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BREAST AND CERVICAL CANCER MORTALITY PREVENTION If we could go to the next chart, this is an illustration of CDC's breast and cervical cancer mortality prevention program. This shows how we are channeling funds so we can do something about these preventible deaths that are caused in women by breast and cervical cancer. This is a high priority of the Public Health Service.

Senator ADAMS. Before you move on from that, Doctor, if I might, you have spent a considerable amount of time both in this committee and elsewhere, and I was pleased to see the administration has requested additional funding for breast and cervical cancer mortality because we have found that it is rapidly increasing among older women. Being the chairman of the Subcommittee on Aging, and we find with women over 65 the morality rate and the breast cancer rate is going up at an exceedingly rapid rate.

I would like first just to ask you whether or not that is correct; and second, whether or not you are pressing ahead to use RU486. I know it had fallen victim to the abortion fight, but RU486 apparently is an effective and at least seems to be one of the most promising drugs for treating breast cancer.

Is that correct, Doctor?

Dr. MASON. I am not sure that I can confirm that it is a particularly promising drug for the treatment of breast cancer. It is a promising drug for the treatment of some of the endometrial and carcinomas of the uterus. This is still experimental and being looked at largely in other countries. I do not think it has really been applied to breast cancer.

Senator ADAMS. But it has to cervical cancer?

Dr. MASON. For cervical endometrial cancers, it looks like it may have some usefulness there. At least it needs to be looked into further.

Senator ADAMS. What I am really asking, Doctor, is, given the potential lifesaving aspects of this, is the Department going to continue to support a ban on research on this drug?

Dr. MASON. The Department has never had a ban on research on the drug.

Senator ADAMS. Good. Then I can take that as a statement that you will continue with your research on the drug.

Dr. MASON. We have two items going on. We have intramural research, and we have research that is being done in the private or public sector. To move ahead in the context of the Food and Drug Administration, we need a sponsor who submits applications for that purpose and for purposes like treatment of cancer. I know of no ban on RU486.

Senator ADAMS. Thank you, Doctor.

DEATHS AMONG WOMEN FROM BREAST, CERVICAL AND LUNG CANCER

For the Period 1960-1989

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Dr. MASON. I think this next chart illustrates your point on the increase in deaths among women from cancer of the breast. When you count the number of deaths that are going up, if you look at rates in our population then it is almost level, but the number of cases is going up.

What I really wanted to show is not only the number of deaths due to cancer of the breast in women but what has happened now with cancer of the lung, which is absolutely surpassing the number of deaths due to cancer of the breast. That comes back to our earlier discussion that tobacco is public health enemy No. 1 in the United States.

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If I could have the next chart, please. I do not want to spend time on this because you will be hearing from Dr. Roper, but I just wanted to indicate that immunization and vaccine development is a high priority, and we are delighted to see increases there. That is one of the administration's priorities.

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MEASLES

The next chart shows reported measles cases in the United States. It shows what happened after the measles vaccine was licensed and what happened as a result of school entrance laws. In the small side graph you see what an extremely contagious disease it is. If we do not maintain immunization and if we are not able to get immunization into children at 1 year of age for measles immunization, then we may soon have an epidemic again.

So the only way to keep measles and diseases like it under control is eternal vigilance in getting those vaccine doses in at an early time, and our appropriations request will enable CDC working collaboratively with State and local governments to do that. I know that Dr. Roper will go into that.

CDC SMOKING PREVENTION 10

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FY 1989 FY 1990 FY 1991 FY 1992

SMOKING PREVENTION The next chart is on CDC smoking prevention and simply indicates the concern of this administration. The amount of money going into the Office on Smoking and Health is nearly doubled so that we can assist States with tobacco education programs, getting out to those kids and adolescents to see that they never start, addressing special needs of minorities, women, blue collar workers' and things of that nature.

TRENDS IN SMOKING PREVALENCE UNITED STATES, 1974-1987, AGES 20+

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The next chart simply indicates the trends in smoking prevalence in the United States for persons age 20 and above. It shows the trend coming down. We are making progress. The stars on the right-hand side show the targets for the year 2000. Certainly, I would like to not only meet the targets but exceed them. I think this Nation has the capacity to exceed those targets, but we wanted this to be realistic in the context of what we were doing today. As I have said before, we need to do more. This is the leading cause of preventible death in the United States.

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