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, particu-
larly 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 signifi-
cantly 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 guide-
lines recommending mammography screenings for women
between the ages of 40 and 49 should remain in place be-
cause 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 de-
tection 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
Resolved, That it is the sense of the House of Rep-
resentatives that—
(1) any comprehensive benefits package under
health care reform should include mammography
screenings—
(A) for women between the ages of 40 and
49 (as well as for women over the age of 49);
and
(B) for women under the age of 40 who
are at high risk for breast cancer or whose phy-
sician determines that it is medically necessary
or appropriate;
(2) a copayment should be imposed for mam-
mography screening under such benefits package,
except for low-income families; and
(3) although it is currently prudent for such
package to include mammography screenings for
women between the ages of 40 and 49, the Public
Health Service, in conjunction with national and
international cancer research centers, should imme-
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diately undertake a randomized clinical trial to de-
termine the effectiveness and benefits of mammog-
raphy and other emerging screening technologies for
such women.
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