SCREENS for Cancer Act of 2023

II Calendar No. 317 118TH CONGRESS 2D SESSION S. 1840 To amend the Public Health Service Act to reauthorize and improve the National Breast and Cervical Cancer Early Detection Program for fiscal years 2024 through 2028, and for other purposes. IN THE SENATE OF THE UNITED STATES JUNE 7, 2023 Ms. BALDWIN (for herself, Ms. COLLINS, Ms. CORTEZ MASTO, Mrs. CAPITO, Ms. KLOBUCHAR, and Ms. MURKOWSKI) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions FEBRUARY 1, 2024 Reported by Mr. SANDERS, with an amendment [Strike out all after the enacting clause and insert the part printed in italic] A BILL To amend the Public Health Service Act to reauthorize and improve the National Breast and Cervical Cancer Early Detection Program for fiscal years 2024 through 2028, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 •S 1840 RS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Screening for Commu- 2 nities to Receive Early and Equitable Needed Services for 3 Cancer Act of 2023’’ or the ‘‘SCREENS for Cancer Act 4 of 2023’’. 5 SEC. 2. FINDINGS. 6 Congress finds the following: 7 (1) In 2023, there will be more than 300,590 8 new cases of invasive breast cancer and nearly 9 44,000 breast cancer deaths in the United States. 10 (2) In 2023, there will be about 13,960 new 11 cases of invasive cervical cancer and about 4,310 12 deaths from cervical cancer. 13 (3) Black women have the highest breast, cer- 14 vical, and uterine cancer death rates of all racial and 15 ethnic groups and are more likely to be diagnosed 16 with triple-negative breast cancer, a more aggressive 17 form of cancer. 18 (4) Research shows that the COVID–19 pan- 19 demic was associated with a decline of more than 20 3,900,000 breast cancer screenings in 2020, as com- 21 pared to 2019. Similarly, cervical cancer screening 22 utilization dropped by 90 percent in April 2020, rel- 23 ative to the prior year. 24 (5) Research suggests that those postponed 25 breast screenings appeared to disproportionately af- 26 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6401 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 3 •S 1840 RS fect women of color: Non-Hispanic White women 1 had 17 percent fewer breast cancer diagnoses, while 2 the year-over-year decline was 53 percent for Asian 3 women, 43 percent for Hispanic women, and 27 per- 4 cent for Black women. 5 (6) The National Cancer Institute estimates 6 that pandemic-related disruptions or delays in breast 7 care and screening are expected to result in an ex- 8 cess of 2,500 breast cancer deaths by 2030. 9 (7) Since its creation in 1991, the National 10 Breast and Cervical Cancer Early Detection Pro- 11 gram (referred to in this section as the 12 ‘‘NBCCEDP’’) has provided lifesaving cancer 13 screening and diagnostic services to low-income, un- 14 insured, or underinsured women in all 50 States, the 15 District of Columbia, 6 territories, and 13 Tribes or 16 Tribal organizations. 17 (8) NBCCEDP seeks to reduce inequities in 18 breast and cervical cancer screening and diagnosis, 19 placing special emphasis on outreach to women who 20 are members of racial or ethnic minority groups, and 21 those who are geographically or culturally isolated. 22 (9) NBCCEDP has served more than 23 6,100,000 people and provided more than 24 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6401 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 •S 1840 RS 15,700,000 breast and cervical cancer screening ex- 1 aminations. 2 (10) These screening exams have diagnosed 3 nearly 76,000 invasive breast cancers and more than 4 24,000 premalignant breast lesions, as well as more 5 than 5,100 invasive cervical cancers and 235,000 6 premalignant cervical lesions, of which 39 percent 7 were high-grade. 8 (11) The program also provides public edu- 9 cation, outreach, patient navigation, and care coordi- 10 nation to increase breast and cervical cancer screen- 11 ing rates and reach underserved populations. 12 (12) Reauthorizing NBCCEDP will result in 13 expanded services, leading to more people being 14 screened and more cancers diagnosed at earlier 15 stages. 16 SEC. 3. NATIONAL BREAST AND CERVICAL CANCER EARLY 17 DETECTION PROGRAM. 18 Title XV of the Public Health Service Act (42 U.S.C. 19 300k et seq.) is amended— 20 (1) in section 1501 (42 U.S.C. 300k)— 21 (A) in subsection (a)— 22 (i) in paragraph (2), by striking ‘‘the 23 provision of appropriate follow-up services 24 and support services such as case manage- 25 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6401 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 •S 1840 RS ment’’ and inserting ‘‘that appropriate fol- 1 low-up services are provided’’; 2 (ii) in paragraph (3), by striking 3 ‘‘programs for the detection and control’’ 4 and inserting ‘‘for the prevention, detec- 5 tion, and control’’; 6 (iii) in paragraph (4), by striking ‘‘the 7 detection and control’’ and inserting ‘‘the 8 prevention, detection, and control’’; 9 (iv) in paragraph (5)— 10 (I) by striking ‘‘monitor’’ and in- 11 serting ‘‘ensure’’; and 12 (II) by striking ‘‘; and’’ and in- 13 serting a semicolon; 14 (v) by redesignating paragraph (6) as 15 paragraph (9); 16 (vi) by inserting after paragraph (5), 17 the following: 18 ‘‘(6) to enhance appropriate support activities 19 to increase breast and cervical cancer screening such 20 as patient navigation, implementation of evidence- 21 based or evidence-informed strategies proven to in- 22 crease breast and cervical cancer screening in health 23 care settings, and facilitating access to health care 24 settings; 25 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6401 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 6 •S 1840 RS ‘‘(7) to reduce disparities in incidents of and 1 deaths due to breast and cervical cancer in popu- 2 lations with higher than average rates; 3 ‘‘(8) to ensure equitable access to screening and 4 diagnostic services and improve access for individ- 5 uals who encounter additional barriers to receiving 6 services, including due to various social determinants 7 of health; and’’; and 8 (vii) in paragraph (9), as so redesig- 9 nated, by striking ‘‘through (5)’’ and in- 10 serting ‘‘through (8)’’; and 11 (B) by striking subsection (d); 12 (2) in section 1503 (42 U.S.C. 300m)— 13 (A) in subsection (a)— 14 (i) in paragraph (1), by striking 15 ‘‘that, initially’’ and all that follows 16 through the semicolon and inserting ‘‘that 17 appropriate breast and cervical cancer 18 screening and diagnostic services are pro- 19 vided based on national recommendations; 20 and’’; 21 (ii) by striking paragraphs (2) and 22 (4); 23 (iii) by redesignating paragraph (3) as 24 paragraph (2); and 25 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6401 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 7 •S 1840 RS (iv) in paragraph (2), as so redesig- 1 nated, by striking ‘‘; and’’ and inserting a 2 period; and 3 (B) by striking subsection (d); 4 (3) in section 1508(b) (42 U.S.C. 300n–4(b))— 5 (A) by striking ‘‘1 year after the date of 6 the enactment of the National Breast and Cer- 7 vical Cancer Early Detection Program Reau- 8 thorization of 2007, and annually thereafter,’’ 9 and inserting ‘‘2 years after the date of enact- 10 ment of the Screening for Communities to Re- 11 ceive Early and Equitable Needed Services for 12 Cancer Act of 2023, and every 5 years there- 13 after,’’; 14 (B) by striking ‘‘Labor and Human Re- 15 sources’’ and inserting ‘‘Health, Education, 16 Labor, and Pensions’’; and 17 (C) by striking ‘‘preceding fiscal year’’ and 18 inserting ‘‘preceding 2 fiscal years in the case 19 of the first report after the date of enactment 20 of the Screening for Communities to Receive 21 Early and Equitable Needed Services for Can- 22 cer Act of 2023 and preceding 5 fiscal years for 23 each report thereafter’’; and 24 (4) in section 1510(a) (42 U.S.C. 300n–5(a))— 25 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6401 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 8 •S 1840 RS (A) by striking ‘‘and’’ after ‘‘2011,’’; and 1 (B) by inserting ‘‘, $275,000,000 for fiscal 2 year 2024, $330,000,000 for fiscal year 2025, 3 $385,000,000 for fiscal year 2026, 4 $440,000,000 for fiscal year 2027, and 5 $500,000,000 for fiscal year 2028’’ before the 6 period at the end. 7 SECTION 1. SHORT TITLE. 8 This Act may be cited as the ‘‘Screening for Commu- 9 nities to Receive Early and Equitable Needed Services for 10 Cancer Act of 2023’’ or the ‘‘SCREENS for Cancer Act of 11 2023’’. 12 SEC. 2. NATIONAL BREAST AND CERVICAL CANCER EARLY 13 DETECTION PROGRAM. 14 Title XV of the Public Health Service Act (42 U.S.C. 15 300k et seq.) is amended— 16 (1) in section 1501 (42 U.S.C. 300k)— 17 (A) in subsection (a)— 18 (i) in paragraph (2), by striking ‘‘the 19 provision of appropriate follow-up services 20 and support services such as case manage- 21 ment’’ and inserting ‘‘that appropriate fol- 22 low-up services are provided’’; 23 (ii) in paragraph (3), by striking 24 ‘‘programs for the detection and control’’ 25 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6203 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 9 •S 1840 RS and inserting ‘‘for the prevention, detection, 1 and control’’; 2 (iii) in paragraph (4), by striking ‘‘the 3 detection and control’’ and inserting ‘‘the 4 prevention, detection, and control’’; 5 (iv) in paragraph (5)— 6 (I) by striking ‘‘monitor’’ and in- 7 serting ‘‘ensure’’; and 8 (II) by striking ‘‘; and’’ and in- 9 serting a semicolon; 10 (v) by redesignating paragraph (6) as 11 paragraph (9); 12 (vi) by inserting after paragraph (5) 13 the following: 14 ‘‘(6) to enhance appropriate support activities to 15 increase breast and cervical cancer screenings, such as 16 navigation of health care services, implementation of 17 evidence-based or evidence-informed strategies to in- 18 crease breast and cervical cancer screening in health 19 care settings, and facilitation of access to health care 20 settings; 21 ‘‘(7) to reduce disparities in breast and cervical 22 cancer incidence, morbidity, and mortality, including 23 in populations with higher than average rates; 24 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6203 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 10 •S 1840 RS ‘‘(8) to improve access to breast and cervical 1 cancer screening and diagnostic services and reduce 2 related barriers, including factors that relate to nega- 3 tive health outcomes; and’’; and 4 (vii) in paragraph (9), as so redesig- 5 nated, by striking ‘‘through (5)’’ and insert- 6 ing ‘‘through (8)’’; and 7 (B) by striking subsection (d); 8 (2) in section 1503 (42 U.S.C. 300m)— 9 (A) in subsection (a)— 10 (i) in paragraph (1), by striking ‘‘that, 11 initially’’ and all that follows through the 12 semicolon and inserting ‘‘that appropriate 13 breast and cervical cancer screening and di- 14 agnostic services are provided consistent 15 with relevant evidence-based recommenda- 16 tions; and’’; 17 (ii) by striking paragraphs (2) and 18 (4); 19 (iii) by redesignating paragraph (3) as 20 paragraph (2); and 21 (iv) in paragraph (2), as so redesig- 22 nated, by striking ‘‘; and’’ and inserting a 23 period; and 24 (B) by striking subsection (d); 25 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6203 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 11 •S 1840 RS (3) in section 1508(b) (42 U.S.C. 300n–4(b))— 1 (A) by striking ‘‘1 year after the date of the 2 enactment of the National Breast and Cervical 3 Cancer Early Detection Program Reauthoriza- 4 tion of 2007, and annually thereafter,’’ and in- 5 serting ‘‘2 years after the date of enactment of 6 the Screening for Communities to Receive Early 7 and Equitable Needed Services for Cancer Act of 8 2023, and every 5 years thereafter,’’; 9 (B) by striking ‘‘Labor and Human Re- 10 sources’’ and inserting ‘‘Health, Education, 11 Labor, and Pensions’’; and 12 (C) by striking ‘‘preceding fiscal year’’ and 13 inserting ‘‘preceding 2 fiscal years in the case of 14 the first report after the date of enactment of the 15 Screening for Communities to Receive Early and 16 Equitable Needed Services for Cancer Act of 2023 17 and preceding 5 fiscal years for each report 18 thereafter’’; and 19 (4) in section 1510(a) (42 U.S.C. 300n–5(a))— 20 (A) by striking ‘‘2011, and’’ and inserting 21 ‘‘2011,’’; and 22 (B) by inserting ‘‘, and $275,000,000 for 23 each of fiscal years 2024 through 2028’’ before 24 the period at the end. 25 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6203 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB 12 •S 1840 RS SEC. 3. GAO STUDY. 1 Not later than September 30, 2027, the Comptroller 2 General of the United States shall report to the Committee 3 on Health, Education, Labor, and Pensions of the Senate 4 and the Committee on Energy and Commerce of the House 5 of Representatives on the work of the National Breast and 6 Cervical Cancer Early Detection Program, including— 7 (1) an estimate of the number of individuals eli- 8 gible for services provided under such program; 9 (2) a summary of trends in the number of indi- 10 viduals served through such program; and 11 (3) an assessment of any factors that may be 12 driving the trends identified under paragraph (2), in- 13 cluding any barriers to accessing breast and cervical 14 cancer screenings provided by such program. 15 VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6203 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB VerDate Sep 11 2014 23:36 Feb 01, 2024 Jkt 049200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6203 E:\BILLS\S1840.RS S1840 kjohnson on DSK7ZCZBW3PROD with $$_JOB Calendar No. 317 118TH CONGRESS 2D SESSION S. 1840 A BILL To amend the Public Health Service Act to reau- thorize and improve the National Breast and Cervical Cancer Early Detection Program for fis- cal years 2024 through 2028, and for other pur- poses. FEBRUARY 1, 2024 Reported with an amendment VerDate Sep 11 2014 23:36 Feb 01, 2024 [Text truncated for display. Full text available on Congress.gov.]