Legislation Seeks to Enhance Access to Cancer Screenings

President Bush recently signed legislation intended to increase the number of screenings for breast and cervical cancer available to low-income uninsured and underinsured women.

Bush signed H.R. 1132 (at the THOMAS Web site, type "HR 1132" in the search box after selecting "Bill Number") into law on April 20. The bill reauthorizes and increases funding for the National Breast and Cervical Cancer Early Detection, or NBCCED, program, which provides breast and cervical cancer screenings for low-income women with little or no insurance. The reauthorized legislation also gives states greater flexibility to reach more women who qualify for the program.

"The passage of this bill literally saves lives," said Rep. Tammy Baldwin, D-Wis., a House sponsor of the legislation, in an interview with AAFP News Now. "It is focused on low-income, uninsured women who could not otherwise afford cancer screening."

The legislation, which reauthorizes the program through fiscal year 2012, increases funding levels for the program to $275 million a year by 2012, enough of an increase to serve about 150,000 more women annually, according to Baldwin, who co-sponsored the legislation in the House with Rep. Sue Myrick, R-N.C. The program includes an outreach component and case management services for women who are diagnosed with cancer as a result of the screenings. Under the reauthorized legislation, certain states will have the ability to place a greater emphasis on education and outreach services.

The NBCCED program, which was established in 1991 and is administered by the CDC, provides funding to states in the form of grants; during the past several years, it has provided nearly 7 million cancer screenings to more than 2.5 million women, according to a news release (PDF file: 3 pages / 144 KB. More about PDFs.) from the American Cancer Society's Cancer Action Network. More than 29,000 breast cancers, 94,000 pre-cancerous cervical lesions and 1,800 cervical cancers have been detected through the program. Nevertheless, it has reached only about 20 percent of the women who qualify for it, a percentage that will surely grow with the increased funding levels, said Baldwin.

The current legislation should bring more low-income women into the health care system, making it possible for family physicians to treat a greater percentage of these women, said Baldwin.

"Primary care physicians understand the struggles we have in our health care system with so many people who are uninsured and underinsured," explained Baldwin. "We know that along with the lack of insurance comes a reluctance to seek preventative care -- a reluctance to seek screenings."

She went on to describe the program as a "tool" that would encourage underinsured and uninsured women to seek care.

Sens. Barbara Mikulski, D-Md., and Kay Hutchinson, R-Texas, introduced an identical bill in the Senate, S. 624, and both houses of Congress passed the legislation in late March.