II 
118TH CONGRESS 
2D SESSION 
H. R. 4424 
IN THE SENATE OF THE UNITED STATES 
SEPTEMBER 18, 2024 
Received 
AN ACT 
To direct the Secretary of Veterans Affairs to study and 
report on the prevalence of cholangiocarcinoma in vet-
erans who served in the Vietnam theater of operations 
during the Vietnam era, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Vietnam Veterans 
Liver Fluke Cancer Study Act’’. 
SEC. 
2. 
STUDY 
ON 
THE 
PREVALENCE 
OF 
CHOLANGIOCARCINOMA IN VETERANS WHO 
SERVED IN THE VIETNAM THEATER OF OPER-
ATIONS DURING THE VIETNAM ERA. 
(a) EPIDEMIOLOGICAL STUDY.—Not later than 120 
days after the date of enactment of this Act, the Secretary 
of Veterans Affairs, in consultation with the Director of 
the Centers for Disease Control and Prevention of the De-
partment of Health and Human Services, shall commence 
an 
epidemiological 
study 
on 
the 
prevalence 
of 
cholangiocarcinoma in covered veterans of the Vietnam 
era, using data from the Veterans Affairs Central Cancer 
Registry and the National Program of Cancer Registries. 
The study shall— 
(1) 
identify 
the 
rate 
of 
incidence 
of 
cholangiocarcinoma in covered veterans of the Viet-
nam era and in residents of the United States, from 
the beginning of the Vietnam era to the date of en-
actment of this Act; and 
(2) for each of the groups specified in para-
graph (1), identify the percentage of individuals with 
cholangiocarcinoma by various demographic charac-
teristics, including by age, gender, race, ethnicity, 
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and the geographic location of the patient at the 
time of diagnosis. 
(b) REPORT TO CONGRESS.—Not later than one year 
after the completion of the study under subsection (a), the 
Secretary shall submit to Congress a report containing— 
(1) the results of the study under subsection 
(a); and 
(2) recommendations for administrative or leg-
islative actions required to address issues identified 
in the study under subsection (a). 
(c) 
CONTINUED
TRACKING
OF 
CHOLANGIOCARCINOMA IN COVERED VETERANS OF THE 
VIETNAM ERA.—The Secretary shall track the prevalence 
of cholangiocarcinoma in covered veterans of the Vietnam 
era using the Veterans Affairs Central Cancer Registry, 
and provide such information to Congress as required 
under subsection (d). 
(d) FOLLOW-UP REPORTS.—The Secretary shall pe-
riodically submit to the Congress an updated report under 
subsection (b), as determined by the Secretary. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘Secretary’’ means the Secretary 
of Veterans Affairs. 
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(2) The term ‘‘Vietnam era’’ has the meaning 
given such term in section 101 of title 38, United 
States Code. 
(3) The term ‘‘covered veterans of the Vietnam 
era’’ means veterans who served in the Vietnam the-
ater of operations during the Vietnam era. 
SEC. 3. MODIFICATION OF CERTAIN HOUSING LOAN FEES. 
The loan fee table in section 3729(b)(2) of title 38, 
United States Code, is amended by striking ‘‘November 
15, 2031’’ each place it appears and inserting ‘‘November 
29, 2031’’. 
Passed the House of Representatives September 17, 
2024. 
Attest: 
KEVIN F. MCCUMBER, 
Clerk. 
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