Most People Would Die for a Screening

Literally. And opponents say we can't have a public option because it would lead to healthcare rationing. Here's what you need to know. ~ No1KState

Poor Being Turned Away From Cancer Screenings

ALBANY, N.Y. (Dec. 13) -- As the economy falters and more people go without health insurance, low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society's Cancer Action Network.

In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears. Just how many are turned away isn't known; in some cases, the women are screened through other programs or referred to different providers.
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The Cancer Society doesn't have an estimate for what percentage of breast cancer diagnoses come from mammogram screenings, but says women have a 98 percent survival rate when breast cancer is caught early, during stage I. That shrinks to about 84 percent during stages II and III, and just 27 percent at stage IV - when cancer has reached its most advanced point.

"I already know there are women who are dying whose lives we could have saved with mammography and other detections," said Dr. Otis Brawley, chief medical officer for the society.

In New York, the Cancer Society says providers in Manhattan, Brooklyn and western Queens, and in Nassau, Suffolk and Westchester counties project they'll perform nearly 15,000 fewer free mammograms for the fiscal year ending April 2010, compared with the previous year.

The Cancer Society has no way to count how many women are being turned away, and many providers don't keep track of how many are denied screening, or whether those women find another alternative. The cost of screening varies, but the average mammogram is about $100, while a Pap screen can range between $75 and $200, according to the society.

Project Renewal Van Scan, which gives mammograms around New York City, usually targets 6,000 women a year but has cut back to 3,100 this year, director Mary Solomon said.

Each state handles free screenings differently. Some use state funds to supplement federal funding, while others get private assistance from the Susan G. Komen for the Cure foundation and other groups.

At least 14 states cut budgets for free cancer screenings this year: Colorado, Montana, Illinois, Alabama, Minnesota, Connecticut, South Carolina, Utah, Missouri, Washington, Ohio, Massachusetts, Pennsylvania and Arkansas.

Some states that have cut their budgets have found ways to maintain services; some states that haven't reduced their budgets still find themselves having to turn women away because they don't have enough funding.

"This is rationing of health care by offering (screenings) only in the first half of the fiscal year, or by cutting back on those programs," Brawley said. "It's rationing that is leading to people dying."

New York, which has fought for two years with deficits in the billions, used to screen women of all ages for breast cancer, but after $3.5 million in budget cuts this year, women under 50 - like LaBarge - are no longer eligible unless they have the breast cancer gene or a serious family cancer history. Despite [one patient]'s family history, she was denied screening because of her age and a lack of funding.
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In 2009, the Cancer Society estimates, 34,600 women between 40 and 49 will be found to have breast cancer nationwide; in that age group, 4,300 breast cancer deaths are projected this year.
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The federal Centers for Disease Control and Prevention estimates that since 1991, the free screening program has provided more than 8 million exams to more than 3.4 million women, detecting more than 39,000 breast cancers, 2,400 invasive cervical cancers and 126,000 pre-malignant cervical lesions.