Controversial Issues
CERVICAL CANCER I: SUBCOMMITTEE APPROVES EXPANDED MEDICAID COVERAGE
10/20/99 8:01PM CST
The House Commerce health and environment subcommittee yesterday approved the Breast and Cervical Treatment Act of 1999, which would allow states to provide Medicaid coverage for breast and cervical cancer-related treatments for certain low-income women diagnosed through the CDC's breast and cervical cancer early detection program. Under the bill, sponsored by Reps. Rick Lazio (R-NY) and Anna Eshoo (D-CA), women under age 65 identified through the early detection program would be eligible if they earned up to 250% of the federal poverty line and did not have private insurance. Rep. Tom Coburn (R-OK) offered two amendments to the bill -- one that would create an HPV surveillance system and another that would require condom packages to warn users that the product does not protect against HPV, which is the primary cause of cervical cancer. Both amendments were withdrawn after some debate, and Coburn agreed to address Rep. Henry Waxman's (D- CA) claim that the amendments "required much more study" (CongressDaily/A.M., 10/1).
NUTS AND BOLTS
Under Coburn's proposal, HPV cases would be reported confidentially to state health departments in an effort to monitor the epidemic, identify at-risk populations and analyze any changes in transmission. Coburn said that the CDC already requires physicians to report cases of 58 infectious diseases, however it does not extend that requirement to HPV, which the CDC estimates affects 45 million Americans and is responsible for 99.7% of all cervical cancers. In a related amendment, Coburn would require condom packages to feature a warning label in the same style as those on tobacco and alcohol products. Coburn suggests the following warning: "The National Cancer Institute has found that condoms are ineffective in preventing the transmission of the human papillomavirus, the cause of cervical cancer." According to the NCI, condoms are ineffective barriers to HPV because the virus thrives in outer skin cells, making it easy for papilloma-laden skin cells to come in contact with the vagina and travel to the cervix. Earlier this year, the Commerce health and environment subcommittee heard from witnesses who cited a recent poll that found only 30% of women said they knew the cause of cervical cancer, and of those, only 5% cited HPV (Coburn release, 9/29).
WEIGHING IN
Coburn participated in a recent Family Research Council news conference that delivered the message that "condoms don't make sex 'safe'" and that sexual abstinence outside of marriage was the only sure way to protect against HPV. Janet Parshall, spokesperson for the Family Research Council, said, "Sadly, the suffering caused by HPV serves as a profound reminder tha sex belongs only in marriage" (FRC release, 9/28). In addition, Independent Women's Forum Executive Director for Policy Barbara Ledeen called on Congress to "take action now to stop HPV" in a letter to Congress. She said, "We have warning labels on everything from step ladders to tobacco products. Adding condom packages to the list is a simple way to save lives, and guard the reproductive futures of countless women. Women have a right to know the risks of HPV, so that they can make sound choices about their bodies, their lives and future families" (Ledeen release, 9/28). Kaiser Foundation.
