Concerns lung cancer screening awareness and access.

A5028

ASSEMBLY, No. 5028

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED MAY 11, 2026

Sponsored by:

Assemblyman� JOHN V. AZZARITI JR., M.D.

District 39 (Bergen)

Assemblyman� JOHN DIMAIO

District 23 (Hunterdon, Somerset and Warren)

SYNOPSIS

���� Concerns lung cancer screening awareness and access.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act
concerning lung cancer screening awareness and access
for first responders and veterans and supplementing Title 26 of the Revised
Statutes.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.� The Legislature finds and
declares that:

���� a. �Lung cancer remains the
leading cause of cancer-related death in the State, exceeding mortality from
breast, colorectal, and prostate cancers combined.

���� b. �Low-dose computed
tomography screening has been shown to reduce lung cancer mortality in
high-risk populations by approximately 20 percent when performed in accordance
with evidence-based guidelines.

���� c. �The United States
Preventive Services Task Force recommends annual low-dose computed tomography
screening for adults aged 50 through 80 years with a 20 pack-year smoking
history who currently smoke or have quit within the past 15 years.

���� d. �Federal law requires most
health plans to provide coverage for U.S. Preventive Services Task Force recommended
preventive services without cost-sharing; however, significant barriers remain,
including lack of awareness, limited provider referral, and gaps affecting
uninsured individuals.

���� e. �Firefighters face elevated
exposure to smoke, combustion byproducts, diesel exhaust, polycyclic aromatic
hydrocarbons, asbestos, and other known or suspected carcinogens over the
course of their service.

���� f.� Law enforcement officers
and emergency medical services personnel are routinely exposed to
traffic-related airborne particulate matter, benzene, hazardous materials,
combustion environments, and shift work�related circadian disruption, all of
which have been studied in relation to cancer risk.

���� g.� Long-term cohort studies
of World Trade Center responders have demonstrated that responders with higher
levels of toxic dust exposure experienced nearly a three-fold increase in lung
cancer incidence compared to minimally exposed responders, even after
adjustment for smoking and demographic factors.

���� h.� Nearly 50,000 first
responders and survivors of the September 11, 2001 attacks have been diagnosed
with cancers associated with environmental exposure, underscoring the long-term
occupational health risks faced by public safety personnel.

���� i.� Epidemiological findings
regarding lung cancer incidence in certain law enforcement populations have
been mixed; however, documented occupational carcinogen exposures and evolving
environmental risk patterns warrant proactive education and screening awareness
initiatives.

���� j.� Veterans, including those
exposed to burn pits and other environmental hazards, face elevated risks of
respiratory disease and malignancy.� Federal law, under the Sergeant First
Class Heath Robinson, Honoring our Promise to Address Comprehensive Toxics
(PACT) Act recognizes multiple exposure-related conditions, including
respiratory cancers.

���� k.� The New Jersey Cancer
Education and Early Detection Program currently provides screening for breast,
cervical, colorectal, and prostate cancers but does not provide dedicated lung
cancer screening outreach to high-risk occupational or veteran populations.

���� l.� The absence of a
coordinated, Statewide education, outreach, and referral strategy for lung
cancer screening among first responders and veterans constitutes a gap in the
State�s cancer control efforts.

���� m.� It is therefore in the
public interest to establish a coordinated program to ensure first responders
and veterans are aware of screening eligibility and are able to access low-dose
computed tomography screening services through existing public and private
coverage pathways.

���� 2.� As used in this act:

���� �Commissioner� means the
Commissioner of Health.

���� �Department� means the
Department of Health.

���� �First responder" means a
paid or volunteer firefighter, law enforcement officer, emergency medical
services personnel, or other emergency response professional designated by the department
as having occupational exposure to carcinogens associated with increased lung
cancer risk.

���� �Low-dose computed tomography�
or �LDCT� is a lung cancer screening that is consistent with current United
States Preventive Services Task Force guidelines.

���� �Screening-eligible� means
meeting the United States Preventive Services Task Force eligibility criteria
for lung cancer screening.

���� �Veteran� means a person who
served in the active military, naval, or air service of the United States and
was discharged or released under conditions other than dishonorable, as defined
by federal law.

���� 3. a. There is established in
the Department of Health the New Jersey First Responder and Veteran Lung Cancer
Screening Awareness and Referral Program. �The program shall be responsible for
coordinating education, outreach, and referral efforts to increase awareness of
and access to lung cancer screening among first responders and veterans. �The
Commissioner of Health, in consultation with the Adjutant General of the
Department of Military and Veterans Affairs and the Attorney General, shall
administer the program.

���� b. The program shall:

���� (1)� develop and distribute
evidence-based educational materials regarding lung cancer risk factors,
eligibility for LDCT screening, the benefits of early detection, and available
screening services; and

���� (2)� distribute the materials
developed pursuant to paragraph (1) of this subsection to:

���� (a)� fire departments, law
enforcement agencies, and emergency medical services units throughout the
State;

���� (b)� veteran service
organizations, including but not limited to posts of the American Legion and
the Veterans of Foreign Wars;

���� (c)� the Division of Pensions
and Benefits for inclusion in retiree communications; and

���� (d)� federally qualified
health centers, hospital systems, primary care providers, and other health care
entities serving high-risk populations.

���� c.� The department shall
maintain and publish on its Internet website a publicly accessible directory,
organized by county, of health care facilities in the State that provide LDCT
screening.

���� d.� The department shall
establish voluntary referral protocols to allow:

���� (1)� licensed health care
providers to refer individuals who may be eligible for lung cancer screening;

���� (2)� first responder agencies
and veteran organizations to provide referral information to their members; and

���� (3)� screening-eligible
individuals to self-refer, consistent with clinical best practices.

���� e.� The department shall
coordinate with the New Jersey Cancer Education and Early Detection Program to
explore the integration of lung cancer screening navigation assistance for
uninsured or underinsured eligible individuals, to the extent permitted by law
and subject to the availability of resources.

���� f. The program shall not
mandate additional insurance benefits beyond those required under federal or
State law, but shall focus on education, navigation, and the utilization of
existing coverage pathways.

���� g.� The department shall
collect and analyze data related to program implementation and outcomes, which
may include:

���� (1) the number of first
responders and veterans receiving LDCT screening through referral pathways
associated with the program;

���� (2) aggregate demographic
data, including age, race, ethnicity, county of residence, and insurance
status, to the extent permitted by law;

���� (3) stage at diagnosis for
screen-detected lung cancers, where available; and

���� (4) identified barriers to
screening participation.

���� h.� No personally identifiable
health information shall be publicly disclosed.

���� 4.� The department shall
submit an annual report to the Governor, and to the Legislature pursuant to
section 2 of P.L.1991, c.164 (C.52:14-19.1), summarizing implementation
efforts, screening participation trends, and recommendations for improving
access.

���� 5.� The Commissioner of Health,
in consultation with the Adjutant General and the Attorney General, shall adopt
rules and regulations pursuant to the �Administrative Procedure Act,� P.L.1968,
c.410 (C.52:14B-1 et seq.), as necessary to implement the provisions of this
act.

���� 6.� This act shall take effect
immediately.

STATEMENT

���� This bill establishes the New
Jersey First Responder and Veteran Lung Cancer Screening Awareness and Referral
Program in the Department of Health to increase awareness of and access to lung
cancer screening among first responders and veterans, who may face elevated
risks of lung cancer due to occupational or service-related exposures.

���� Under the bill, the
Commissioner of Health is to administer the program in consultation with the
Adjutant General of the Department of Military and Veterans Affairs and the
Attorney General.� The program is to coordinate education, outreach, and
referral efforts to promote awareness of lung cancer risk factors, eligibility
for low-dose computed tomography (LDCT) screening, the benefits of early
detection, and available screening services.

���� The bill requires the
Department of Health (department) to develop and distribute evidence-based
educational materials regarding lung cancer screening.� These materials are to
be provided to fire departments, law enforcement agencies, and emergency medical
services units throughout the State; veteran service organizations, including
posts of the American Legion and the Veterans of Foreign Wars; the Division of
Pensions and Benefits for inclusion in retiree communications; and federally
qualified health centers, hospital systems, primary care providers, and other
health care entities serving high-risk populations.

���� The bill also requires the
department to maintain and publish on its Internet website a publicly
accessible directory, organized by county, of health care facilities in the
State that provide LDCT lung cancer screening.� In addition, the department is
to establish voluntary referral protocols to allow licensed health care
providers, first responder agencies, and veteran organizations to refer
individuals who may be eligible for lung cancer screening, and to allow
screening-eligible individuals to self-refer, consistent with clinical best
practices.

���� The bill further directs the
department to coordinate with the New Jersey Cancer Education and Early
Detection Program to explore opportunities to integrate lung cancer screening
navigation assistance for uninsured or underinsured eligible individuals, to
the extent permitted by law and subject to the availability of resources.� The
program is not to mandate additional insurance benefits beyond those required
under federal or State law, but is instead intended to focus on education,
navigation, and increasing utilization of existing screening services.

���� Finally, the bill requires the
department to collect and analyze data related to program implementation and
outcomes, including the number of first responders and veterans receiving LDCT
screening through referral pathways associated with the program, demographic
information to the extent permitted by law, stage at diagnosis for
screen-detected lung cancers where available, and barriers to screening
participation.� The bill provides that no personally identifiable health
information is to be publicly disclosed.