Report Title:

Cancer Surveillance and Research; Data Collection

Description:

Allows a cancer patient to be contacted directly without initial physician contact for purposes of cancer surveillance.  Adds pre-cancer to diseases about which data are authorized for collection.  Adds biological specimens to the materials that may be collected to assist cancer research.

THE SENATE	S.B. NO.	2040
TWENTY-FOURTH LEGISLATURE, 2008
STATE OF HAWAII

A BILL FOR AN ACT

relating to cancer surveillance.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that surveillance of cancer incidence and survival to assist individuals to make informed decisions is but one of eight goals to advance cancer control in Hawaii.  The other seven goals revolve around the following issues:

     (1)  Prevention, primarily through education and behavior change;

     (2)  Early detection and assurance of coordination with cancer management services;

     (3)  Treatment with the most current and effective treatments available;

     (4)  Quality of life enhancement for all cancer survivors;

     (5)  Research to advance the capabilities in Hawaii for prevention, early detection, treatment, and quality of life;

     (6)  Uniform access to cancer services; and

     (7)  Adequate insurance.

     However, several obstacles impede the fulfillment of the goal of cancer incidence and survival surveillance.  First, the Hawaii Tumor Registry is currently unable to directly contact cancer survivors in Hawaii to educate them on the work of the Hawaii Tumor Registry for cancer research, including clinical trials they may be eligible to participate in, to assist in the fight against cancer.  Second, it is unclear under existing law that collection of data on pre-cancerous conditions is permissible.  Third, the collection of biological specimens that may assist in cancer prognosis and outcome is also uncertain under existing law.

     The purpose of this Act is to remove the obstacles impeding the fulfillment of the goal of cancer incidence and survival surveillance by:

     (1)  Allowing a cancer patient to be contacted directly, without initial physician contact, to inform the patient that the patient is registered in the state cancer surveillance and registration program;

     (2)  Adding "pre-cancer" to the diseases about which data are authorized for collection in order to monitor cancer screening activities and the efficacy of cancer vaccines; and

     (3)  Adding "biological specimens" to the materials that may be collected to assist in research efforts to reduce, mitigate, and ameliorate the morbidity and mortality of cancer in Hawaii.

     SECTION 2.  Section 321-43, Hawaii Revised Statutes, is amended to read as follows:

     "§321-43  Statistical activities.  The department of health shall engage in the collection and analysis of statistical information on the morbidity and mortality of cancer in the State.  The morbidity data may be collected in cooperation with the University of Hawaii, the Hawaii state medical association, and the Hawaii cancer society.  The mortality data as collected from death certificates shall be analyzed by the staff of the department in order to determine the significance of cancer in the State by race, sex, age, occupation, site in the body, and in any other way found desirable for the purpose of determining the areas where greatest emphasis should be laid in the statewide cancer control program.  The morbidity data shall be used [in]:

(1) In determining the prognosis and chance of cure, as well as the number of persons cured of cancer in the State; [for]

(2) For assisting in the direction of tumor research; [for]

(3) For determining, if possible, the tendencies of benign tumors to become malignant; and [for]

(4) For assisting in the follow-up of diagnosed or treated tumor cases as requested by attending physicians.

All statistical material collected under this section shall be considered confidential as to the names of persons or physicians concerned, except that researchers may use the names of [such] those persons when requesting additional information for research studies when [such] the studies have been approved by the cancer commission of the Hawaii medical association."

     SECTION 3.  Section 324-21, Hawaii Revised Statutes, is  amended by amending subsections (a) and (b) to read as follows:

     "(a)  Any person, public or private medical facility, or social or educational agency, may provide information, interviews, reports, statements, memoranda, biological specimens, or other data or relevant material relating to individuals with cancer to the Hawaii Tumor Registry.  This information may be used in the course of any cancer research study approved by the cancer commission of the Hawaii Medical Association.

     (b)  Hospitals, skilled nursing homes, intermediate care homes, free-standing radiation oncology facilities, and other treatment or pathology facilities shall submit a report of any person admitted with or diagnosed as having cancer or pre-cancer to the Hawaii Tumor Registry or participating hospital registry according to a format approved by the cancer commission of the Hawaii Medical Association.  Physicians who diagnose or treat a patient for cancer shall also submit a report to the Hawaii Tumor Registry or participating hospital registry unless the patient has previously been admitted or treated at a hospital, skilled nursing home, intermediate care home, or free-standing radiation oncology facility for that particular cancer[.] or pre-cancer.  The Hawaii Tumor Registry staff or their representative or hospital-based registry staff may assist the hospitals, institutions, treatment or pathology facilities, and physician offices in the preparation of the reports."

     SECTION 4.  Section 324-22, Hawaii Revised Statutes, is amended to read as follows:

     "§324-22  Identity of persons studied and material, restrictions.  (a)  The material collected under this part shall be used or published only for the purpose of advancing medical research, medical education, or education of the public in the interest of reducing morbidity or mortality; provided that the Hawaii Tumor Registry may reveal all relevant information to [a patient's attending physician.] appropriate human subject protection boards.

     (b)  The identity[,] or any group of facts [which] that tends to lead to the identity[,] of any person whose condition or treatment has been studied shall be confidential and shall not be revealed in any report or any other matter prepared, released, or published.  Researchers [may], however, may use the names of persons when requesting additional information for research studies approved by the cancer commission; provided that when a request for additional information is to be made directly from a patient, the researcher shall first obtain approval for [such] the request from the [patient's attending physician.] patient.

     (c)  The use of [such] additional information obtained by researchers shall also be governed by subsection (a) and, in addition, where the patient is still living and the information is to be obtained directly from the patient, the researcher shall first obtain the approval of the patient[,] or the patient's immediate family, including a reciprocal beneficiary [, or attending physician], in that order of priority."

     SECTION 5.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 6.  This Act shall take effect upon its approval.

INTRODUCED BY:

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