II 118th CONGRESS 1st Session S. 2665 IN THE SENATE OF THE UNITED STATES July 27, 2023 Mr. Carper (for himself and Ms. Collins ) introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To require the Secretary of Defense to provide to firefighters of the Department of Defense medical testing and related services to detect and prevent certain cancers.

1. Short title This Act may be cited as the Federal Firefighter Cancer Detection and Prevention Act of 2023 . 2. Medical testing and related services for firefighters of Department of Defense (a) Provision of services During the annual periodic health assessment of each firefighter of the Department of Defense, or at such other intervals as may be indicated in subsection (b), the Secretary of Defense shall provide to the firefighter (at no cost to the firefighter) appropriate medical testing and related services to detect, document the presence or absence of, and prevent, certain cancers. (b) Criteria Services required to be provided under subsection (a) shall meet, at a minimum, the following criteria: (1) Breast cancer With respect to breast cancer screening, if the firefighter is a female firefighter— (A) such services shall include the provision of a mammogram to the firefighter— (i) if the firefighter is 40 years old to 49 years old (inclusive), not less frequently than twice each year; (ii) if the firefighter is 50 years old or older, not less frequently than annually; and (iii) as clinically indicated (without regard to age); and (B) in connection with the provision of a mammogram under subparagraph (A), a licensed radiologist shall review the most recent mammogram provided to the firefighter, as compared to prior mammograms so provided, and provide to the firefighter the results of such review. (2) Colon cancer With respect to colon cancer screening— (A) if the firefighter is 40 years old or older, or as clinically indicated without regard to age, such services shall include the communication to the firefighter of the risks and benefits of stool-based blood testing; (B) if the firefighter is 45 years old or older, or as clinically indicated without regard to age, such services shall include the provision, at regular intervals, of visual examinations (such as a colonoscopy, CT colonoscopy, or flexible sigmoidoscopy) or stool-based blood testing; and (C) in connection with the provision of a visual examination or stool-based blood testing under subparagraph (B), a licensed physician shall review and provide to the firefighter the results of such examination or testing, as the case may be. (3) Prostate cancer With respect to prostate cancer screening, if the firefighter is a male firefighter, such services shall include the communication to the firefighter of the risks and benefits of prostate cancer screenings and the provision to the firefighter of a prostate-specific antigen test— (A) not less frequently than annually if the firefighter— (i) is 50 years old or older; or (ii) is 40 years old or older and is a high-risk individual; and (B) as clinically indicated (without regard to age). (4) Other cancers Such services shall include routine screenings for any other cancer the risk or occurrence of which the Director of the Centers for Disease Control and Prevention has identified as higher among firefighters than among the general public, the provision of which shall be carried out during the annual periodic health assessment of the firefighter. (c) Optional nature A firefighter of the Department of Defense may opt out of the receipt of medical testing or a related service provided under subsection (a). (d) Use of consensus technical standards In providing medical testing and related services under subsection (a), the Secretary shall use consensus technical standards in accordance with section 12(d) of the National Technology Transfer and Advancement Act of 1995 ( Public Law 104–113 ; 15 U.S.C. 272 note). (e) Documentation (1) In general In providing medical testing and related services under subsection (a), the Secretary— (A) shall document the acceptance rates of such tests offered and the rates of such tests performed; (B) shall document tests results to identify trends in the rates of cancer occurrences among firefighters; and (C) may collect and maintain additional information from the recipients of such tests and other services to allow for appropriate scientific analysis. (2) Privacy In analyzing any information of an individual documented, collected, or maintained under paragraph (1), in addition to complying with other applicable privacy laws, the Secretary shall ensure the name and any other personally identifiable information of the individual is removed from such information prior to the analysis. (3) Sharing with Centers for Disease Control and Prevention The Secretary may share data from any tests performed under subsection (a) with the Director of the Centers for Disease Control and Prevention, as appropriate, to increase the knowledge and understanding of cancer occurrences among firefighters. (f) Definitions In this section: (1) Firefighter The term firefighter means someone whose primary job or military occupational specialty is being a firefighter. (2) High-risk individual The term high-risk individual means an individual who— (A) is African American; (B) has at least one first-degree relative who has been diagnosed with prostate cancer at an early age; or (C) is otherwise determined by the Secretary to be high risk with respect to prostate cancer.