MMWR Morb Mortal Wkly Rep. 1998 Mar 27;47(11):215-8.
The Breast and Cervical Cancer Mortality Prevention Act of 1990 authorized CDC to establish the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to increase screening services for women at low income levels who are uninsured or underinsured. Although the NBCCEDP covers most diagnostic services that women need after receiving an abnormal mammography or Papanicolaou (Pap) test result, the program does not reimburse for breast biopsies. In addition, the Act prohibits the use of NBCCEDP funds for cancer treatment. Participating health agencies must ensure that NBCCEDP clients receive timely, appropriate diagnostic and treatment services. In 1996, CDC began a case study to determine how early detection programs in seven participating states (California, Michigan, Minnesota, New Mexico, New York, North Carolina, and Texas) identified resources and obtained diagnostic and treatment services. This report summarizes the results of the study, which indicate that respondents in these states reported that treatment had been initiated for almost all NBCCEDP clients in whom cancer was diagnosed. However, respondents also considered the strategies used to obtain these services as short-term solutions that were labor-intensive and diverted resources away from screening activities.
1990年的《乳腺癌和宫颈癌死亡率预防法案》授权美国疾病控制与预防中心(CDC)设立国家乳腺癌和宫颈癌早期检测项目(NBCCEDP),以增加为未参保或保险不足的低收入女性提供的筛查服务。尽管NBCCEDP涵盖了女性在乳房X光检查或巴氏试验结果异常后所需的大多数诊断服务,但该项目不报销乳房活检费用。此外,该法案禁止将NBCCEDP资金用于癌症治疗。参与的卫生机构必须确保NBCCEDP的客户能够及时获得适当的诊断和治疗服务。1996年,CDC开展了一项案例研究,以确定七个参与州(加利福尼亚州、密歇根州、明尼苏达州、新墨西哥州、纽约州、北卡罗来纳州和得克萨斯州)的早期检测项目是如何确定资源并获得诊断和治疗服务的。本报告总结了该研究的结果,结果表明这些州的受访者表示,几乎所有被诊断患有癌症的NBCCEDP客户都已开始接受治疗。然而,受访者也认为,用于获得这些服务的策略是短期解决方案,劳动强度大,且使资源从筛查活动中转移。