[Congressional Record Volume 149, Number 64 (Thursday, May 1, 2003)]
[Senate]
[Pages S5674-S5675]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CHAFEE (for himself, Mr. Reid, Mr. Hatch, Ms. Mikulski, 
        Ms. Collins, Mr. Leahy, Mr. Warner, Mr. Kennedy, Mr. Voinovich, 
        Mr. Biden, Mr. Allen, Mrs. Clinton, Mr. Fitzgerald, Mrs. 
        Murray, Ms. Snowe, Mr. Johnson, Mr. Feingold, Mrs. Feinstein, 
        Mr. Reed, and Mr. Corzine):
  S. 983. A bill to amend the Public Health Service Act to authorize 
the Director of the National Institute of Environmental Health Sciences 
to make grants for the development and operation of research centers 
regarding environmental factors that may be related to the etiology of 
breast cancer; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. CHAFEE. Mr. President, I am pleased to be joined today by Senator 
Harry Reid and others in introducing the Breast Cancer and 
Environmental Research Act of 2003. This bill would establish research 
centers that would be the first in the Nation to specifically study the 
environmental factors that may be related to the development of breast 
cancer. The lack of agreement within the scientific community and among 
breast cancer advocates on this question highlights the need for 
further study.
  It is generally believed that the environment plays some role in the 
development of breast cancer, but the extent of that role is not 
understood. The Breast Cancer and Environmental Research Act of 2003 
will enable us to conduct more conclusive and comprehensive research to 
determine the impact of the environment on breast cancer. Before we can 
find the answers, we must determine the right questions we should be 
asking.
  While more research is being conducted into the relationship between 
breast cancer and the environment, there are still several issues that 
must be resolved to make this research more effective. They are as 
follows:
  There is no known cause of breast cancer. There is little agreement 
in the scientific community on how the environment affects breast 
cancer. While studies have been conducted on the links between 
environmental factors like pesticides, diet, and electromagnetic 
fields, no consensus has been reached. There are other factors that 
have not yet been studied that could provide valuable information. 
While there is much speculation, it is clear that the relationship 
between environmental exposures and breast cancer is poorly understood.
  There are challenges in conducting environmental research. 
Identifying linkages is difficult. Laboratory experiments and cluster 
analyses, such as those in Long Island, New York, cannot reveal whether 
an environmental exposure increases a woman's risk of breast cancer. 
Epidemiological studies must be designed carefully, because 
environmental exposures are difficult to measure.
  Coordination between the National Institutes of Health, NIH, the 
National Cancer Institute, NCI, and the National Institute of 
Environmental Health Sciences, NIEHS, needs to occur. NCI and NIEHS are 
the two institutes in the NIH that fund most of the research related to 
breast cancer and the environment; however, comprehensive information 
is not currently available.
  This legislation would establish eight Centers of Excellence to study 
these potential links. These ``Breast Cancer Environmental Research 
Centers'' would provide for multi-disciplinary research among basic, 
clinical, epidemiological and behavioral scientists interested in 
establishing outstanding, state-of-the-art research programs addressing 
potential links between the environment and breast cancer. The NIEHS 
would award grants based on a competitive peer-review process. This 
legislation would require each Center to collaborate with community 
organizations in the area, including those that represent women with 
breast cancer. The bill would authorize $30 million for the next five 
years for these grants.
  ``Genetics loads the gun, the environment pulls the trigger,'' as Ken 
Olden, the Director of NIEHS, frequently says. Many scientists believe 
that certain groups of women have genetic variations that may make them 
more susceptible to adverse environmental exposures. We need to step 
back and gather evidence before we come to conclusions--that is the 
purpose of this bill. People are hungry for information, and there is a 
lot of inconclusive data out there, some of which has no scientific 
merit whatsoever. We have the opportunity through this legislation to 
gather legitimate and comprehensive data from premier research 
institutions across the nation.
  According to the American Cancer Society, each year 800 women in 
Rhode Island are diagnosed with breast cancer, and 200 women in my 
state will die of this terrible disease this year. We owe it to these 
women who are diagnosed with this life-threatening disease to provide 
them with answers for the first time.
  I urge my colleagues to join me in supporting and cosponsoring this 
important legislation, and ask unanimous consent that the text of the 
legislation be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 983

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Breast Cancer and 
     Environmental Research Act of 2003''.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) Breast cancer is the second leading cause of cancer 
     deaths among American women.
       (2) More women in the United States are living with breast 
     cancer than any other cancer (excluding skin cancer). 
     Approximately 3,000,000 women in the United States are living 
     with breast cancer, 2,000,000 of which have been diagnosed 
     and an estimated 1,000,000 who do not yet know that they have 
     the disease.
       (3) Breast cancer is the most commonly diagnosed cancer 
     among women in the United States and worldwide (excluding 
     skin cancer). In 2003, it is estimated that 258,600 new cases 
     of breast cancer will be diagnosed among women in the United 
     States, 211,300

[[Page S5675]]

     cases of which will involve invasive breast cancer and 47,300 
     cases of which will involve ductal carcinoma in situ (DCIS).
       (4) Breast cancer is the second leading cause of cancer 
     death for women in the United States. Approximately 40,000 
     women in the United States die from the disease each year. 
     Breast cancer is the leading cause of cancer death for women 
     in the United States between the ages of 20 and 59, and the 
     leading cause of cancer death for women worldwide.
       (5) A woman in the United States has a 1 in 8 chance of 
     developing invasive breast cancer in her lifetime. This risk 
     was 1 in 11 in 1975. In 2001, a new case of breast cancer 
     will be diagnosed every 2 minutes and a woman will die from 
     breast cancer every 13 minutes.
       (6) All women are at risk for breast cancer. About 90 
     percent of women who develop breast cancer do not have a 
     family history of the disease.
       (7) The National Action Plan on Breast Cancer, a public 
     private partnership, has recognized the importance of 
     expanding the scope and breadth of biomedical, 
     epidemiological, and behavioral research activities related 
     to the etiology of breast cancer and the role of the 
     environment.
       (8) To date, there has been only a limited research 
     investment to expand the scope or coordinate efforts across 
     disciplines or work with the community to study the role of 
     the environment in the development of breast cancer.
       (9) In order to take full advantage of the tremendous 
     potential for avenues of prevention, the Federal investment 
     in the role of the environment and the development of breast 
     cancer should be expanded.
       (10) In order to understand the effect of chemicals and 
     radiation on the development of cancer, multi-generational, 
     prospective studies are probably required.

     SEC. 3. NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES; 
                   AWARDS FOR DEVELOPMENT AND OPERATION OF 
                   RESEARCH CENTERS REGARDING ENVIRONMENTAL 
                   FACTORS RELATED TO BREAST CANCER.

       Subpart 12 of part C of title IV of the Public Health 
     Service Act (42 U.S.C. 285l et seq.) is amended by adding at 
     the end the following section:

     ``SEC. 463B. RESEARCH CENTERS REGARDING ENVIRONMENTAL FACTORS 
                   RELATED TO BREAST CANCER.

       ``(a) In General.--The Director of the Institute, based on 
     recommendations from the Breast Cancer and Environmental 
     Research Panel established under subsection (b) (referred to 
     in this section as the `Panel') shall make grants, after a 
     process of peer review and programmatic review, to public or 
     nonprofit private entities for the development and operation 
     of not more than 8 centers for the purpose of conducting 
     multidisciplinary and multi-institutional research on 
     environmental factors that may be related to the etiology of 
     breast cancer. Each such center shall be known as a Breast 
     Cancer and Environmental Research Center of Excellence.
       ``(b) Breast Cancer and Environmental Research Panel.--
       ``(1) Establishment.--The Secretary shall establish in the 
     Institute of Environmental Health Sciences a Breast Cancer 
     and Environmental Research Panel.
       ``(2) Composition.--The Panel shall be composed of--
       ``(A) 9 members to be appointed by the Secretary, of 
     which--
       ``(i) six members shall be appointed from among physicians, 
     and other health professionals, who--

       ``(I) are not officers or employees of the United States;
       ``(II) represent multiple disciplines, including clinical, 
     basic, and public health sciences;
       ``(III) represent different geographical regions of the 
     United States;
       ``(IV) are from practice settings or academia or other 
     research settings; and
       ``(V) are experienced in biomedical review; and

       ``(ii) three members shall be appointed from the general 
     public who are representatives of individuals who have had 
     breast cancer and who represent a constituency; and
       ``(B) such nonvoting, ex officio members as the Secretary 
     determines to be appropriate.
       ``(3) Chairperson.--The members of the Panel appointed 
     under paragraph (2)(A) shall select a chairperson from among 
     such members.
       ``(4) Meetings.--The Panel shall meet at the call of the 
     chairperson or upon the request of the Director, but in no 
     case less often than once each year.
       ``(5) Duties.--The Panel shall--
       ``(A) oversee the peer review process for the awarding of 
     grants under subsection (a) and conduct the programmatic 
     review under such subsection;
       ``(B) make recommendations with respect to the funding 
     criteria and mechanisms under which amounts will be allocated 
     under this section; and
       ``(C) make final programmatic recommendations with respect 
     to grants under this section.
       ``(c) Collaboration With Community.--Each center under 
     subsection (a) shall establish and maintain ongoing 
     collaborations with community organizations in the geographic 
     area served by the center, including those that represent 
     women with breast cancer.
       ``(d) Coordination of Centers; Reports.--The Director of 
     the Institute shall, as appropriate, provide for the 
     coordination of information among centers under subsection 
     (a) and ensure regular communication between such centers, 
     and may require the periodic preparation of reports on the 
     activities of the centers and the submission of the reports 
     to the Director.
       ``(e) Required Consortium.--Each center under subsection 
     (a) shall be formed from a consortium of cooperating 
     institutions, meeting such requirements as may be prescribed 
     by the Director of the Institute. Each center shall require 
     collaboration among highly accomplished scientists, other 
     health professionals and advocates of diverse backgrounds 
     from various areas of expertise.
       ``(f) Duration of Support.--Support of a center under 
     subsection (a) may be for a period not exceeding 5 years. 
     Such period may be extended for one or more additional 
     periods not exceeding 5 years if the operations of such 
     center have been reviewed by an appropriate technical and 
     scientific peer review group established by the Director of 
     the Institute and if such group has recommended to the 
     Director that such period should be extended.
       ``(g) Geographic Distribution of Centers.--The Director of 
     the Institute shall, to the extent practicable, provide for 
     an equitable geographical distribution of centers under this 
     section.
       ``(h) Innovative Approaches.--Each center under subsection 
     (a) shall use innovative approaches to study unexplored or 
     under-explored areas of the environment and breast cancer.
       ``(i) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there is authorized to be 
     appropriated $30,000,000 for each of the fiscal years 2004 
     through 2009. Such authorization is in addition to any other 
     authorization of appropriations that is available for such 
     purpose.''.

  Mr. REID. Mr. President, I am pleased to join Senator Chafee in 
reintroducing the Breast Cancer and Environmental Research Act. Senator 
Chafee and I serve together on the Environment and Public Works 
Committee where we have had the opportunity to take a closer look at 
different environment-related health concerns. After a number of 
children in the small town of Fallon, NV, were diagnosed with leukemia, 
the committee traveled to Nevada to investigate what environmental 
factors may have contributed to the cancer cluster.
  The Fallon hearing reminded me how little we know about what causes 
cancer and what, if any, connection exists between the environment and 
cancer. Three decades have passed since President Nixon declared the 
``War on Cancer'' and scientists are still struggling with these and 
other crucial unanswered questions about cancer. This is particularly 
true in the case of breast cancer. We still don't know what causes 
breast cancer. We don't know if the environment plays a role in the 
development of breast cancer, and if it does, we don't know how 
significant that role is. In our search for answers about breast 
cancer, we need to make sure we are asking the right questions.
  To date, there has been only a limited research investment to study 
the role of the environment in the development of breast cancer. More 
research needs to be done to determine the impact of the environment on 
breast cancer. The Breast Cancer and Environmental Research Act would 
give scientists the tools they need to pursue a better understanding 
about what links between the environment and breast cancer may exist. 
Specifically, our bill would authorize $30 million to the National 
Institute of Environmental Health Sciences to establish eight Centers 
of Excellence that would focus on breast cancer and the environment.
  In the year 2003 alone, it is estimated that 258,600 new cases of 
breast cancer will be diagnosed among women in the United States. In 
Nevada, an estimated 1400 new cases will be diagnosed in 2003, and 
tragically, approximately 300 women in Nevada will die of breast cancer 
this year. If we miss promising research opportunities because of 
Congress' failure to act, millions of women and their families will 
face critical unanswered questions about breast cancer. During the 
107th Congress, almost half of the Senate cosponsored this important 
legislation. There is no reason we should not be able to work together 
during this session to pass this bill so we can find answers for the 
millions of Americans affected by breast cancer. I urge my colleagues 
to join in our quest for answers about this deadly disease and to 
support the Breast Cancer and Environmental Research Act.
                                 ______