After Pap tests

February 19, 1992

The intention behind a new screening program to detect cancers among Maryland's low-income women is a good one, but it could fall short of the health-care goals it hopes to achieve if there isn't money available for treatment.

The program, funded by a $15 million federal grant and $5 million in matching state funds over five years, will include education and outreach efforts to let women know about the importance of Pap smears and mammograms. The grants will also pay for those tests, for follow-up services and for quality-control monitoring. The state hopes, through this effort, to reach as many as 12,000 women a year.

There is no dispute about the need for such a program. Maryland bears the stigma of having the highest cancer death rate in the nation. While there is no consensus on why the people of this state suffer disproportionately, state health officials note that nearly 600 of the more than 1,770 women who died from breast and cervical cancer in 1987 and 1988 (the most recent statistics available), could have been saved if their diseases had been identified in earlier stages.

Sadly, these simple, routine procedures to detect these cancers have been out of reach of low-income women who don't have health insurance coverage, who are are not poor enough to be covered by Medicaid or who are ineligible for Medicare.

This highlights a larger problem, which will not be solved by the availability of annual medical procedures. Women who don't have $25 for a Pap test, or $100 for a mammogram, probably aren't going to have the money to pay for long and costly cancer treatments, either.

Letting women know that they have a health problem is an important first step. But unless federal or state lawmakers enact comprehensive health-care reform, offering screening tests, when there isn't any money for treatment, may be more a political coup than a solid step forward in health-care access.

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