Free and Low Cost Breast and Cervical Cancer Screening

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Through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the Centers for Disease Control and Prevention (CDC) provides low-income, uninsured, and underserved women access to timely breast and cervical cancer screening and diagnostic services.

To improve access to screening, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the NBCCEDP. Currently, the NBCCEDP funds all 50 states, the District of Columbia, 5 U.S. territories, and 12 American Indian/Alaska Native tribes or tribal organizations to provide screening services for breast and cervical cancer. The program helps low-income, uninsured, and underinsured women gain access to breast and cervical cancer screening and diagnostic services. These services include-

  • Clinical breast examinations.
  • Mammograms.
  • Pap tests.
  • Pelvic examinations.
  • Diagnostic testing if results are abnormal.
  • Referrals to treatment.

In 2000, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act, which gives states the option to offer women in the NBCCEDP access to treatment through Medicaid. To date, all 50 states and the District of Columbia have approved this Medicaid option. In 2001, with passage of the Native American Breast and Cervical Cancer Treatment Technical Amendment Act, Congress explained that this option also applies to American Indians/Alaska Natives who are eligible for health services provided by the Indian Health Service or by a tribal organization.

Program Eligibility

An estimated 8%-11% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18-64 for cervical screening; ages 40-64 for breast screening. Find screening in your state.

Accomplishments

Since 1991, NBCCEDP-funded programs have served more than 3.9 million women, provided more than 9.8 million breast and cervical cancer screening examinations, and diagnosed more than 52,694 breast cancers, 2,856 invasive cervical cancers, and 136,837 premalignant cervical lesions, of which 41% are high-grade. Approximately 14.3% of NBCCEDP-eligible women aged 40-64 years are screened for breast cancer and 8.7% of eligible women aged 18-64 years are screened for cervical cancer through the program.

In program year 2010, the NBCCEDP-

  • Screened 325,291 women for breast cancer with mammography and found 5,530 breast cancers.
  • Screened 299,854 women for cervical cancer with the Pap test and found 4,813 cervical cancers and high-grade precancerous lesions.

These and other public health efforts that address breast and cervical cancer support CDC's overarching goal of healthy people in every stage of life. They also address the U.S. Department of Health and Human Services' Healthy People 2010 goals of-

  • Reducing the breast cancer death rate by 20%.
  • Reducing the cervical cancer death rate to 2 deaths per 100,000 women.
  • Increasing to 97% the proportion of women who have ever received a Pap test, and to 90% the proportion of women who have received a Pap test in the last 3 years.
  • Increasing to 70% the proportion of women aged 40 years and older who have received a mammogram in the last 2 years.

To reach underserved women, the NBCCEDP supports an array of strategies, including program management, screening and diagnostic services, data management, quality assurance and quality improvement, evaluation, partnerships, professional development, and recruitment. Providers in the program work collaboratively to provide breast and cervical cancer screening, diagnostic evaluation, and treatment referrals (where appropriate). The program's continued success depends in large part on the complementary efforts of a variety of national organizations, as well as on state and community partners.

Screening

Deaths from breast and cervical cancers could be avoided if cancer screening rates increased among women at risk. Deaths from these diseases occur disproportionately among women who are uninsured or underinsured. Mammography and Pap tests are underused by women who have no source or no regular source of health care, women without health insurance, and women who immigrated to the United States within the past 10 years.1

Women Screened through the NBCCEDP, by Year
July 2005 to June 2010
National Aggregate
Description: This bar graph illustrates the number of women who received NBCCEDP-funded screenings by program year from July 2005 to June 2010.
See text description of this graph.

Future Directions

The Program Services Branch (PSB) of CDC's Division of Cancer Prevention and Control administers the NBCCEDP and is engaged in strategic planning to set directions and priorities for the future. Achieving program efficiency and effectiveness will continue to be high priorities.

VISION: Healthy women living cancer-free.

MISSION: To lead and support breast and cervical cancer screening to save lives.

GOALS:

  • Reduce breast and cervical cancer mortality through public health approaches.
  • Address environmental factors* to plan, manage, and communicate priorities.
  • Provide the highest level of support to grantees to maximize their performance.

*Environmental factors are issues that may impact the ability of the PSB to achieve its mission. They include potential reimbursement for more costly new technologies, trends in health care reform and universal coverage, recent evidence of population declines in mammography rates, and increases in the eligible population due to a rise in the number of uninsured women and an aging population.

Reference

1Pleis JR, Schiller JS, Benson V. Summary health statistics for U.S. adults: National Health Interview Survey, 2000.Description: External Web Site Icon Vital and Health Statistics. Series 10, Data from the National Health Survey. 2003;(215):1-132.


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