May 15, 1995 CONGRESSIONAL RECORD — Extensions of Remarks E 1035

of this legislation. The bill, H.R. 1046, is intended to establish the basis for a comprehensive colorectal cancer screening program in

the United States. The bill is designed, however, to leave the important decision about

how to screen for colorectal cancer where it

belongs—with the patient and his or her physician, not the Federal Government.

Colorectal cancer screening is, as the saying goes, ‘‘an idea whose time has come.’’ A

number of recent medical studies confirm that

the best way to reduce the mortality rate for

colorectal cancer is to ensure that more of the

approximately 60 million Americans between

the ages of 50 and 75 follow the recommendations of the American Cancer Society and be screened every 3 to 5 years for

early signs of precancerous polyps in the

colorectal area. About 150,000 new cases of

colorectal cancer are diagnosed in the United

States each year, and more then 60,000

Americans will die from this disease. Thousands of these deaths could be prevented by

catching the disease at the earliest possible

stage through screening.

The Colorectal Cancer Screening Act of

1995 amends the Social Security Act to include coverage for periodic colorectal cancer

screening as a covered benefit under the

Medicare Program. This will ensure coverage

for screening individuals over the age of 65,

and hopefully will lead private health care

plans to establish screening programs that

start at age 50.

Equally important, the Colorectal Cancer

Screening Act of 1995 does not force the Federal Government into the physician-patient relationship with regard to the decision on how

to screen for colorectal cancer. The bill permits a number of current screening procedures to be used, and establishes a mechanism through which new technologies can be

included as they are developed and can be

provided within the reimbursement levels set

pursuant to the legislation.

It is critical that we leave the decision on

how to screen to the physician and the patient

for a number of reasons. First, with regards to

current technologies, the medical literature indicates that colorectal cancer screening can

be accomplished with a number of different

procedures, each of which has distinct advantages and disadvantages. For example,

screening with sigmoidoscopy is generally

seen as more convenient than the other procedures because it can be performed by a

general physician during a comprehensive

physical, and costs about $125 to $200. The

clear disadvantage of sigmoidoscopy, however, is that it reaches only one-half of the

colon and, therefore, is incapable of finding

about 50 percent of the cancers and

precancerous polyps. As a result, it is impossible for a physician to tell a patient who has

been screened with sigmoidoscopy that they

do not have colon cancer or precancerous polyps in their colon.

By contrast, the barium sulfate enema examination and colonoscopy are capable of examining the entire colon and can detect between 90 and 95 percent of the polyps and lesions. The disadvantages of these procedures

are cost—barium enema charges are about

$200 to $350, and colonoscopy charges commonly exceed $1,000—and convenience. In

addition, the risks of perforation from

colonoscopy are about 10 times greater than

for the barium sulfate examination. The

Colorectal Cancer Screening Act of 1995

keeps the Federal Government out of the

process of deciding which procedure is right

for each patient.

The other critical reason to leave individual

screening decisions to physicians and patients

is that it allows for the development of new

technologies. For example, a number of research centers in the United States are working on a new technology for colorectal cancer

screening that uses computers to create a virtual reality image of the colon and colorectal

area from a single 45-second CAT scan. It

has the potential to make colorectal cancer

screening more cost-effective, and more accepted by patients than the current alternatives. Unlike other proposals for colorectal

cancer screening, the Colorectal Cancer

Screening Act of 1995 encourages research

and development on these new technologies

because it provides a mechanism to have the

procedures covered under Medicare when it is

ready for patient use.

In conclusion, medical research has provided the evidence to make clear that it is time

for the United States to develop a program for

colorectal cancer screening. Today, less than

1 percent of all Americans over the age of 65

have ever been screened for colorectal cancer. That has to change.

The goal of the Colorectal Cancer Screening Act of 1995, H.R. 1046, is to cut by 50

percent the number of Americans who die of

colorectal cancer—30,000 lives. Including

colorectal cancer screening as a covered benefit under Medicare will establish the beginning of a program that can accomplish this

goal. I urge my colleagues to examine this

legislation, and hope that you will join me as

a cosponsor of the bill.

TRIBUTE TO JACK V. CAPPITELLI,

JR. AND ROBIN S. SCHWARTZ

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HON. PATRICK J. KENNEDY OF RHODE ISLAND

IN THE HOUSE OF REPRESENTATIVES

Monday, May 15, 1995

Mr. KENNEDY of Rhode Island. Mr. Speaker, I rise today to offer my sincere congratulations to Mr. Jack V. Cappitelli, Jr., and Ms.

Robin C. Schwartz. Jack and Robin were wed

on Sunday, May 14 in Montclair, NJ.

Jack, who is formerly of Old Bridge, NJ, is

the son of Mr. Jack Cappitelli, Sr. and his wife,

Mrs. Theresa Cappitelli. From Old Bridge he

moved on to enroll at Rutgers University

where he graduated in 1990. He went on to

study medicine at the New Jersey University

of Medicine and Dentistry. Today, Mr.

Cappitelli is contributing his services to his

local community as a resident physician at the

Robert Wood Johnson Hospital in New Brunswick, NJ.

Robin grew up in Cedar Grove, NJ, and is

the daughter of Mr. and Mrs. Theodore

Schwartz. She graduated from New York University in May 1992 with a masters degree in

urban planning. She now serves as a municipal credit analyst at Moody’s Investor Service

in New York City.

As Jack and Robin begin their new life together I sincerely hope that their years are

filled with happiness. I know that they must be

excited to begin a journey hand in hand—partners in life. I ask all my colleagues to join me

in congratulating Jack, Robin, and both their

families while wishing them the best for a long

and prosperous life together.

COMMUNITY PSYCHIATRIC CLINIC

CELEBRATES 60 YEARS

f

HON. CONSTANCE A. MORELLA OF MARYLAND

IN THE HOUSE OF REPRESENTATIVES

Monday, May 15, 1995

Mrs. MORELLA. Mr. Speaker, on May 17 I

will have the honor of participating in the Gala

60th Anniversary Celebration of the Community Psychiatric Clinic [CPC]. The clinic has

been a leader in providing high quality mental

health services in Montgomery County since

its founding in 1935. It remains dedicated to

serving those who are most vulnerable among

us—abused children, low-income single mothers, immigrant families, and emotionally troubled adolescents.

CPC was founded in 1935 by concerned

citizens who recognized the need to bring

health services out of metropolitan areas and

into the community, to serve people where

and when they need help. The inspiration behind this small group of local citizens was a

politically active and socially aware suffragist,

Lavinia Engle, who became one of Montgomery County’s most admired citizens, and who

is being honored with a posthumous award by

CPC tonight.

The clinic began in then-rural outreaches of

Montgomery County in a small office above a

bank in Rockville. Services were available 1

day a month and the clinic’s initial budget was

$50. In its 60th year, CPC is a $3.6 million

agency that will serve more than 4,500 individuals this year.

While these numbers are striking, what is

most significant is that CPC has grown in response to the very special needs of our country’s population, in particular, the needs of

those without a powerful voice of their own.

Many of the economic and social changes of

the last decade have been particularly felt by

women and children and the growing elderly

population in our community. As early as the

1960’s, CPC had developed an adolescent

‘‘drop-in’’ program. Redl House, a residential

facility for troubled boys aged 8 to 12, began

in 1982, and Camp Greentree, a therapeutic

summer program for 80 emotionally disabled

children, will celebrate its 25th anniversary this

year.

CPC’s commitment to the community continues. Recognizing the emotional strains on

many needy families and the difficulties they

often face in accessing services, CPC has

begun offering school-based programs.

Through its outreach efforts, the clinic continues to work with all families in crisis, including

adults in work-training programs and elderly

persons and their families.

It is with great pride that I join in honoring

CPC after 60 years of service. CPC is an example of our community at its best, founded

by local citizens, sustained by a dedicated

staff and board, and forging new directions

through a continued commitment to those in

need. I look forward to CPC’s next decades,

knowing that the clinic will continue to set the

pace in responding to the increasingly demanding and complex human needs of the future.