,i #aai? ,,congress #a/ ,session ,h4 ,r4 #dhda ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,augu/ #a1 #bjbe,ms4 ,*u 7= h]self & ,mr4 ,wilson ( ,s\? ,c>ol9a7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committees on ,arm$ ,s]vices1 & ,vet]ans' ,affairs1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to require ! ,director ( ! ,national ,canc] ,in/itute to conduct a review ( ! curr5t /ate ( /oma* canc] incid5ce1 prev5tion1 scre5+1 aw>5ess1 & future public heal? importance1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,/oma* ,canc] ,prev5tion & ,e>ly ,detection ,act4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,/oma* canc] acc\nts = ab\t #a4e p]c5t ( all new canc]s diagnos$ 9 ! ,unit$ ,/ates ea* ye>4 7#b7 ,x is e/imat$ t !re w be ne>ly #cj1cjj new cases ( /oma* canc] 9 #bjbe4 7#c7 ,!re are disp>ities 9 /oma* canc] incid5ce & mortality among racial & e?nic gr\ps 9 ! ,unit$ ,/ates4 7#d7 ,:ile !re has be5 a decl9e 9 /oma* canc] incid5ce1 ! lack ( aw>5ess & focus on risk factors & e>ly detection ?r\gh scre5+ & surveillance may cause individuals at high risk = ! disease to dismiss _! symptoms4 7#e7 ,e/abli%+ a basis = /oma* canc] preval5ce1 aw>5ess1 curr5t scre5+1 & implications = future public heal? importance w all[ =-- 7,a7 m effective outrea* & scre5+ among individuals at risk2 7,b7 increas$ aw>5ess & education among ! g5]al public to prev5t /oma* canc]2 & 7,c7 increas$ aw>5ess & education among heal? c>e provid]s reg>d+ ga/ric canc] disp>ities1 scre5+1 treatm5t1 & monitor+4 #c4 ,,nci review on curr5t /ate ( /oma* canc] incid5ce1 prev5tion1 scre5+1 aw>5ess1 & future public heal? importance 7a7 ,review ,! ,director ( ! ,national ,canc] ,in/itute %all conduct a review (-- 7#a7 ! curr5t incid5ce ( /oma* canc] 9 ! ,unit$ ,/ates2 7#b7 ! risk factors = /oma* canc]1 includ+ ! incid5ce ( su* risk factors among high-risk populations & ! g5]al public2 7#c7 ! optimal age range to te/ = & treat ,helicobact] pylori 7,h4 pylori7 infection1 z a risk factor1 = ! purpose ( prim>y prev5tion 9 high-risk populations & ! g5]al population2 7#d7 ! availability & frequ5cy ( scre5+ = /oma* canc]1 includ+ utilization & effectiv5ess1 among high-risk populations2 7#e7 ! availability & effectiv5ess ( endoscopic scre5+s 9 high-risk populations2 7#f7 ! availability & effectiv5ess ( endoscopic resection & surveillance endoscopy = pati5ts ) confirm$ ga/ric inte/9al metaplasia 7,,gim7 ) high-grade dysplasia & e>ly ga/ric canc]2 7#g7 ! b5efits ( surveillance endoscopy = pati5ts at elevat$ risk1 includ+ pati5ts ) ga/ric inte/9al metaplasia 7,,gim7 :o are at increas$ risk ( ga/ric canc] due to e?nic backgr\nd1 family hi/ory1 or o!r risk /ratification p>amet]s su* z smok+ & ,h4 pylori infection2 7#h7 curr5t aw>5ess & education ab\t /oma* canc] risk factors1 prev5tion1 symptoms1 scre5+1 & treatm5t options among high-risk populations & ! g5]al public2 & 7#i7 curr5t ,f$]al ef=ts to increase aw>5ess & education ( /oma* canc] among high-risk populations & ! g5]al public4 7b7 ,report ,n lat] ?an #ah mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,director ( ! ,national ,canc] ,in/itute %all-- 7#a7 submit to ! ,congress a report on ! results ( ! review "u subsection 7a72 & 7#b7 include 9 su* report recomm5dations =-- 7,a7 e/abli%+ a cle> def9ition ( high-risk populations 9 ! ,unit$ ,/ates2 7,b7 in=m+ rese>*]s1 cl9icians1 physicians1 pati5ts1 & o!r relevant /akehold]s on-- 7i7 id5tify+ high-risk individuals2 & 7ii7 effective me?ods = detect+ precanc]\s lesions & e>ly ga/ric canc]2 7,c7 e/abli%+ r\t9e scre5+ guidel9es = /oma* canc]2 & 7,d7 actions to improve rese>* on1 prev5tion & e>ly diagnosis (1 & scre5+ & treatm5t = /oma* canc]4 #d4 ,dep>tm5t ( ,def5se /udy on /oma* canc] incid5ce & risk factors among milit>y p]sonnel 7a7 ,/udy ,! ,secret>y ( ,def5se1 9 coord9ation ) ! ,director ( ! ,national ,canc] ,in/itute & ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all conduct a /udy on ! incid5ce1 risk factors1 prev5tion1 & e>ly detection ( /oma* canc] among memb]s ( ! ,arm$ ,=ces & =m] memb]s ( ! ,arm$ ,=ces4 7b7 ,elem5ts ,! /udy "u subsection 7a7 %all include-- 7#a7 an exam9ation (-- 7,a7 ! incid5ce1 preval5ce1 & mortality rates ( /oma* canc] among memb]s ( ! ,arm$ ,=ces s]v+ on active duty & =m] memb]s ( ! ,arm$ ,=ces :o s]v$ on active duty2 7,b7 ! id5tification ( s]vice-relat$ or deploym5t-relat$ risk factors1 includ+ exposure to burn pits1 haz>d\s *emicals1 contam9at$ wat]1 occupational haz>ds1 & endemic infections su* z ,helicobact] pylori 7,h4 pylori72 7,c7 disp>ities 9 /oma* canc] outcomes bas$ on race1 e?nicity1 g5d]1 ,arm$ ,=ce1 or geographic deploym5t hi/ory )9 milit>y populations2 7,d7 ! availability & use ( /oma* canc] scre5+1 diagno/ic1 & treatm5t s]vices )9 ! milit>y heal? sy/em & ! heal? sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7,e7 opportunities to improve prev5tion & e>ly detection /rategies )9 ! milit>y heal? sy/em & ! heal? sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7#b7 relevant coord9ation ) ! ,surveillance1 ,epidemiology1 & ,end ,results ,program & o!r national canc] regi/ries to ensure compreh5sive data collection & analysis4 7c7 ,report ,n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,def5se %all submit to ,congress a report on ! f9d+s ( ! /udy "u subsection 7a71 includ+-- 7#a7 policy & programmatic recomm5dations to r$uce /oma* canc] incid5ce & mortality among memb]s ( ! ,arm$ ,=ces & =m] memb]s ( ! ,arm$ ,=ces2 & 7#b7 propos$ /rategies = integrat+ /oma* canc] aw>5ess1 scre5+1 & treatm5t protocols into ! milit>y heal? sy/em & ! heal? sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs4