisters, our nieces and our 
daughters in the future that they would be given the knowledge with 
which to make great decisions, and the knowledge is that a condom does 
not prevent transmission of this disease. And until young women know 
that and know that certainly so that they can make a different choice, 
at least allow the young women in this country the ability to make an 
informed choice.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I ask for support of this resolution, and I also ask 
that Congress move on the conference committee on the breast and 
cervical cancer bill. Public health officials want us to move on the 
Senate version of the bill. We should not bog this legislation down in 
this argument that we heard today. We should move forward, pass this 
legislation, and also move forward and pass the Millender-McDonald 
resolution
  Mr. Speaker, I have no other speakers, and I yield back the balance 
of my time.
  The SPEAKER pro tempore (Mr. LaTourette). The question is on the 
motion offered by the gentleman from Oklahoma (Mr. Coburn) that the 
House suspend the rules and agree to the concurrent resolution, H. Con. 
Res. 64.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the concurrent resolution was 
agreed to.
  A motion to reconsider was laid on the table.

                          ____________________