WASHINGTON, D.C. -- January 29, 2008 -- U.S. House Committee members today explored why a successful cancer early detection and prevention program is only reaching one out of five eligible women between the ages of 50-64 nationwide. To date, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), run by the Centers for Disease Control and Prevention (CDC), has provided 7.2 million screening exams to more than 3 million underserved women. About 50 percent of the women who received screenings through the program were minority women. The program was first established in 1991 and since then, it has been implemented in all 50 states, the District of Columbia, 4 U.S. territories, and 13 American Indian/Alaska Native organizations. But 80 percent of the eligible population nationwide is still not reaping the benefit of the valuable, life-saving program.
Chairman Henry Waxman (D-CA) and Ranking Member Tom Davis (R-VA) held the hearing on the NBCCEDP in the Committee on Oversight and Government Reform. Otis Brawley, MD, the American Cancer Society’s Chief Medical Officer, testified at the hearing as an expert on early detection and cancer disparities.
“Breast and cervical cancer are two of the most curable life-threatening diseases -- but we can only combat these cancers if we take the steps necessary to detect it early and provide access to treatment,” Brawley said. “Our goal is to ensure that all women have access to existing and future detection methods and treatments so that breast and cervical cancer will eventually no longer kill so many of our mothers, sisters, wives and friends.”
Last year, the Society estimated 178,480 women in the U.S. would be diagnosed with breast cancer and another 40,460 would die from the disease. The Society estimated that an additional 11,150 women would be diagnosed with cervical cancer in 2007 and another 3,670 would die from it. Together, breast and cervical cancer account for 28 percent of the estimated new cancer cases in women.
Mammography is the single most effective method of early detection for breast cancer, but studies show that only 65-70 percent of women get this routine screening and that rate is even lower for uninsured women. Studies show that early detection of breast cancer through mammography greatly improves chances of successful treatment and survival. The Society recommends yearly mammograms for all women starting at age 40.
Pap tests are also critical to prevent and detect cervical cancer. Unfortunately, women are still dying from this disease because they are not being screened regularly. When detected at a localized stage, the 5-year survival rate for cervical cancer is 92%. Treating cancer after it metastasizes or providing end-of-life care is extremely costly. For example, treating a precancerous lesion found in an abnormal Pap smear costs between $1,000 and $3,000. If the lesions become cancerous, it can cost as much as $47,000 to treat.
Gail Carey, an American Cancer Society volunteer and a past beneficiary of the NBCCEDP, testified that like so many other women without insurance, she was forced to delay screening because she couldn’t afford it.
“Five months could be the difference between life and death, so I was really playing with a loaded gun,” said Carey. “This program is a phenomenon. I thought I was going to die because I didn't have coverage, and nobody should have that as their only option.”
The American Cancer Society Cancer Action Network (ACS CAN) supports a number of federal initiatives to help improve access to cancer prevention and early detection services. ACS CAN, the sister advocacy organization of the American Cancer Society, is leading efforts to boost funding for the NBCCEDP to $250 million next year and to expand the program with additional funding going forward. NBCCEDP provides community-based breast and cervical cancer screening and diagnosis to low-income, uninsured and underinsured women that would not otherwise have access to a mammogram or Pap test.
In addition to its legislative efforts around NBCCEDP, ACS CAN also supports the elimination of Medicare co-pays for mammography and the extension of the Welcome to Medicare visit time limit from six months to one year to allow new Medicare beneficiaries more time to take advantage of preventative tests such as lifesaving cancer screenings. Additionally, ACS CAN is also seeking $18.6 million from Congress to ensure continued funding for the federal Patient Navigator, Outreach, and Chronic Disease Prevention Program, a demonstration program that will serve medically underserved populations suffering from a disproportionate burden of cancer and other chronic diseases.
There is substantial evidence that lack of adequate health insurance coverage is associated with less access to care and poorer outcomes for many patients. National surveys show that the uninsured are less likely to receive recommended screening tests for breast and cervical cancer. New data from American Cancer Society researchers finds that the uninsured are more likely to be diagnosed with later stage breast cancer and they have lower survival rates than those with private insurance for all cancers combined.
Dr. Brawley is a practicing oncologist and the chief medical officer at the American Cancer Society. A world renowned cancer expert, Dr. Brawley most recently served as professor of hematology, oncology, and epidemiology at Emory University, medical director of the Georgia Cancer Center for Excellence at Grady Memorial Hospital in Atlanta, and deputy director for cancer control at Winship Cancer Institute at Emory University. He has also previously served as a member of the Society’s Prostate Cancer Committee, co-chaired the Surgeon General’s Task Force on Cancer Health Disparities, and served in a variety of capacities at the National Cancer Institute (NCI), most recently serving as director of the Office of Special Populations Research. He currently serves as chair of the National Institutes of Health Consensus Panel on the Treatment of Sickle Cell Anemia, and as a member of the Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection and Control Advisory Committee.
ACS CAN is the nonprofit, nonpartisan sister advocacy organization of the American Cancer Society, which is dedicated to eliminating cancer as a major health problem. ACS CAN works to encourage lawmakers, candidates and government officials to support laws and policies that will make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer. For more information, visit www.fightcancer.org.
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Alissa Havens
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