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Breast cancer screening program for poor women to stop accepting new patients

December 4, 2009 |  6:02 pm

A cigarette tax-funded program that pays for breast cancer screenings for low-income women will stop accepting new patients Jan. 1, public health officials said this week. Officials said the decision came as a result of “unprecedented fiscal challenges” to the program which they hope to reopen by summertime.

If “Every Woman Counts” reopens July 2 as planned, its scope will be scaled back significantly. Although women ages 50 and older will still be eligible, women ages 40-49 will no longer be screened. State officials acknowledged that women ages 40 to 49 who had been served by the program will no longer have access to state-funded screening.

Officials said demand has grown for the free screening even as the program's main source of revenue, a tobacco tax, has dwindled. Women already enrolled in the program will continue to be eligible for annual screenings, officials said.

But Dr. Mark Horton, the state health officer, said in a statement that short-term increases in state funding for the program “have not been enough to keep pace with the growing demand for and cost of providing breast cancer screening services to women in this program.”

Officials said the age requirement was tightened because, according to the California Department of Public Health, most breast cancer cases occur in women older than 50.
The service covered breast cancer screening tests for women that were not covered by other government medical programs, such as Medi-Cal; had medical insurance that failed to cover such screenings; had a high insurance deductible or copayment; or were low-income.

Debora Wright, president of Inner Images, a mobile mammography service based in Los Angeles County who relies heavily on the state program, called the state’s changes to the program “cruel.”

“We’re absolutely horrified,” Wright said, who added  that aggressive breast cancer can occur in women younger than 50. “I don’t think our business can survive it.”

Wright said three out of four of her clients are first-time screeners or between the ages of 40 and 49.

The Department of Public Health said women seeking low-cost or free breast cancer screenings can contact their local health department or American Cancer Society.

The state’s announcement comes a few weeks after the U.S. Preventive Services Task Force recommended that women younger than 50 do not need regular mammograms, concluding that the risk of breast cancer is very low in women ages 40 to 50. The task force concluded that the risk of a false breast cancer diagnosis and complications from biopsies and other invasive procedures is too high for the procedure to be used routinely.

Though screening saves lives, recent studies have made it clear that it also leads to biopsies, surgeries, chemotherapy and radiation, including some deaths, that otherwise would not have occurred.

Cancer doctors, however, have attacked those guidelines, as have other groups, including the American Cancer Society, the National Cancer Institute and the American College of Obstetricians and Gynecologists, which said they would not change their guidelines and would continue to urge women to undergo the tests.

Dr. Willie Goffney, a surgical cancer doctor who serves on the board of directors for the California division of the American Cancer Society, said he was disappointed by the state's decision to put the free screening program on hiatus and then limit who can enroll.

“We feel we are moving in the wrong direction. We know that screening for breast cancer and having access to that screening saves lives,” Goffney said. “So to take those resources from people who need that access means more people will fall through the cracks, and will lead to more deaths from breast cancer.”

--Rong-Gong Lin II