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Implementing recommendations for the early detection of breast and cervical cancer among low-income women.

Abstract Among U.S. women, breast cancer is the most commonly diagnosed cancer and remains second only to lung cancer as a cause of cancer-related mortality. The American Cancer Society (ACS) estimates that 182,800 new cases of female breast cancer and 41,200 deaths from breast cancer will occur in 2000. Since the 1950s, the incidence of invasive cervical cancer and mortality from this disease have decreased substantially; much of the decline is attributed to widespread use of the Papanicolaou (Pap) test. ACS estimates that 12,800 new cases of invasive cervical cancer will be diagnosed, and 4,600 deaths from this disease will occur in the United States in 2000.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title mmwr. recommendations and reports : morbidity and mortality weekly report. recommendations and reports
Publication Year Start




PMID- 15580731
OWN - NLM
STAT- MEDLINE
DCOM- 20041209
LR  - 20161021
IS  - 1545-8601 (Electronic)
IS  - 1057-5987 (Linking)
VI  - 49
IP  - RR-2
DP  - 2000 Mar 31
TI  - Implementing recommendations for the early detection of breast and cervical
      cancer among low-income women.
PG  - 37-55
AB  - SCOPE OF THE PROBLEM: Among U.S. women, breast cancer is the most commonly
      diagnosed cancer and remains second only to lung cancer as a cause of
      cancer-related mortality. The American Cancer Society (ACS) estimates that
      182,800 new cases of female breast cancer and 41,200 deaths from breast cancer
      will occur in 2000. Since the 1950s, the incidence of invasive cervical cancer
      and mortality from this disease have decreased substantially; much of the decline
      is attributed to widespread use of the Papanicolaou (Pap) test. ACS estimates
      that 12,800 new cases of invasive cervical cancer will be diagnosed, and 4,600
      deaths from this disease will occur in the United States in 2000. ETIOLOGIC
      FACTORS: The risk for breast cancer increases with advancing age; other risk
      factors include personal or family history of breast cancer, certain benign
      breast diseases, early age at menarche, late age at menopause, white race,
      nulliparity, and igher socioeconomic status. Risk factors for cervical cancer
      include certain human papilloma virus infections, early age at first intercourse,
      multiple male sex partners, a history of sexually transmitted diseases, and low
      socioeconomic status. Black, Hispanic, or American Indian racial/ethnic
      background is considered a risk factor because cervical cancer detection and
      death rates are higher among these women. RECOMMENDATIONS FOR PREVENTION: Because
      studies of the etiology of breast cancer have failed to identify feasible primary
      prevention strategies suitable for use in the general population, reducing
      mortality from breast cancer through early detection has become a high priority. 
      The potential for reducing death rates from breast cancer is contingent on
      increasing mammography screening rates and subsequently detecting the disease at 
      an early stage--when more treatment options are available and survival rates are 
      higher. Effective control of cervical cancer depends primarily on early detection
      of precancerous lesions through use of the Papanicolaou test, followed by timely 
      evaluation and treatment. Thus, the intended outcome of cervical cancer screening
      differs from that of breast cancer screening. In 1991, the National Breast and
      Cervical Cancer Early Detection Program (NBCCEDP) was implemented to increase
      breast and cervical cancer screening among uninsured, low-income women. RESEARCH 
      AGENDA: To support recommended priority activities for NBCCEDP, CDC has developed
      a research agenda comprising six priorities. These six priorities are a)
      determining effective strategies to communicate changes in NBCCEDP policy to
      cancer screening providers and women enrolled in the program; b) identifying
      effective strategies to increase the proportion of enrolled women who complete
      routine breast and cervical cancer rescreening according to NBCCEDP policy; c)
      identifying effective strategies to increase NBCCEDP enrollment among eligible
      women who have never received breast or cervical cancerscreening; d) evaluating
      variations in clinical practice patterns among providers of NBCCEDP screening
      services; e) determining optimal models for providing case-management services to
      women in NBCCEDP who have an abnormal screening result, precancerous breast or
      cervical lesion, or a diagnosis of cancer; and f) conducting economic analyses to
      determine costs of providing screening services in NBCCEDP. CONCLUSION: The
      NBCCEDP, through federal, state, territorial, and tribal governments, in
      collaboration with national and community-based organizations, has increased
      access to breast and cervical cancer screening among low-income and uninsured
      women. This initiative enabled the United States to make substantial progress
      toward achieving the Healthy People 2000 objectives for breast and cervical
      cancer control among racial/ethnic minorities and persons who are medically
      underserved. A continuing challenge for the future is to increase national
      commitment to providing screening services for all eligible uninsured women to
      ultimately reduce morbidity and mortality from breast and cervical cancer.
FAU - Lawson, H W
AU  - Lawson HW
AD  - Division of Cancer Prevention and Control, National Center for Chronic Disease
      Prevention and Health Promotion, USA.
FAU - Henson, R
AU  - Henson R
FAU - Bobo, J K
AU  - Bobo JK
FAU - Kaeser, M K
AU  - Kaeser MK
LA  - eng
PT  - Journal Article
PL  - United States
TA  - MMWR Recomm Rep
JT  - MMWR. Recommendations and reports : Morbidity and mortality weekly report.
      Recommendations and reports
JID - 101124922
SB  - IM
MH  - Breast Neoplasms/*diagnosis/epidemiology
MH  - Female
MH  - Healthy People Programs
MH  - Humans
MH  - Mammography
MH  - Mass Screening/*standards
MH  - Papanicolaou Test
MH  - Poverty
MH  - Practice Guidelines as Topic
MH  - Risk Factors
MH  - United States/epidemiology
MH  - Uterine Cervical Neoplasms/*diagnosis/epidemiology
MH  - Vaginal Smears
EDAT- 2004/12/08 09:00
MHDA- 2004/12/16 09:00
CRDT- 2004/12/08 09:00
PHST- 2004/12/08 09:00 [pubmed]
PHST- 2004/12/16 09:00 [medline]
PHST- 2004/12/08 09:00 [entrez]
PST - ppublish
SO  - MMWR Recomm Rep. 2000 Mar 31;49(RR-2):37-55.