,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #dhda  ,,in ,,the ,,house ,,of  
,,representatives  ,august #a1 #bjbe,ms4
 ,chu 7for herself and ,mr4 ,wilson of  
,south ,carolina7 introduced the        
following bill2 which was referred to   
the ,committee on ,energy and ,commerce1
 and in addition to the ,committees on  
,armed ,services1 and ,veterans'        
,affairs1 for a period to be            
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to require the ,director of 
the ,national ,cancer ,institute to     
conduct a review of the current state of
 stomach cancer incidence1 prevention1  
screening1 awareness1 and future public 
health importance1 and for other        
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,stomach ,cancer    
,prevention and ,early ,detection ,act4 
#b4 ,findings ,congress finds the       
following3  7#a7 ,stomach cancer        

accounts for about #a4e percent of all  
new cancers diagnosed in the ,united    
,states each year4  7#b7 ,it is         
estimated that there will be nearly     
#cj1cjj new cases of stomach cancer in  
#bjbe4  7#c7 ,there are disparities in  
stomach cancer incidence and mortality  
among racial and ethnic groups in the   
,united ,states4  7#d7 ,while there has 
been a decline in stomach cancer        
incidence1 the lack of awareness and    
focus on risk factors and early         
detection through screening and         
surveillance may cause individuals at   
high risk for the disease to dismiss    
their symptoms4  7#e7 ,establishing a   
basis for stomach cancer prevalence1    
awareness1 current screening1 and       
implications for future public health   
importance will allow for-- 7,a7 more   
effective outreach and screening among  
individuals at risk2  7,b7 increased    
awareness and education among the       
general public to prevent stomach       
cancer2 and  7,c7 increased awareness   

and education among health care         
providers regarding gastric cancer      
disparities1 screening1 treatment1 and  
monitoring4  #c4 ,,nci review on current
 state of stomach cancer incidence1     
prevention1 screening1 awareness1 and   
future public health importance  7a7    
,review ,the ,director of the ,national 
,cancer ,institute shall conduct a      
review of-- 7#a7 the current incidence  
of stomach cancer in the ,united        
,states2  7#b7 the risk factors for     
stomach cancer1 including the incidence 
of such risk factors among high-risk    
populations and the general public2     
7#c7 the optimal age range to test for  
and treat ,helicobacter pylori 7,h4     
pylori7 infection1 as a risk factor1 for
 the purpose of primary prevention in   
high-risk populations and the general   
population2  7#d7 the availability and  
frequency of screening for stomach      
cancer1 including utilization and       
effectiveness1 among high-risk          
populations2  7#e7 the availability and 

effectiveness of endoscopic screenings  
in high-risk populations2  7#f7 the     
availability and effectiveness of       
endoscopic resection and surveillance   
endoscopy for patients with confirmed   
gastric intestinal metaplasia 7,,gim7   
with high-grade dysplasia and early     
gastric cancer2  7#g7 the benefits of   
surveillance endoscopy for patients at  
elevated risk1 including patients with  
gastric intestinal metaplasia 7,,gim7   
who are at increased risk of gastric    
cancer due to ethnic background1 family 
history1 or other risk stratification   
parameters such as smoking and ,h4      
pylori infection2  7#h7 current         
awareness and education about stomach   
cancer risk factors1 prevention1        
symptoms1 screening1 and treatment      
options among high-risk populations and 
the general public2 and  7#i7 current   
,federal efforts to increase awareness  
and education of stomach cancer among   
high-risk populations and the general   
public4  7b7 ,report ,not later than #ah

 months after the date of enactment of  
this ,act1 the ,director of the         
,national ,cancer ,institute shall--    
7#a7 submit to the ,congress a report on
 the results of the review under        
subsection 7a72 and  7#b7 include in    
such report recommendations for-- 7,a7  
establishing a clear definition of      
high-risk populations in the ,united    
,states2  7,b7 informing researchers1   
clinicians1 physicians1 patients1 and   
other relevant stakeholders on-- 7i7    
identifying high-risk individuals2 and  
7ii7 effective methods for detecting    
precancerous lesions and early gastric  
cancer2  7,c7 establishing routine      
screening guidelines for stomach cancer2
 and  7,d7 actions to improve research  
on1 prevention and early diagnosis of1  
and screening and treatment for stomach 
cancer4  #d4 ,department of ,defense    
study on stomach cancer incidence and   
risk factors among military personnel   
7a7 ,study ,the ,secretary of ,defense1 
in coordination with the ,director of   

the ,national ,cancer ,institute and the
 ,director of the ,centers for ,disease 
,control and ,prevention1 shall conduct 
a study on the incidence1 risk factors1 
prevention1 and early detection of      
stomach cancer among members of the     
,armed ,forces and former members of the
 ,armed ,forces4  7b7 ,elements ,the    
study under subsection 7a7 shall        
include-- 7#a7 an examination of--  7,a7
 the incidence1 prevalence1 and         
mortality rates of stomach cancer among 
members of the ,armed ,forces serving on
 active duty and former members of the  
,armed ,forces who served on active     
duty2  7,b7 the identification of       
service-related or deployment-related   
risk factors1 including exposure to burn
 pits1 hazardous chemicals1 contaminated
 water1 occupational hazards1 and       
endemic infections such as ,helicobacter
 pylori 7,h4 pylori72  7,c7 disparities 
in stomach cancer outcomes based on     
race1 ethnicity1 gender1 ,armed ,force1 
or geographic deployment history within 

military populations2  7,d7 the         
availability and use of stomach cancer  
screening1 diagnostic1 and treatment    
services within the military health     
system and the health system of the     
,department of ,veterans ,affairs2 and  
7,e7 opportunities to improve prevention
 and early detection strategies within  
the military health system and the      
health system of the ,department of     
,veterans ,affairs2 and  7#b7 relevant  
coordination with the ,surveillance1    
,epidemiology1 and ,end ,results        
,program and other national cancer      
registries to ensure comprehensive data 
collection and analysis4  7c7 ,report   
,not later than #ah months after the    
date of the enactment of this ,act1 the 
,secretary of ,defense shall submit to  
,congress a report on the findings of   
the study under subsection 7a71         
including-- 7#a7 policy and programmatic
 recommendations to reduce stomach      
cancer incidence and mortality among    
members of the ,armed ,forces and former

 members of the ,armed ,forces2 and     
7#b7 proposed strategies for integrating
 stomach cancer awareness1 screening1   
and treatment protocols into the        
military health system and the health   
system of the ,department of ,veterans  
,affairs4