About the Program

CDC provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages, through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

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.

Accomplishments

To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the NBCCEDP. The NBCCEDP provides screening support in all 50 states, the District of Columbia, 5 U.S. territories, and 12 American Indian/Alaska Native tribes or tribal organizations, and 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.
• Diagnostic testing for women whose screening outcome is abnormal.
• Surgical consultation.
• Referrals to treatment.

Since 1991, the NBCCEDP has served more than 3.2 million women, provided more than 7.8 million screening examinations, and diagnosed 35,090 breast cancers, 2,161 invasive cervical cancers, and 114,390 precursor cervical lesions, of which 42% were high-grade. The NBCCEDP is currently reaching 14.6% of women age 40–64 eligible to participate in breast cancer screening and 7.5% of women age 18–64 eligible for cervical cancer screening.

In program year 2007, the NBCCEDP

• screened 295,338 women for breast cancer using mammography and found 3,962 breast cancers



• screened 318,220 women for cervical cancer using the Pap test and found 4,996 high-grade and invasive cervical lesions

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.

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.

In 2005, CDC released The National Breast and Cervical Cancer Early Detection Program: 1991–2002 National Report, (PDF-1.3MB) the first summary of the program's progress. The report provides information about the program's framework, history, and future direction, as well as data on breast and cervical cancer screening outcomes for women served through NBCCEDP.

Screening

Many 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 Program Year
July 2002 to June 2007
National Aggregate

Future Directions

CDC has invested in developing a system to achieve efficiency in the NBCCEDP and to address the relative stability of funding allocations. The system includes a performance-based approach to making funding decisions. CDC continues to refine this approach, which ensures that funds will be distributed appropriately to programs, based on the programs' ability to comply with program guidelines; provide high-quality care to the largest number of low-income, uninsured women; and maximize available funds.

Reference

1. Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2000. 141 pp. (PHS) 2004–1543.

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