II 

117TH CONGRESS 

1ST SESSION S. 699 

To require a review of women and lung cancer, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 11, 2021 

Mr. RUBIO (for himself, Mrs. FEINSTEIN, Mrs. CAPITO, and Mr. MANCHIN) 

introduced the following bill; which was read twice and referred to the 

Committee on Health, Education, Labor, and Pensions 

A BILL 

To require a review of women and lung cancer, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Women and Lung Can5 cer Research and Preventive Services Act of 2021’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) According to the American Cancer Society, 

9 in the United States, approximately 171 women die 


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1 each day of lung cancer, or about one woman every 

2 8.4 minutes. 

3 (2) Lung cancer is the leading cause of cancer 

4 death among women. 

5 (3) The American Cancer Society estimates 

6 that 62,470 women will die of lung cancer in 2021. 

7 (4) Studies have shown a higher incidence rate 

8 of lung cancer for women who were never smokers 

9 compared to men who were never smokers. 

10 (5) According to the American Cancer Society, 

11 new cases of lung cancer dropped by 3 percent per 

12 year in men from 2011 to 2015, while new cases in 

13 women only dropped 1.5 percent per year in the 

14 same time period. 

15 (6) According to the 2014 report, ‘‘The Health 

16 Consequences of Smoking—50 Years of Progress: A 

17 Report of the Surgeon General, 2014’’, the relative 

18 risk of developing lung cancer increased tenfold 

19 among female smokers between 1959 and 2010. 

20 (7) According to the American Cancer Society, 

21 approximately 40 percent of lung cancers are adeno22 carcinoma, a subtype of non-small cell lung cancer, 

23 which is the most common type of cancer seen in 

24 non-smokers and is more common in women than in 

25 men. 


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1 (8) According to the Environmental Protection 

2 Agency, exposure to radon accounts for approxi3 mately 21,000 deaths from lung cancer each year 

4 and is the leading cause of lung cancer in non-smok5 ers. 

6 (9) A Government Accountability Office report 

7 published on October 22, 2015, called for the Na8 tional Institutes of Health to do more in evaluating 

9 gender differences in research. 

10 (10) Additional research strategies, including 

11 clinical trials, are necessary to explore the dif12 ferences in lung cancer risk factors, incidence, and 

13 treatment response in women, and to address the 

14 disparate impact of lung cancer on women who have 

15 never smoked. 

16 (11) Lung cancer screening, which can detect 

17 lung cancer at its earliest, most curable stage, is a 

18 covered service available without cost-sharing for 

19 those at high risk. 

20 (12) Published peer-reviewed actuarial studies 

21 indicate that lung cancer screening individuals at 

22 high risk may be cost-effective. 

23 (13) The National Framework of Excellence in 

24 Lung Cancer Screening and Continuum of Care, 

25 launched in 2012, demonstrated that lung cancer 


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1 screening can be safely and effectively carried out in 

2 community hospital settings around the Nation. 

3 (14) Information on the impact of lung cancer 

4 on women and the importance of early detection 

5 should be incorporated into all relevant public health 

6 awareness campaigns. 

7 SEC. 3. SENSE OF CONGRESS CONCERNING WOMEN AND 

8 LUNG CANCER. 

9 It is the sense of Congress that— 

10 (1) there is a disparate impact of lung cancer 

11 on women and, in particular, on women who have 

12 never smoked; 

13 (2) additional research strategies to explore the 

14 differences in women with respect to lung cancer 

15 risk factors, incidence, histology, and response to 

16 treatment are justified and necessary; 

17 (3) the implementation of lung cancer preven18 tive services for women should be accelerated; and 

19 (4) the public health agencies of the Federal 

20 Government should coordinate public education and 

21 awareness programs on the impact of lung cancer on 

22 women and the importance of early detection. 


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1 SEC. 4. INTERAGENCY REVIEW TO EVALUATE AND IDEN2 TIFY OPPORTUNITIES FOR THE ACCELERA3 TION OF RESEARCH ON WOMEN AND LUNG 

4 CANCER, GREATER ACCESS TO PREVENTIVE 

5 SERVICES, AND STRATEGIC PUBLIC AWARE6 NESS AND EDUCATION CAMPAIGNS. 

7 (a) IN GENERAL.—The Secretary of Health and 

8 Human Services, in consultation with the Secretary of De9 fense and Secretary of Veterans Affairs, shall conduct an 

10 interagency review to evaluate the status of, and identify 

11 opportunities related to— 

12 (1) research on women and lung cancer; 

13 (2) access to lung cancer preventive services; 

14 and 

15 (3) strategic public awareness and education 

16 campaigns on lung cancer. 

17 (b) CONTENT.—The review and recommendations 

18 under subsection (a) shall include— 

19 (1) a review and comprehensive report on the 

20 outcomes of previous research, the status of existing 

21 research activities, and knowledge gaps related to 

22 women and lung cancer in all agencies of the Fed23 eral Government; 

24 (2) specific opportunities for collaborative, 

25 interagency, multidisciplinary, and innovative re26 search, that would— 


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1 (A) encourage innovative approaches to 

2 eliminate knowledge gaps in research; 

3 (B) evaluate environmental and genomic 

4 factors that may be related to the etiology of 

5 lung cancer in women; and 

6 (C) foster advances in imaging technology 

7 to improve risk assessment, diagnosis, treat8 ment, and the simultaneous application of other 

9 preventive services; 

10 (3) opportunities regarding the development of 

11 a national lung cancer screening strategy with suffi12 cient infrastructure and personnel resources to ex13 pand access to such screening, particularly among 

14 underserved populations; and 

15 (4) opportunities regarding the development of 

16 a national public education and awareness campaign 

17 on women and lung cancer and the importance of 

18 early detection of lung cancer. 

19 (c) REPORT.—Not later than one year after the date 

20 of the enactment of this Act, the Secretary of Health and 

21 Human Services shall submit to Congress a report on the 

22 review conducted under subsection (a). 

Æ 


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