Economics of Breast and Cervical Cancer Screening

Economics of Breast & Cervical Cancer Screening

Breast and cervical cancer screenings are offered at low or no cost to low-income, uninsured or underinsured women living in the United States through the CDC-funded National Breast and Cervical Cancer Early Detection Program (NBCCEDP). CDC funds the program through cooperative agreements across the country. Sixty-eight programs are supported in all 50 states, Washington, DC, 5 U.S. territories, and 12 American Indian/Alaska Native tribal organizations. In 2006, the NBCCEDP provided breast cancer screening services to an estimated total of 14.7% of all eligible American women under the program. Of that amount, 380,719 women received mammograms and breast cancer was detected in 4,013 women. The same year, the NBCCEDP screened 367,200 women for cervical cancer using the Pap test and detected 5,162 high-grade and invasive cancer lesions. The NBCCEDP screened an estimated 6.7% of all eligible women for cervical cancer.

In fiscal year 2008, the program received approximately $220 million in funding. If Congress continues to appropriate funds at this level, NBCCEDP can reach approximately 15 percent of eligible women in the U.S.

The Breast and Cervical Cancer Mortality Prevention Act of 1990 requires that at least 60 percent of program funds go directly to pay for patient services such as mammograms and Pap tests. The remaining 40 percent is used to support the program through data management, quality assurance, recruitment, and outreach efforts.

Analyzing Screening Program Costs

"Cost Analysis of the National Breast and Cervical Cancer Early Detection Program: Selected States, 2003 to 2004"

This report, published online December 21, 2007 in the journal Cancer, summarized a recent CDC cost analysis of 9 programs funded by NBCCEDP. The median¹ cost of screening a woman for breast cancer was $94 and the cost for screening for cervical cancer was $56. The median total cost of screening services to women was $555 per woman served. According to CDC, the reimbursement rate for these clinical services is fairly consistent since they are at the Medicare rate.

This cost analysis was the first part of an effort to determine the resources required to reach and screen women for breast and cervical cancer. Understanding how state, territorial and tribal programs spend money on breast and cervical cancer screening will help in making budget decisions.

CDC plans to conduct a second study to examine the cost-effectiveness of approaches used in the early detection program. This larger study will look at all 68 local programs in NBCCEDP. State health departments and tribal partners will be able to report data using a new web-based collection tool. The cost effectiveness analysis will help to inform decision makers about which approaches for use in delivering screening services work best.

¹ A statistics term. The middle value in a set of measurements.  Half are lower and half are higher.

Low-Cost or Free Screenings

The National Breast and Cervical Cancer Early Detection Program offers free or low-cost mammograms to eligible woman. To find out if you qualify, call your local program. A list of program contacts is available online.

For More Information

• National Breast and Cervical Cancer Early Detection Program
• Alaska Breast & Cervical Cancer Early Detection Programs: Partners for Success
  
• Cost Analysis of the National Breast and Cervical Cancer Early Detection Program: Selected States, 2003 to 2004, Cancer, 2008;112:626-35. Published online 2007 by the American Cancer Society.