,,ii  #aai? ,,congress  #b;d ,session   
,s4 #ebhg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,augu/ #f1 #bjbf,mr4   
,oss(f 7= himself & ,mrs4 ,britt7       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to au?orize ! ,secret>y (   
,heal? & ,human ,s]vices1 act+ ?r\gh !  
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 to make grants to ,/ates 
to increase aw>5ess & education =       
colorectal canc] & improve e>ly         
detection ( colorectal canc] 9 "y       
individuals1 & = o!r purposes4  #a4     
,%ort title ,?is ,act may be cit$ z !   
,colorectal ,canc] ,e>ly ,detection     
,act4  #b4 ,f9d+s ,congress f9ds !      
foll[+3 7#a7 ,9 ! ,unit$ ,/ates1        
colorectal canc] is ! ?ird-lead+ cause (
 canc]-relat$ dea?s 9 m5 & ! f\r?-lead+ 
cause 9 wom54 ,colorectal canc] is !    
second mo/ common cause ( canc] dea?s :5
 numb]s = m5 & wom5 are comb9$4  7#b7 ,9
 ! ,unit$ ,/ates1 !re 7 ov] #ada1jjj new

 colorectal canc] cases & #eb1jjj new   
colorectal canc] dea?s report$ 9 #bjba4 
,x is e/imat$ t !re w be ov] #aed1bgj   
new cases ( colorectal canc] & #eb1ijj  
cases ( colorectal canc] dea?s 9 #bjbe4 
7#c7 ,colorectal canc] rates h be5      
increas+ 9 "y pati5ts4 ,ab\t #a 9 #e    
cases ( colorectal canc] 7 9 individuals
 age #ed & y\ng]4  7#d7 ,9 e>ly #bjbc1 x
 0 report$ t ab\t #bj p]c5t ( diagnoses 
( colorectal canc] 7 among pati5ts "u ! 
age ( #ee4 ,additionally1 half ( all    
e>ly-onset colorectal canc] cases are   
diagnos$ 9 individuals "u #de ye>s old4 
7#e7 ,colorectal canc] cases among      
individuals ages #bj to #ci are expect$ 
to increase by #ij p]c5t by #bjcj4      
,additionally1 colorectal canc] is      
project$ to be ! lead+ cause (          
canc]-relat$ dea?s = individuals "u #ej 
ye>s ( age by #bjcj4  #c4 ,,cdc ,/ate   
grants = colorectal canc] aw>5ess1      
education1 & e>ly detection among "y    
individuals  7a7 ,def9itions ,9 ?is     
section3 7#a7 ,/ate ,! t]m ,/ate means  

ea* ( ! sev]al ,/ates1 ! ,di/rict (     
,columbia1 & any t]ritory or possession 
( ! ,unit$ ,/ates4  7#b7 ,"y individual 
,! t]m "y individual means an individual
 :o has n atta9$ ! age ( #de4  7b7      
,grants ,! ,secret>y ( ,heal? & ,human  
,s]vices1 act+ ?r\gh ! ,director ( !    
,c5t]s = ,disease ,control & ,prev5tion 
79 ?is section ref]r$ to z ! ,secret>y71
 may make grants to ,/ates1 on a        
competitive basis1 = ! purpose (        
increas+ aw>5ess & education =          
colorectal canc] & e>ly detection (     
colorectal canc] 9 "y individuals4  7c7 
,application ,to be eligible = a grant  
"u ?is section1 a ,/ate %all submit to !
 ,secret>y an application at su* "t1 9  
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 includ+ a detail$
 description ( ! ,/ate's plan to        
implem5t ! grant4 ,su* description %all 
include h[ ! ,/ate w use ! grant to--   
7#a7 conduct outrea* & provide education
 reg>d+ incid5ce ( colorectal canc] &   
risk factors1 ) an emphasis on-- 7,a7 "y

 individuals ) an increas$ risk or high 
risk = colorectal canc]1 includ+-- 7i7  
"y individuals ) a family hi/ory (      
colorectal canc] or advanc$ ad5omat\s   
polyps2  7ii7 "y individuals ) a p]sonal
 hi/ory ( inflammatory b[el disease     
7commonly kn[n z ,,ibd71 includ+        
ulc]ative colitis & ,crohn's disease ( !
 colon2  7iii7 "y individuals ) an      
inh]it$ syndrome1 includ+ ,lyn*         
syndrome1 familial ad5omat\s polyposis1 
& o!r inh]it$ syndromes l9k$ to         
colorectal canc]2  7iv7 "y individuals )
 signs & symptoms ( colorectal canc]1   
p>ticul>ly rectal ble$+ & iron defici5cy
 anemia2 &  7v7 o!r "y individuals )    
risk factors 7su* z risk factors        
id5tifi$ by nationally recogniz$        
guidel9es7 t put su* individuals at     
increas$ risk = colorectal canc]1 z     
det]m9$ by ! ,secret>y2 &  7,b7         
individuals 9 und]s]v$ & rural areas1   
individuals :o are ,am]ican ,indian1    
,alaska ,native1 or ,african ,am]ican1 &
 individuals ) type #b diabetes1 = !    

purposes (-- 7i7 id5tify+ individuals :o
 are at increas$ risk or high risk =    
colorectal canc] 7includ+ "y individuals
 describ$ 9 clauses 7i7 ?r\gh 7v7 (     
subp>agraph 7,a77 & w\ld b5efit f e>ly  
detection be=e age #de2 &  7ii7 provid+ 
education to initiate e>ly detection at 
age #de = individuals :o are n at       
increas$ risk or high risk = colorectal 
canc]2  7#b7 p>tn] ) hospitals1 cl9ics1 
,tribal organizations 7z def9$ 9 section
 #d ( ! ,indian ,self-,det]m9ation &    
,education ,assi/ance ,act 7#be         
,u4,s4,c4 #ecjd771 nonpr(it             
organizations1 in/itutions ( high]      
education1 colorectal canc] prev5tion & 
control programs1 & o!r relevant        
entities & programs to enhance outrea*1 
education1 & e>ly detection ef=ts )     
respect to colorectal canc] 9 "y        
individuals2 &  7#c7 conduct activities 
to increase aw>5ess & education =       
colorectal canc] & improve e>ly         
detection ( colorectal canc] 9 "y       
individuals1 includ+ navigation &       

program evaluation4  7d7 ,use ( funds ,a
 grant "u ?is section %all be us$ to    
support e>ly detection & diagno/ic te/+ 
= colorectal canc] 9 "y individuals     
det]m9$ to be at increas$ risk or high  
risk ( colorectal canc] z "p ( a        
prev5tive heal? measure /rategy & may   
additionally be us$ = any ( ! foll[+3   
7#a7 ,to provide appropriate ref]rals = 
m$ical treatm5t1 includ+ g5etic te/+ &  
c\nsel+ ( su* "y individuals1 & to      
ensure1 to ! ext5t practicable1 !       
provision ( appropriate foll[-up &      
surveillance s]vices4  7#b7 ,to develop 
& implem5t a public aw>5ess & education 
campaign = ! e>ly detection1 signs &    
symptoms1 risk factors1 & control       
managem5t ( colorectal canc]1           
specifically 9 "y individuals4  7#c7 ,to
 conduct education & outrea* to heal?   
pr(essionals 7includ+ alli$ heal?       
pr(essionals7 on conduct+ & int]pret+   
colorectal canc] scre5+ & diagno/ic te/s
 & ! late/ advancem5ts 9 ! e>ly         
detection ( colorectal canc]1 ) a focus 

on symptoms1 g5etic risk factors1 family
 hi/ory1 & c>e = "y individuals4  7#d7  
,to e/abli% me*anisms ?r\gh :i* ! ,/ates
 c monitor ! quality ( scre5+ &         
diagno/ic proc$ures = colorectal canc]  
among "y individuals1 includ+ !         
int]pretation ( su* proc$ures4  7#e7 ,to
 conduct surveillance to help det]m9e   
o!r risk factors = colorectal canc]4    
7#f7 ,to develop /rategies to capture & 
assess family hi/ory & g5etic           
pr$ispositions to colorectal canc] 9 "y 
individuals4  7#g7 ,to e/abli% pati5t   
navigation support to assi/ individuals 
?r\gh ! process ( scre5+1 p>ticul>ly ^? 
at increas$ risk or high risk =         
colorectal canc]4  7#h7 ,to design      
cl9ician decision support tools bas$ on 
cl9ical practice guidel9es = e>ly       
detection ( colorectal canc] 9 "y       
individuals4  7#i7 ,to monitor &        
evaluate activities conduct$ "u         
p>agraphs 7#a7 ?r\gh 7#h7 to det]m9e !  
effectiv5ess ( su* activities to in=m   
cont9u\s improvem5t ( su* activities4   

7e7 ,grant p]iod ,a grant "u ?is section
 %all be = a p]iod ( #e ye>s1 & may be  
r5ew$ at ! discretion ( ! ,secret>y4    
7f7 ,report ,n lat] ?an #e ye>s aft]    
receiv+ a grant "u ?is section 7includ+ 
a r5ewal ( a grant71 a ,/ate %all submit
 to ! ,secret>y a report describ+ h[ !  
,/ate us$ su* grant4  7g7 ,au?orization 
( appropriations ,!re are au?oriz$ to be
 appropriat$ su* sums z may be necess>y 
to c>ry out ?is section4