IV

103D CONGRESS

2D SESSION H. RES. 368

Expressing the sense of the House of Representatives with respect to the

inclusion in any comprehensive benefits package under health care reform

of mammography screenings for women under the age of 50.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 23, 1994

Mr. TOWNS (for himself, Mrs. COLLINS of Illinois, Ms. VELA ́ZQUEZ, and Mrs.

VUCANOVICH) submitted the following resolution; which was referred

jointly to the Committees on Energy and Commerce and Ways and

Means

RESOLUTION

Expressing the sense of the House of Representatives with

respect to the inclusion in any comprehensive benefits

package under health care reform of mammography

screenings for women under the age of 50.

Whereas breast cancer is a substantial public health problem

in the United States, and the incidence and prevalence of

this cancer is increasing;

Whereas breast cancer is the number one cause of cancer

death in women between the ages of 15 and 54, particularly in African-American and Hispanic women;

Whereas, in 1992 alone, 40,000 cases of breast cancer were

diagnosed in women under 50, of which 28,900 cases

were diagnosed in women between the ages of 40 and 49;
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Whereas the risk of breast cancer increases significantly at

age 40;

Whereas, in 1992, the difference between the incidence of

breast cancer in women in their forties and women in

their fifties amounted to a difference of only 1 percent

of all breast cancer cases;

Whereas there has been a 2.5 percent increase in the breast

cancer mortality rate of premenopausal African-American

women, and experts believe that the increase is significantly influenced by the lack of access to early detection

and health care;

Whereas the 5-year survival rates for low-income women with

breast cancer are 9 percent lower than the rates for

upper-income women;

Whereas the National Cancer Advisory Board of the National

Cancer Institute voted 14 to 1 that the Institute’s guidelines recommending mammography screenings for women

between the ages of 40 and 49 should remain in place because the science is inconclusive to support any changes

at this time;

Whereas mammography is among the most effective and

widely available methods of early detection;

Whereas the Special Commission on Breast Cancer (formed

by the President’s Cancer Panel) found that earlier detection increases the likelihood of reducing mortality;

Whereas such Special Commission concluded that the failure

of health care providers to recommend mammography is

a major cause of poor utilization of mammography

screening;
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Whereas the Special Commission concluded that health care

reform must ensure the removal of financial barriers to

access to early detection and screening; and

Whereas the Special Commission recommended that further

studies be conducted to determine the mortality benefit

of screenings in women between the ages of 40 and 49:

Now, therefore, be it

1 Resolved, That it is the sense of the House of Rep2 resentatives that—

3 (1) any comprehensive benefits package under

4 health care reform should include mammography

5 screenings—

6 (A) for women between the ages of 40 and

7 49 (as well as for women over the age of 49);

8 and

9 (B) for women under the age of 40 who

10 are at high risk for breast cancer or whose phy11 sician determines that it is medically necessary

12 or appropriate;

13 (2) a copayment should be imposed for mam14 mography screening under such benefits package,

15 except for low-income families; and

16 (3) although it is currently prudent for such

17 package to include mammography screenings for

18 women between the ages of 40 and 49, the Public

19 Health Service, in conjunction with national and

20 international cancer research centers, should imme-
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1 diately undertake a randomized clinical trial to de2 termine the effectiveness and benefits of mammog3 raphy and other emerging screening technologies for

4 such women.

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