[House Report 110-889]
[From the U.S. Government Publishing Office]
110th Congress Report
2d Session HOUSE OF REPRESENTATIVES 110-889
======================================================================
BREAST CANCER AND ENVIRONMENTAL RESEARCH ACT OF 2008
_______
September 25, 2008.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Dingell, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 1157]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 1157) to amend the Public Health Service Act to
authorize the Director of the National Institute of
Environmental Health Sciences to make grants for the
development and operation of research centers regarding
environmental factors that may be related to the etiology of
breast cancer, having considered the same, report favorably
thereon with an amendment and recommend that the bill as
amended do pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 3
Background and Need for Legislation.............................. 3
Hearings......................................................... 6
Committee Consideration.......................................... 6
Committee Votes.................................................. 6
Committee Oversight Findings..................................... 6
Statement of General Performance Goals and Objectives............ 6
New Budget Authority, Entitlement Authority, and Tax Expenditures 6
Earmarks and Tax and Tariff Benefits............................. 7
Committee Cost Estimate.......................................... 7
Congressional Budget Office Estimate............................. 7
Federal Mandates Statement....................................... 7
Advisory Committee Statement..................................... 7
Constitutional Authority Statement............................... 7
Applicability to Legislative Branch.............................. 7
Section-by-Section Analysis of the Legislation................... 7
Changes in Existing Law Made by the Bill, as Reported............ 10
Amendment
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Breast Cancer and Environmental
Research Act of 2008''.
SEC. 2. EXPANDING COLLABORATIVE RESEARCH ON BREAST CANCER AND THE
ENVIRONMENT.
(a) In General.--Subpart 1 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285 et seq.) is amended by adding at the end the
following:
``SEC. 417F. INTERAGENCY BREAST CANCER AND ENVIRONMENTAL RESEARCH
COORDINATING COMMITTEE.
``(a) Interagency Breast Cancer and Environmental Research
Coordinating Committee.--
``(1) Establishment.--Not later than 6 months after the date
of the enactment of this section, the Secretary shall establish
a committee, to be known as the Interagency Breast Cancer and
Environmental Research Coordinating Committee (in this section
referred to as the `Committee').
``(2) Duties.--The Committee shall--
``(A) share and coordinate information on existing
research activities, and make recommendations to the
National Institutes of Health and other Federal
agencies regarding how to improve existing research
programs, that are related to breast cancer research;
``(B) develop a comprehensive strategy and advise the
National Institutes of Health and other Federal
agencies in the solicitation of proposals for
collaborative, multidisciplinary research, including
proposals to evaluate environmental and genomic factors
that may be related to the etiology of breast cancer
that would--
``(i) result in innovative approaches to
study emerging scientific opportunities or
eliminate knowledge gaps in research to improve
the research portfolio;
``(ii) outline key research questions,
methodologies, and knowledge gaps;
``(iii) expand the number of research
proposals that involve collaboration between 2
or more national research institutes or
national centers, including proposals for
Common Fund research described in section
402(b)(7) to improve the research portfolio;
and
``(iv) expand the number of collaborative,
multidisciplinary, and multi-institutional
research grants;
``(C) develop a summary of advances in breast cancer
research supported or conducted by Federal agencies
relevant to the diagnosis, prevention, and treatment of
cancer and other diseases and disorders; and
``(D) not later than 2 years after the date of the
establishment of the Committee, make recommendations to
the Secretary--
``(i) regarding any appropriate changes to
research activities, including recommendations
to improve the research portfolio of the
National Institutes of Health to ensure that
scientifically-based strategic planning is
implemented in support of research priorities
that impact breast cancer research activities;
``(ii) to ensure that the activities of the
National Institutes of Health and other Federal
agencies, including the Department of Defense,
are free of unnecessary duplication of effort;
``(iii) regarding public participation in
decisions relating to breast cancer research to
increase the involvement of patient advocacy
and community organizations representing a
broad geographical area;
``(iv) on how best to disseminate information
on breast cancer research progress; and
``(v) on how to expand partnerships between
public entities, including Federal agencies,
and private entities to expand collaborative,
cross-cutting research.
``(3) Rule of construction.--For the purposes of the
Committee, when focusing on research to evaluate environmental
and genomic factors that may be related to the etiology of
breast cancer, nothing in this section shall be construed to
restrict the Secretary from including other forms of cancer, as
appropriate, when doing so may advance research in breast
cancer or advance research in other forms of cancer.
``(4) Membership.--
``(A) In general.--The Committee shall be composed of
the following voting members:
``(i) Not more than 7 voting Federal
representatives as follows:
``(I) The Director of the Centers for
Disease Control and Prevention.
``(II) The Director of the National
Institutes of Health and the directors
of such national research institutes
and national centers (which may include
the National Institute of Environmental
Health Sciences) as the Secretary
determines appropriate.
``(III) One representative from the
National Cancer Institute Board of
Scientific Advisors, appointed by the
Director of the National Cancer
Institute.
``(IV) The heads of such other
agencies of the Department of Health
and Human Services as the Secretary
determines appropriate.
``(V) Representatives of other
Federal agencies that conduct or
support cancer research, including the
Department of Defense.
``(ii) 12 additional voting members appointed
under subparagraph (B).
``(B) Additional members.--The Committee shall
include additional voting members appointed by the
Secretary as follows:
``(i) 6 members shall be appointed from among
scientists, physicians, and other health
professionals, who--
``(I) are not officers or employees
of the United States;
``(II) represent multiple
disciplines, including clinical, basic,
and public health sciences;
``(III) represent different
geographical regions of the United
States;
``(IV) are from practice settings,
academia, or other research settings;
and
``(V) are experienced in scientific
peer review process.
``(ii) 6 members shall be appointed from
members of the general public, who represent
individuals with breast cancer.
``(C) Nonvoting members.--The Committee shall include
such nonvoting members as the Secretary determines to
be appropriate.
``(5) Chairperson.--The voting members of the Committee shall
select a chairperson from among such members. The selection of
a chairperson shall be subject to the approval of the Director
of NIH.
``(6) Meetings.--The Committee shall meet at the call of the
chairperson of the Committee or upon the request of the
Director of NIH, but in no case less often than once each year.
``(b) Review.--The Secretary shall review the necessity of the
Committee in calendar year 2011 and, thereafter, at least once every 2
years.''.
(b) Authorization of Appropriations.--For the purpose of carrying out
research activities under title IV of the Public Health Service Act,
including section 417F of such Act as added by subsection (a), there
are authorized to be appropriated $40,000,000 for each of fiscal years
2009 through 2012. Amounts authorized to be appropriated under the
preceding sentence shall be in addition to amounts otherwise authorized
to be appropriated for such purpose under section 402A of the Public
Health Service Act (42 U.S.C. 282a).
Purpose and Summary
The purpose of H.R. 1157, the Breast Cancer and
Environmental Research Act of 2007, is to amend the Public
Health Service Act to authorize the Secretary of Health and
Human Services to establish an Interagency Breast Cancer and
Environmental Research Coordinating Committee.
Background and Need for Legislation
Breast cancer is the second most common type of cancer
among women in the United States. In the United States, a
woman's lifetime risk of breast cancer increased steadily and
dramatically over the course of the 20th century. Between 1973
and 1998, breast cancer incidence rates in the United States
increased by more than 40 percent. Today, a woman's lifetime
risk of breast cancer is one in eight. In 2008, the National
Cancer Institute (NCI) estimates that 182,460 women and 1,990
men will be diagnosed with breast cancer and 40,480 women and
450 men will die as a result of breast cancer.
One of the hopeful messages from cancer research generally
is that many cases of cancer are linked to environmental causes
and, in principle, can be prevented. Cancer develops over
several years and has many causes. Numerous factors both inside
and outside the body contribute to the development of cancer.
In this context, scientists refer to everything outside the
body that interacts with humans as the ``environment.''
Exposure to a wide variety of natural and man-made substances
in the environment accounts for at least two-thirds of all the
cases of cancer in the United States. These environmental
factors include lifestyle choices such as cigarette smoking,
excessive alcohol consumption, poor diet, lack of exercise, and
excessive sunlight exposure. Other factors include exposure to
certain medical drugs, hormones, radiation, viruses, bacteria,
and environmental chemicals that may be present in the air,
water, food, and workplace.
Environmental factors such as viruses, sunlight, and
chemicals interact with cells throughout our lives. Mechanisms
to repair damage to our genes and healthy lifestyle choices
(wearing protective clothing for sun exposure or not smoking)
help to protect us from harmful exposures. Over time, however,
substances in the environment may cause gene alterations, which
accumulate inside our cells. While many alterations have no
effect on a person's health, permanent changes in certain genes
can lead to cancer. The chance that an individual will develop
cancer in response to a particular environmental agent depends
on several interacting factors: how long and how often a person
is exposed to a particular substance, his/her exposure to other
agents, genetic factors, diet, lifestyle, health, age, and
gender.
Because of the complex interplay of many factors and the
lack of conclusive evidence about the links between cancer and
environmental factors, it is not currently possible to predict
whether a specific environmental exposure will cause a
particular person to develop cancer. It is known that certain
genetic and environmental factors increase the risk of
developing cancer, but it is not known exactly which
combination of factors is responsible for a person's specific
cancer.
With respect to environmental effects on breast cancer,
research has varied widely. Some studies have linked alcohol
consumption to an increased risk of the most common type of
breast cancer. Other studies have suggested that infants
exposed to butyl benzyl phthalate (BBP), a chemical additive
used in pipes, vinyl floor tiles, carpet-backing, and other
household items may affect mammary gland development and
perhaps increase the susceptibility to breast cancer.
Researchers have also found that bisphenol A, a chemical found
in some plastic food and drink packaging, including baby
bottles, may be tied to early puberty and prostate and breast
cancer. Other research has shown that hormone replacement
therapy may increase breast cancer risk. Breast cancer is a
complex disease that occurs in an environmentally complex
world. While it is generally believed that environmental
factors play some role in the development of breast cancer, the
full extent of that role is not yet understood.
In addition to studying environmental impacts, the recently
completed Human Genome Project is providing an entirely new
avenue of research opportunities to better understand why some
women are more likely to develop breast cancer than others.
Understanding the relevance of genetic markers and potential
predisposition to developing breast cancer are also critically
important areas of cancer research that need to be further
explored. The Cancer Genome Atlas project is one of several
genomic research programs that could help to identify how
environmental factors may or may not impact the development of
breast cancer.
Currently, there are several sources of Federal funding for
research on the links between breast cancer and the
environment. The National Institute of Environmental Health
Sciences (NIEHS) and NCI have partnered to support a network of
research centers in which multidisciplinary teams of
scientists, clinicians, and breast cancer advocates work
collaboratively on a unique set of scientific questions. The
focus is on the interaction of chemical, physical, biological,
and social factors in the environment with genetic factors to
cause breast cancer. The network is working towards integrating
histologic, pathologic, cellular, and sub-cellular changes that
occur in normal mammary gland tissue across the lifespan along
with comparisons to exposure-induced changes. The seven-year
study began in September 2003 with a $5 million per year
budget.
In addition, the Department of Defense (DOD) has a
federally-funded Breast Cancer Research Program (BCRP). Since
its inception in 1992, the BCRP has funded research targeted
toward the program's vision to eradicate breast cancer.
Recognizing that the war against breast cancer must be fought
on multiple fronts, the DOD BCRP developed a multidisciplinary
research portfolio that encompasses a wide spectrum of
prevention, detection, diagnosis, and treatment research
projects. The BCRP specifically avoids duplication of research
funded by other Federal agencies. Research awards are made
using a two-tier review process composed of peer and
programmatic review. An important element in the BCRP is its
partnership with scientists and consumers, who participate
during both levels of review. Peer review evaluates the
scientific merit of the research proposals, and programmatic
review determines the relevance of proposals to the BCRP vision
and goals. The Integration Panel, comprised of scientists and
consumers, makes final funding recommendations and provides
guidance on the BCRP's investment strategies. The program's
initial success encouraged Congress to appropriate additional
funds to the BCRP in subsequent years, totaling $1.96 billion
through FY 2006. These funds have supported 4,894 awards.
Hearings
The Subcommittee on Health held a legislative hearing in
connection with the bill reported by the Committee. This
hearing was held on May 21, 2008, and was entitled ``H.R. 1157,
Breast Cancer and Environmental Research Act of 2007, and H.R.
758, Breast Cancer Patient Protection Act of 2007.''
The Subcommittee on Health heard the testimony of three
panels. The witnesses on the first panel were: Deborah Winn,
Ph.D., Director, Epidemiology and Genetics Research Program,
Division of Cancer Control and Population Sciences, National
Cancer Institute, National Institutes of Health.
The witnesses on the second panel were: Ms. Fran Visco,
President, National Breast Cancer Coalition; Ms. Sheryl Crow,
Singer-Songwriter and breast cancer advocate; and H. Kim
Lyerly, M.D., Director and George Barth Geller Professor of
Research in Cancer, Duke Comprehensive Cancer Center, Duke
University Medical Center.
The witnesses on the third panel were: Kristen Zarfos,
M.D., F.A.C.S., St. Francis Hospital, Hartford, CT; and Ms.
Alva Williams.
Committee Consideration
On Tuesday, September 23, 2008, the full Committee met in
open markup session and ordered H.R. 1157 favorably reported to
the House, amended, by a voice vote.
Committee Votes
Clause 3(b) of rule XIII of the rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto. No
record votes were taken on amendments or in connection with
ordering H.R. 1157 reported to the House. A motion by Mr.
Dingell to order H.R. 1157 favorably reported to the House,
amended, was agreed to by a voice vote.
Committee Oversight Findings
Regarding clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Subcommittee on Health held a
legislative hearing on H.R. 1157, and the oversight findings of
the Committee regarding the bill are reflected in this report.
Statement of General Performance Goals and Objectives
The objective of H.R. 1157 is to amend the Public Health
Service Act to require the Secretary of HHS to establish an
Interagency Breast Cancer and Environmental Research
Coordinating Committee and to authorize $40,000,000 for each of
fiscal years 2009 through 2012 for the purpose of carrying out
research activities under title IV of the Public Health Service
Act, including provisions added by this legislation.
New Budget Authority, Entitlement Authority, and Tax Expenditures
Regarding compliance with clause 3(c)(2) of rule XIII of
the Rules of the House of Representatives, the Committee finds
that H.R. 1157 would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
Earmarks and Tax and Tariff Benefits
Regarding compliance with clause 9 of rule XXI of the Rules
of the House of Representatives, H.R. 1157 does not contain any
congressional earmarks, limited tax benefits, or limited tariff
benefits as defined in clause 9(d), 9(e), or 9(f) of rule XXI.
Committee Cost Estimate
The Committee adopts as its own the cost estimate on H.R.
1157 prepared by the Director of the Congressional Budget
Office pursuant to section 402 of the Congressional Budget Act
of 1974.
Congressional Budget Office Estimate
Regarding clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, a cost estimate on H.R. 1157 by the
Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974 was not available at the time
of the filing of this report.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates regarding H.R. 1157 prepared by the Director of the
Congressional Budget Office pursuant to section 423 of the
Unfunded Mandates Reform Act.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
1157.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
Constitutional authority for H.R. 1157 is provided in the
provisions of Article I, section 8, clause 1, that relate to
expending funds to provide for the general welfare of the
United States.
Applicability to Legislative Branch
The Committee finds that H.R. 1157 does not relate to the
terms and conditions of employment or access to public services
or accommodations within the meaning of section 102(b)(3) of
the Congressional Accountability Act of 1995.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 establishes the short title of the bill as the
Breast Cancer and Environmental Research Act of 2008.
Section 2. Expanding collaborative research on breast cancer and the
environment
Section 2 amends subpart 1 of part C of title IV of the
Public Health Service Act (PHSA) to add a new section which
requires the Secretary of HHS to establish a committee, to be
known as the Interagency Breast Cancer and Environmental
Research Coordinating Committee.
Section 2 sets forth requirements for the composition of
the Coordinating Committee and directs that the Coordinating
Committee shall be composed of voting and nonvoting members.
The voting members of the Coordinating Committee shall select a
chairperson from among the members, subject to the approval of
the Director of NIH. The Coordinating Committee is required to
meet at the call of the chairperson or upon the request of the
Director of NIH, but at least once annually.
Section 2 establishes the duties of the Coordinating
Committee to include sharing and coordinating information on
existing research activities, and making recommendations to NIH
and other Federal agencies regarding how to improve existing
research programs that are related to breast cancer research.
Another required duty of the Coordinating Committee is to
develop a summary of advances in breast cancer research
supported or conducted by Federal agencies relevant to the
diagnosis, prevention, and treatment of cancer and other
diseases and disorders.
In addition, section 2 directs the Coordinating Committee
to develop a comprehensive strategy and advise NIH and other
Federal agencies in the solicitation of proposals for
collaborative, multidisciplinary research. Such research shall
focus on proposals to evaluate environmental and genomic
factors that may be related to the etiology of breast cancer
that would: (1) result in innovative approaches to study
emerging scientific opportunities or eliminate knowledge gaps
in research to improve the research portfolio; (2) outline key
research questions, methodologies, and knowledge gaps; (3)
expand the number of research proposals that involve
collaboration between two or more national research institutes
or centers, including proposals for Common Fund research to
improve the research portfolio; and (4) expand the number of
collaborative, multidisciplinary, and multi-institutional
research grants.
Section 2 also requires that the Coordinating Committee
make recommendations to the Secretary regarding any appropriate
changes to research activities, including recommendations on
how to improve the research portfolio of NIH to ensure that
scientifically-based strategic planning is implemented in
support of research priorities that impact breast cancer and
environmental research activities. The Coordinating Committee
must also make recommendations to the Secretary regarding
public participation in decisions relating to breast cancer and
environmental research to increase the involvement of patient
advocacy and community organizations representing a broad
geographical area.
In addition, the Coordinating Committee must make
recommendations on how: (1) to ensure that NIH and other
Federal agencies, including the Department of Defense, are free
of unnecessary duplication of effort; (2) to disseminate
information on progress related to breast cancer and
environmental research; and (3) to expand partnerships between
public and private entities to expand collaborative, cross-
cutting research, particularly related to the study of breast
cancer and the environment. All recommendations required by
this section must be made to the Secretary not later than two
years after the establishment of the Coordinating Committee.
Section 2 provides that, for the purposes of the
Coordinating Committee, when focusing on research to evaluate
environmental and genomic factors that may be related to the
etiology of breast cancer, nothing in this legislation shall be
construed to restrict the Secretary from including other forms
of cancer, as appropriate, when doing so may advance research
in breast cancer or advance research in other forms of cancer.
The Committee believes that this clarification is necessary
because of the complex interplay in the field of cancer
research and science. While the focus of the Coordinating
Committee is intended to be on breast cancer and environmental
research, the Committee recognizes that oftentimes knowledge
and advances in one field of cancer research can have important
implications and relevance to other fields of cancer research.
For example, scientists using a three-dimensional cell culture
system have identified a mechanism by which dormant, metastatic
tumor cells can begin growing again after long periods of
inactivity. The new findings indicate that the switch from
dormancy to proliferative, metastatic growth may be regulated,
in part, through signaling from the surrounding
microenvironment, which leads to changes in the skeletal
architecture of dormant tumor cells. Targeting this mechanism
may also provide strategies for inhibiting the switch from
dormancy to proliferation. The results of this study by NCI
scientists and their collaborators, appeared in the August 1,
2008, issue of ``Cancer Research'' and has broad implications
for all forms of cancer research.
This discovery was not born out of research focused
specifically on breast cancer and the environment, but rather
it was born out of basic science research focused on
understanding how tumors grow. This type of research, though
not explicitly focused on breast cancer and the environment,
does have a direct impact on the understanding of the etiology
of breast cancer. An NIH press release stated, ``The recurrence
of breast cancer often follows a long latent period in which
there are no signs of cancer, and metastases may not become
clinically apparent until many years after removal of the
primary tumor and follow-up therapy. According to NCI's Jeffrey
E. Green, M.D., one of the lead researchers of this study,
``Recent evidence suggests that, in many cases, tumor cells
have already seeded metastatic sites even when the primary
tumor is diagnosed at an early stage.'' Approximately 30
percent of breast cancer patients diagnosed with early-stage
disease have been found to have breast cancer cells in their
bone marrow. However, these cells seem to exist primarily as
micrometastases that do not manifest themselves clinically in
any way.''
Another example of how knowledge and advances in one field
of cancer research can have important implications and
relevance to other fields of cancer research, such as breast
cancer, pertains to cancer stem cells. Many cancer researchers
believe that the most promising frontier is in the area of
cancer stem cells. The hypothesis is that cancers grow from
cancer stem cells. When a stem cell divides, it produces two
unequal cells--one stem cell, and one that multiplies into
cells that are required by its organ. Most cancer therapies
target all cells in a tumor as the same, and the function and
origin of these cancer stem cells is not fully understood. A
researcher studying AML (leukemia) was one of the first to
advance this theory. The theory was then tested in breast
cancer cells--and brain, prostate, colon, pancreas, and ovary
cells. Theses stem cell studies might not naturally fall under
a heading of breast cancer research, but clearly could be
critical to understanding how and why tumor cells multiply.
Because of examples like these, it is the Committee's view
that, while the focus of the Coordinating Committee is breast
cancer and environmental research, this should not be
interpreted in a way that would preclude the Committee from
taking into account the important role of basic science
research in advancing environmental and genomic research that
may be related to the etiology of breast cancer.
Beginning in calendar year 2011, section 2 requires the
Secretary of HHS to review the necessity of the Committee at
least once every two years.
Finally, section 2 authorizes $40 million to be
appropriated for each of fiscal years 2009 through 2012, for
purposes of carrying out research activities under title IV of
the PHSA, including provisions added by this legislation. This
is intended to be in addition to amounts otherwise authorized
to be appropriated for title IV of the PHSA.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italics and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE IV--NATIONAL RESEARCH INSTITUTES
* * * * * * *
Part C--Specific Provisions Respecting National Research Institutes
Subpart 1--National Cancer Institute
* * * * * * *
SEC. 417F. INTERAGENCY BREAST CANCER AND ENVIRONMENTAL RESEARCH
COORDINATING COMMITTEE.
(a) Interagency Breast Cancer and Environmental Research
Coordinating Committee.--
(1) Establishment.--Not later than 6 months after the
date of the enactment of this section, the Secretary
shall establish a committee, to be known as the
Interagency Breast Cancer and Environmental Research
Coordinating Committee (in this section referred to as
the `Committee').
(2) Duties.--The Committee shall--
(A) share and coordinate information on
existing research activities, and make
recommendations to the National Institutes of
Health and other Federal agencies regarding how
to improve existing research programs, that are
related to breast cancer research;
(B) develop a comprehensive strategy and
advise the National Institutes of Health and
other Federal agencies in the solicitation of
proposals for collaborative, multidisciplinary
research, including proposals to evaluate
environmental and genomic factors that may be
related to the etiology of breast cancer that
would--
(i) result in innovative approaches
to study emerging scientific
opportunities or eliminate knowledge
gaps in research to improve the
research portfolio;
(ii) outline key research questions,
methodologies, and knowledge gaps;
(iii) expand the number of research
proposals that involve collaboration
between 2 or more national research
institutes or national centers,
including proposals for Common Fund
research described in section 402(b)(7)
to improve the research portfolio; and
(iv) expand the number of
collaborative, multidisciplinary, and
multi-institutional research grants;
(C) develop a summary of advances in breast
cancer research supported or conducted by
Federal agencies relevant to the diagnosis,
prevention, and treatment of cancer and other
diseases and disorders; and
(D) not later than 2 years after the date of
the establishment of the Committee, make
recommendations to the Secretary--
(i) regarding any appropriate changes
to research activities, including
recommendations to improve the research
portfolio of the National Institutes of
Health to ensure that scientifically-
based strategic planning is implemented
in support of research priorities that
impact breast cancer research
activities;
(ii) to ensure that the activities of
the National Institutes of Health and
other Federal agencies, including the
Department of Defense, are free of
unnecessary duplication of effort;
(iii) regarding public participation
in decisions relating to breast cancer
research to increase the involvement of
patient advocacy and community
organizations representing a broad
geographical area;
(iv) on how best to disseminate
information on breast cancer research
progress; and
(v) on how to expand partnerships
between public entities, including
Federal agencies, and private entities
to expand collaborative, cross-cutting
research.
(3) Rule of construction.--For the purposes of the
Committee, when focusing on research to evaluate
environmental and genomic factors that may be related
to the etiology of breast cancer, nothing in this
section shall be construed to restrict the Secretary
from including other forms of cancer, as appropriate,
when doing so may advance research in breast cancer or
advance research in other forms of cancer.
(4) Membership.--
(A) In general.--The Committee shall be
composed of the following voting members:
(i) Not more than 7 voting Federal
representatives as follows:
(I) The Director of the
Centers for Disease Control and
Prevention.
(II) The Director of the
National Institutes of Health
and the directors of such
national research institutes
and national centers (which may
include the National Institute
of Environmental Health
Sciences) as the Secretary
determines appropriate.
(III) One representative from
the National Cancer Institute
Board of Scientific Advisors,
appointed by the Director of
the National Cancer Institute.
(IV) The heads of such other
agencies of the Department of
Health and Human Services as
the Secretary determines
appropriate.
(V) Representatives of other
Federal agencies that conduct
or support cancer research,
including the Department of
Defense.
(ii) 12 additional voting members
appointed under subparagraph (B).
(B) Additional members.--The Committee shall
include additional voting members appointed by
the Secretary as follows:
(i) 6 members shall be appointed from
among scientists, physicians, and other
health professionals, who--
(I) are not officers or
employees of the United States;
(II) represent multiple
disciplines, including
clinical, basic, and public
health sciences;
(III) represent different
geographical regions of the
United States;
(IV) are from practice
settings, academia, or other
research settings; and
(V) are experienced in
scientific peer review process.
(ii) 6 members shall be appointed
from members of the general public, who
represent individuals with breast
cancer.
(C) Nonvoting members.--The Committee shall
include such nonvoting members as the Secretary
determines to be appropriate.
(5) Chairperson.--The voting members of the Committee
shall select a chairperson from among such members. The
selection of a chairperson shall be subject to the
approval of the Director of NIH.
(6) Meetings.--The Committee shall meet at the call
of the chairperson of the Committee or upon the request
of the Director of NIH, but in no case less often than
once each year.
(b) Review.--The Secretary shall review the necessity of the
Committee in calendar year 2011 and, thereafter, at least once
every 2 years.
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