In an effort to cut Maryland's high rate of breast cancer deaths, hospitals in the state have been asked to develop a low-cost screening program for early detection and make it available to all women, including those who are poor and uneducated.
Under the program, the maximum charge for a mammogram would be $45, and women who could not afford to pay this fee would get free care or be eligible for state medical assistance, said Paul Averill, program director of the Maryland Cancer Consortium.
The typical cost of a mammogram ranges from about $50 to $150 in Maryland and nationally, according to the cancer information service at Johns Hopkins Hospital.
In a letter sent this month to the chief executive officers of all Maryland general hospitals, Dr. Albert H. Owens Jr., chairman of the Maryland Cancer Consortium, said approximately 3,300 new cases of breast cancer would be diagnosed in Maryland this year.
"The greater accessibility of low-cost breast cancer screening services for Maryland women is essential if breast cancer mortality is to be reduced," Dr. Owens said.
The National Cancer Institute ranks Maryland seventh-highest in the nation in its death rate for breast cancer, which is considered highly treatable when detected early but difficult to treat in later stages.
Sent with the letter from Dr. Owens was a letter from John M. Colmers, executive director of the Maryland Health Services Cost Review Commission, saying the commission would provide to three years of seed money for developing the screening program. Those hospitals whose applications are approved will be allowed to increase their rates slightly to absorb the program's cost.
The hospital rate-setting commission offered such financial assistance three years ago, Mr. Averill said, but many hospitals didn't seem to be aware of it, and only eight hospitals have begun commission-supported screening programs for breast cancer.
Since receiving the recent letter from Mr. Colmers, 18 hospitals have responded and plan to have representatives at a meeting today, hosted by the Maryland Hospital Association, to learn how to apply for the screening program, Mr. Averill said.
"This is a significant change for the regulators instead of just being the cop at the gate on hospital rates," said Richard H. Wade, vice president of the hospital association. The willingness of the hospital rate-setting commission to finance a program aimed at disease prevention and early detection allows some hospitals to set up low-cost mammography programs that otherwise they could not afford, he said.
A low-cost breast cancer screening program is one of the recommendations from the state's first Cancer Control Plan, written a few months ago.
Mr. Averill said the consortium was "very pleased" by the response from 18 additional hospitals, especially because many of them are in counties along the Baltimore-Washington corridor, which has the highest breast cancer death rate in Maryland.
To participate in the state-funded screening program, hospitals must promise to set up public education and outreach programs "with particular emphasis on high risk, low-income, uneducated and minorities," Mr. Averill said. The program must also include follow-up biopsies and treatment for women diagnosed with cancer.
Overall, Maryland has the highest cancer death rate of any state in the United States. The Maryland Cancer Consortium is working under a grant from the National Cancer Institute to find ways to reduce the death rate for some of the major cancers.