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19-11-2012 | Article

Cancer screening programs still a must despite ACA


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medwireNews: Despite the Patient Protection and Affordable Care Act (ACA) providing an expected 6.8 million low-income women with health insurance by 2014, the Centers for Disease Control (CDC) Cancer Screening Program will remain essential for millions of low-income women who remain uninsured, concludes a study in Preventing Chronic Disease.

Insurance expansion is expected to lower the current number of low-income uninsured women by 60%, resulting in an increase in demand for annual cancer screenings by 500,000 mammograms and 1.3 million Papanicolaou (Pap) tests. Yet the study estimates that CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) will still serve fewer than one-third of the low-income women who remain uninsured.

"The two big messages," co-author Leighton Ku, from George Washington University, Washington DC, explained to medwireNews, "are [that] there should be big gains for women's health when health insurance is expanded under the ACA. On the other hand, it's not as though the ACA is set up in such a way that un-insurance will end in the US."

Ku said. "Even if states had to expand Medicaid as originally planned under the [ACA] there would still be millions of women left uninsured," leaving the need to provide important cancer screening programs for women who cannot afford it otherwise.

Historically, cost has always been the largest barrier to those seeking and obtaining cancer screening. "If [someone] feels healthy, even if they have a disease, [but] have low income," Ku observed, "they don't want to spend the money on preventative health services."

Ku and study co-authors also looked at women who would most likely remain uninsured to identify other prohibitive circumstances that play into the health issue. "Many more of them have low education, low literacy, low English proficiency, and a larger share of them are Latino," he said. "In that regard we think the CDC program ought to change in how they provide services [and] think about outreach materials and programs in multiple languages, particularly Spanish, as well as simpler language."

"[Overall], what's distressing," Ku lamented, "is we've come up with better ways to treat cancer [and] improve survival, yet sadly the screening rates have remained about the same for the past decade. So we haven't seen the improvements in women's ability to go get the test that could eventually help save their lives."

By Peter Sergo, medwireNews Reporter