Breast cancer screenings save lives, but access is limited.

Byline: GUEST VIEWPOINT By Cathryn Chicola For The Register-Guard

Breast Cancer Awareness Month - October - is an opportune time to celebrate success in one field of the battle against the deadly disease. While breast cancer remains the second leading cause of death among women, survival rates have steadily improved since 1990.

Patient education and awareness campaigns over the past 15 years have contributed to the increase in breast cancer survival rates by driving home a vital message: A combination of regular mammograms, breast self-exams, and clinical exams can detect breast cancers at an earlier stage. Early detection can literally mean the difference between life and death. According to the American Cancer Society, the five-year survival rate is more than 95 percent for patients whose breast cancer is caught in its earliest stages.

Access to breast cancer screening is paramount. According to the Susan G. Komen for the Cure national Web site, uninsured women are 41 percent more likely to receive a late-stage breast cancer diagnosis and are, therefore, three times more likely to die from the disease than are women with insurance.

For women who lack insurance or otherwise can't afford regular screenings, a federal program is designed to help. In 1991 the National Breast and Cervical Cancer Early Detection Program was established to provide limited-income, uninsured and underserved women between 40 and 64 years of age with services for early detection of breast and cervical cancer - including clinical breast exams, mammograms, Pap tests, surgical consultations, diagnostic testing, outreach and case management. Administered by the Centers for Disease Control and Prevention, the successful program has served nearly 3 million women and provided an estimated 7 million screening exams.

To date, more than 26,000 cases of breast cancer have been diagnosed through the early detection program. Additionally, the program has reduced disparities in screening for women who are members of racial and ethnic minorities, who represent half of all women to receive services through the program.

In Oregon, eligible women can access the program by phoning the Oregon Breast and Cervical Cancer Program toll-free at [phone]. Assistance is provided in English and in Spanish.

The Breast and Cervical Cancer Program receives federal funding, with supplementary funds from the Susan G. Komen Foundation. While many states provide additional funding for the National Breast and Cervical Cancer Early Detection Program to provide services to their residents, Oregon does not.

Woefully inadequate funding provides a two-pronged dilemma for the Oregon Breast and Cervical Cancer Program. First, only a small fraction of eligible women can be served by the program. The Oregon Health Department estimates that 44,000 Oregon women are eligible, yet the program's budget for 2007-08 funds screening for just 6,500 women, or 15 percent of those who are eligible.

The second funding dilemma is that because the reimbursement to the program's participating health care providers is so low - currently about 50 cents on the dollar - many providers, especially in rural areas, can't afford to see the program's patients. In Lane County, a very small handful of primary care physicians and women's health specialists have contracted with the state to participate in the program. At Oregon Imaging Centers, we're encouraging greater Breast and Cervical Cancer Program participation among our physician peers.

Limited access to breast cancer screening is simply a microcosm of the nation's monumental health care crisis. Still, we know for certain that the screenings save lives.

So, for those women fortunate to have insurance or the means to pay for regular clinical exams and mammography, the message is simple: Do it. And while you're at it, be sure to ask your physician or mammographer if they participate in Oregon Breast and Cervical Cancer Program. For those who cannot otherwise afford breast cancer screening, be sure to phone the program at [phone]. But do it soon, before the funding runs out.

Cathryn Chicola, M.D., is a radiologist with Oregon Imaging Centers, the only imaging facility in Lane County to participate in the Oregon Breast and Cervical Cancer Program.