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The 109th Congress adjourned without passing legislation updating the federal program for breast and cervical cancer screening last year, a program that provided access to mammography and Pap smears for hundreds of thousands of low-income women. Since its inception in 1991, the National Breast and Cervical Cancer Early Detection Program, which is run through the Centers for Disease Control and Prevention, has screened approximately 2.5 million women. However, under current funding levels, the program can provide screening to only one of fi ve eligible women. In some states, there is only enough money to screen one in 20, according to the American Cancer Society. Despite modest increases over the past few years, the overall lack of federal money has hamstrung states’ efforts to extend the free screening to all eligible women, said Pama Joyner , director of the state of Washington’s Breast and Cervical Health Program and president-elect of the Breast and Cervical Cancer Program Directors Council. With the help of new private and state funds — Washington’s legislature recently allocated about $2.3 million for the program, exceeding the federal matching requirements — the program can be ex pected to serve one of every four eligible women. “We went 5 years without any increase in funding, so it was really more of a catchup,” she said. However, there are 10 states with programs that get little or no direct funding from their legislatures ( see box ). For those programs, restrictions on how the federal grant money can be spent have affected outreach efforts, a problem that would have been corrected in the failed bill. In other states, outreach has been so successful that programs are running out of money. For example, Michigan’s program began turning women away as early as August of last year because of funding shortfalls. Many programs are struggling to fi nd the right balance. “You don’t want to set up an expectation you cannot fulfi ll, but at the same time it is hard to justify requests for more money if you don’t have people on a waiting list,” Joyner said.

Screening Program Serves Fraction of Those Eligible