I 
110TH CONGRESS 
1ST SESSION H. R. 1738 
To amend the Public Health Service Act to establish a national screening 
program at the Centers for Disease Control and Prevention and to 
amend title XIX of the Social Security Act to provide States the option 
to provide medical assistance for men and women screened and found 
to have colorectal cancer or colorectal polyps. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 28, 2007 
Ms. GRANGER (for herself and Mr. WYNN) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to establish a na-
tional screening program at the Centers for Disease Con-
trol and Prevention and to amend title XIX of the Social 
Security Act to provide States the option to provide 
medical assistance for men and women screened and 
found to have colorectal cancer or colorectal polyps. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Colorectal Cancer Pre-
vention, Early Detection, and Treatment Act of 2007’’. 
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SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Colorectal cancer is the second leading 
cause of cancer deaths in the United States for men 
and women combined. 
(2) According to the American Cancer Society, 
in 2007, an estimated 153,760 new cases of 
colorectal cancer will be diagnosed in the United 
States and this cancer will kill an estimated 52,180 
individuals, constituting almost 10 percent of all 
cancer deaths. 
(3) Screening and early detection saves lives. 
When colorectal cancer is diagnosed at an early 
stage, the 5-year survival rate is 90 percent. 
(4) When colorectal cancer is not diagnosed 
until it has spread to distant organs, the 5-year sur-
vival rate drops to 10 percent. 
(5) Only 39 percent of colorectal cancer pa-
tients have their cancers detected at an early stage. 
(6) Despite the scientific evidence supporting 
the effectiveness of screening, there is only a 50 per-
cent screening rate of people in the United States 
who are 50 years of age and older. 
(7) Only 21 percent of those without health 
coverage in the United States have currently been 
screened for colorectal cancer. 
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(8) Far too many avoidable deaths are occur-
ring from a disease that can be prevented through 
the early identification and removal of pre-cancerous 
polyps, detectable only through colorectal cancer 
screenings. 
(9) The Centers for Disease Control and Pre-
vention is in its ninth year of the Screen for Life: 
National Colorectal Cancer Action Campaign, which 
informs men and women aged 50 years or older 
about the importance of having regular colorectal 
cancer screening tests. 
(10) If adults in the United States had received 
colorectal cancer screenings as recommended, at 
least 31,500 deaths would have been prevented and 
338,000 years of life would be gained this year. 
(11) Colorectal cancer screening has been 
shown to be more cost effective than screening for 
breast cancer and screening for cervical cancer, with 
the potential to save between 30,000 and 44,000 
lives a year if all individuals who are 50 years of age 
or older got screened for colorectal cancer. 
(12) Treatment costs for colorectal cancer are 
extremely high, and could be significantly reduced 
with widespread screening for colorectal cancer. 
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Costs associated with treatment for colorectal cancer 
are estimated at $8,400,000,000 for 2004. 
(13) Colorectal cancer screening is not only life 
saving, 
it 
is 
cost-effective. 
If 
recommended 
screenings were provided to an increased number of 
people in the United States who are between the 
ages of 50 years and 64 years of age, there would 
be a significant savings of billions of dollars to the 
Medicare program in screening and treatment costs. 
(14) In 2005, the Centers for Disease Control 
and 
Prevention 
established 
a 
demonstration 
colorectal cancer screening program at five sites 
across the United States to learn about the feasi-
bility of delivering screening and follow-up services 
to the population of low-income, uninsured, and 
underinsured individuals. The demonstration pro-
gram has already produced many findings that can 
inform a national effort to screen this population for 
colorectal cancer. 
SEC. 2. PREVENTIVE HEALTH MEASURES WITH RESPECT 
TO COLORECTAL CANCER. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317S the following new section: 
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‘‘SEC. 317T. PREVENTIVE HEALTH MEASURES WITH RE-
SPECT TO COLORECTAL CANCER. 
‘‘(a) GRANT PROGRAM AUTHORIZATION.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, may make grants to eligible 
entities for the purpose of carrying out a program 
described in subsection (b). An eligible entity that is 
a recipient of a grant under this subsection may use 
such grant to carry out such programs directly or 
through grants to, or contracts with, public and not- 
for-profit private entities. 
‘‘(2) ELIGIBLE
ENTITY
DEFINED.—For pur-
poses of this section, the term ‘eligible entity’ in-
cludes the following: 
‘‘(A) A State, including, in addition to the 
several States, the District of Columbia, Guam, 
the Commonwealth of Puerto Rico, the North-
ern Mariana Islands, the Virgin Islands, Amer-
ican Samoa, and the Trust Territory of the Pa-
cific Islands. 
‘‘(B) An Indian tribe or tribal organiza-
tion, as such terms are defined in section 4 of 
the Indian Self-Determination and Education 
Assistance Act. 
‘‘(b) PROGRAMS DESCRIBED.— 
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‘‘(1) IN GENERAL.—Subject to paragraph (2), a 
program described in this subsection is a program 
for planning or implementing the following: 
‘‘(A) Providing screenings for colorectal 
cancer to individuals who— 
‘‘(i) are 50 years of age or older; or 
‘‘(ii)(I) are under 50 years of age; and 
‘‘(II) are at high risk for such cancer. 
‘‘(B) Providing appropriate case manage-
ment and referrals for medical treatment of in-
dividuals screened pursuant to subparagraph 
(A). 
‘‘(C) Ensuring (directly or through coordi-
nation or an arrangement with health care pro-
viders or programs) the full continuum of fol-
lowup and cancer care for individuals so 
screened, including appropriate follow-up for 
abnormal tests, diagnostic services, therapeutic 
services, and treatment of detected cancers and 
management of unanticipated medical complica-
tions. 
‘‘(D) Carrying out activities to improve the 
education, training, and skills of health profes-
sionals (including allied health professionals) in 
the detection and control of colorectal cancer, 
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which activities are carried out pursuant to the 
participation of the health professionals in the 
program. 
‘‘(E) Establishing mechanisms through 
which the eligible entity involved can monitor 
the quality of screening and diagnostic follow- 
up procedures for colorectal cancer, including 
the interpretation of such procedures. 
‘‘(F) Evaluating the activities described in 
this subsection through appropriate surveillance 
and program monitoring activities. 
‘‘(G) Developing and disseminating find-
ings derived through such evaluations and the 
collection of data on outcomes. 
‘‘(H) Developing and disseminating public 
information and education programs for the de-
tection and control of colorectal cancer and pro-
moting the benefits of receiving screenings 
through this program. 
‘‘(2) SUPPLEMENT
NOT
SUPPLANT.—In the 
case of an eligible entity that implements a universal 
colorectal screening program that funds activities de-
scribed in subparagraph (A), (B), or (C) of para-
graph (1), such entity shall be able to receive grant 
funds under subsection (a) only for purposes of— 
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‘‘(A) carrying out those activities under 
this subsection that are not so funded; or 
‘‘(B) supplementing (and not supplanting) 
funds made available by the entity for such 
funded program. 
‘‘(c) PRIORITY FOR LOW-INCOME, UNINSURED AND 
UNDERINSURED INDIVIDUALS.—A grant may be made 
under subsection (a) to an eligible entity only if the eligible 
entity agrees that, in providing screenings under sub-
section (b)(1)(A), the eligible entity will give priority to 
low-income individuals who lack adequate coverage under 
health insurance and health plans with respect to 
screenings for colorectal cancer. 
‘‘(d) SPECIAL CONSIDERATION FOR CERTAIN APPLI-
CANTS.—In making grants under subsection (a) for a fis-
cal year, the Secretary shall give special consideration to 
the following eligible entities: 
‘‘(1) In the case of services under such sub-
section for women, to such entities that, for such 
year, are grantees under title XV. 
‘‘(2) In the case of services under such sub-
section for men, to such entities that, for such year, 
are grantees under section 317D. 
‘‘(3) To such entities that coordinate with other 
Federal, State, and local colorectal cancer programs. 
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‘‘(4) To such entities with an existing program 
to provide cancer screening to individuals. 
‘‘(e) USE OF CERTAIN STANDARDS UNDER MEDI-
CARE PROGRAM.—A grant may be made under subsection 
(a) to an eligible entity only if the eligible entity provides, 
as applicable, assurances as follows: 
‘‘(1) Screenings under subsection (b)(1)(A) will 
be carried out as preventive health measures in ac-
cordance with evidence-based screening guidelines 
and procedures as specified in section 1861(pp)(1) 
of the Social Security Act. 
‘‘(2) An individual will be considered high risk 
for purposes of subsection (b)(1)(A)(ii) only if the 
individual is high risk within the meaning of section 
1861(pp)(2) of such Act. 
‘‘(3) The payment made from the grant for a 
screening procedure under subsection (b)(1)(A) will 
not exceed the amount that would be paid under 
part B of title XVIII of such Act if payment were 
made under such part for furnishing the procedure 
to an individual enrolled under such part. 
‘‘(f) RELATIONSHIP TO ITEMS AND SERVICES UNDER 
OTHER PROGRAMS.—A grant under subsection (a) may 
be made to an eligible entity only if the eligible entity, 
as applicable, provides assurances that the grant will not 
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be expended to make payment for any item or service to 
the extent that payment has been made, or can reasonably 
be expected to be made, with respect to such item or serv-
ice— 
‘‘(1) under any State compensation program, 
under an insurance policy, or under any Federal or 
State health benefits program; or 
‘‘(2) by an entity that provides health services 
on a prepaid basis. 
‘‘(g) RECORDS AND AUDITS.—A grant under sub-
section (a) may be made to an eligible entity only if the 
eligible entity provides assurances that the eligible entity 
will— 
‘‘(1) establish such fiscal control and fund ac-
counting procedures as may be necessary to ensure 
proper disbursal of, and accounting for, amounts re-
ceived under subsection (a); and 
‘‘(2) upon request, provide records maintained 
pursuant to paragraph (1) to the Secretary or the 
Comptroller General of the United States for pur-
poses of auditing the expenditures of the grant by 
the eligible entity. 
‘‘(h) REQUIREMENT OF MATCHING FUNDS.— 
‘‘(1) IN
GENERAL.—The Secretary may not 
make a grant under subsection (a) to an eligible en-
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