[Congressional Record Volume 170, Number 144 (Tuesday, September 17, 2024)]
[House]
[Pages H5277-H5278]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             VIETNAM VETERANS LIVER FLUKE CANCER STUDY ACT

  Mr. BOST. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 4424) to direct the Secretary of Veterans Affairs to study and 
report on the prevalence of cholangiocarcinoma in veterans who served 
in the Vietnam theater of operations during the Vietnam era, and for 
other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4424

       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 ``Vietnam Veterans Liver Fluke 
     Cancer Study Act''.

     SEC. 2. STUDY ON THE PREVALENCE OF CHOLANGIOCARCINOMA IN 
                   VETERANS WHO SERVED IN THE VIETNAM THEATER OF 
                   OPERATIONS DURING THE VIETNAM ERA.

       (a) Epidemiological Study.--Not later than 120 days after 
     the date of enactment of this Act, the Secretary of Veterans 
     Affairs, in consultation with the Director of the Centers for 
     Disease Control and Prevention of the Department of Health 
     and Human Services, shall commence an epidemiological study 
     on the prevalence of cholangiocarcinoma in covered veterans 
     of the Vietnam era, using data from the Veterans Affairs 
     Central Cancer Registry and the National Program of Cancer 
     Registries. The study shall--
       (1) identify the rate of incidence of cholangiocarcinoma in 
     covered veterans of the Vietnam era and in residents of the 
     United States, from the beginning of the Vietnam era to the 
     date of enactment of this Act; and
       (2) for each of the groups specified in paragraph (1), 
     identify the percentage of individuals with 
     cholangiocarcinoma by various demographic characteristics, 
     including by age, gender, race, ethnicity, and the geographic 
     location of the patient at the time of diagnosis.
       (b) Report to Congress.--Not later than one year after the 
     completion of the study under subsection (a), the Secretary 
     shall submit to Congress a report containing--
       (1) the results of the study under subsection (a); and
       (2) recommendations for administrative or legislative 
     actions required to address issues identified in the study 
     under subsection (a).
       (c) Continued Tracking of Cholangiocarcinoma in Covered 
     Veterans of the Vietnam Era.--The Secretary shall track the 
     prevalence of cholangiocarcinoma in covered veterans of the 
     Vietnam era using the Veterans Affairs Central Cancer 
     Registry, and provide such information to Congress as 
     required under subsection (d).
       (d) Follow-Up Reports.--The Secretary shall periodically 
     submit to the Congress an updated report under subsection 
     (b), as determined by the Secretary.
       (e) Definitions.--In this section:
       (1) The term ``Secretary'' means the Secretary of Veterans 
     Affairs.
       (2) The term ``Vietnam era'' has the meaning given such 
     term in section 101 of title 38, United States Code.
       (3) The term ``covered veterans of the Vietnam era'' means 
     veterans who served in the Vietnam theater of operations 
     during the Vietnam era.

     SEC. 3. MODIFICATION OF CERTAIN HOUSING LOAN FEES.

       The loan fee table in section 3729(b)(2) of title 38, 
     United States Code, is amended by striking ``November 15, 
     2031'' each place it appears and inserting ``November 29, 
     2031''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Illinois (Mr. Bost) and the gentleman from California (Mr. Takano) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Illinois.


                             General Leave

  Mr. BOST. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Illinois?
  There was no objection.
  Mr. BOST. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of H.R. 4424, as amended, 
introduced by my friend and fellow veteran, Mr. LaLota from New York. 
Representative LaLota's bill would require VA to conduct a study and 
produce a report on the frequency of bile duct cancer for veterans who 
served in and around the Vietnam war.
  Mr. Speaker, it goes without saying that many veterans and Vietnam 
veterans suffered greatly in their service to their country. Thousands 
of Vietnam veterans still live with the invisible and visible wounds of 
war today.
  Eating uncooked fish while deployed over 60 years ago may have added 
to that harm. Certain undercooked fish contain a parasite known as a 
liver fluke, which can cause infection and scarring that could lead to 
bile duct cancer.
  This type of cancer is a rare form of cancer and is in the U.S. but 
is more common in Southeast Asia. The study in this bill would rightly 
require VA to determine if the bile duct cancer is a result of the 
Vietnam-era veterans' deployment in that region.
  One of the VA's most important missions is to take care of veterans' 
service-connected injuries. This study would help uphold that sacred 
mission. This bill is also an important step in continuing to ensure 
our Vietnam veterans receive the respect and care they have earned.
  Mr. Speaker, I thank Mr. LaLota for his vitally important work on 
this bill, and I urge all of my colleagues to support H.R. 4424, as 
amended.

[[Page H5278]]

  Mr. Speaker, I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise to express my support for H.R. 4424, the Vietnam 
Veterans Liver Fluke Cancer Study Act, as amended.
  Liver fluke is a serious parasitic infection that is a well-
recognized risk factor for the development of bile duct cancer.
  H.R. 4424, as amended, would require VA, in consultation with the 
Centers for Disease Control and Prevention, to commence an 
epidemiological study on the prevalence of bile duct cancer in veterans 
who served in the Vietnam war versus their nonveteran U.S. resident 
counterparts. This legislation requires VA to submit a regular report 
with the results of the study broken out by age, gender, race, 
ethnicity, and geographic location.
  I certainly understand why Vietnam war veterans would be concerned 
about their exposure to this disease and believe we should do 
everything possible to ensure veterans have access to care and 
treatment for diseases they may have been exposed to as a part of their 
service.
  Mr. Speaker, while I have concerns that this effort is duplicative 
given VA's previous and ongoing research on this disorder, I welcome 
additional research and will support the bill today, and I urge my 
colleagues to do the same.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BOST. Mr. Speaker, I yield such time as he may consume to the 
gentleman from New York (Mr. LaLota), the sponsor of the bill.
  Mr. LaLOTA. Mr. Speaker, I thank the chairman, a Marine Corps 
veteran, for yielding.
  Mr. Speaker, there is an obvious link between liver fluke disease and 
our Vietnam veterans' service in that war, but the VA won't cover their 
care. My bill would help fix that and do right by our Vietnam veterans.
  Data from multiple studies clearly demonstrate Vietnam veterans have 
a much greater chance of contracting, suffering from, and dying from 
the liver fluke parasite, yet the VA does not help veterans who are 
fighting liver fluke disease. That is wrong, Mr. Speaker.
  The correlation between the liver fluke parasite and service in 
Vietnam is obvious. In 2018, the Northport VA Medical Center conducted 
a first-of-its-kind study using a 50-veteran sample size. The initial 
results of that study highlighted three things: a substantial need for 
greater study of this issue; two, the development of standardized 
treatment options; and three, broader accessibility of care for 
veterans at VA facilities across the country.
  That study was 6 years ago and could have been justification enough 
for the VA to start covering affected Vietnam veterans, but the VA 
insisted on another study. A second study was ordered. After years of 
delays, supposedly due to the pandemic, a more recent study finally 
concluded in 2024. The 2024 study affirmed what so many Vietnam 
veterans have been saying for years, that there is indeed a link 
between the liver fluke disease and service in Vietnam.

                              {time}  1730

  Specifically, the study in which Marine Corps veterans participated 
demonstrate that there is a 30 percent greater risk of mortality from 
this liver fluke disease for marines who served in the Vietnam war 
theater as compared to marines who served elsewhere.
  Mr. Speaker, you would think these findings, coupled with the 2018 
findings, would be justification enough for the VA to start covering 
affected Vietnam veterans. Yet, after multiple in-depth studies which 
corroborate the link between our veterans' service in Vietnam and the 
rare liver fluke disease, the VA still says these studies still are not 
enough.
  To fight the VA's ambivalence towards these Vietnam veterans, I am 
urging all of my colleagues to support my bipartisan legislation, H.R. 
4424, the Vietnam Veterans Liver Fluke Cancer Study Act.
  This act would require the VA, in conjunction with the Centers for 
Disease Control and Prevention, to conduct a third study to determine 
the prevalence of liver fluke amongst the Vietnam veteran population.
  If the VA won't take action, then we will continue to force them to 
confront the facts until they come to the same conclusion as the rest 
of us.
  Our Vietnam veterans are dying every day, and we do not have the 
luxury of time. Too much time has passed already. We went through a 
similar and terrible situation with our blue water Navy veterans and 
Agent Orange. Let us not make the same mistake with liver fluke.
  I thank Chairman Bost and Ranking Member Takano for their leadership 
and support of this critical legislation. Together, we can make sure 
that our Vietnam veterans get the care, recognition, and support they 
so rightfully deserve.
  Mr. BOST. Mr. Speaker, I have no further speakers on this particular 
legislation, I am ready to close, and I reserve the balance of my time.
  Mr. TAKANO. Mr. Speaker, I have no further speakers, and I yield 
myself the balance of my time to close.
  Mr. Speaker, I ask all of my colleagues to join me in passing H.R. 
4424, the Vietnam Veterans Liver Fluke Cancer Study Act, as amended, 
and I yield back the balance of my time.
  Mr. BOST. Mr. Speaker, once again, I also encourage Members to 
support this legislation, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Illinois (Mr. Bost) that the House suspend the rules and 
pass the bill, H.R. 4424, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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