State seeks more breast-cancer screening


Some Maryland hospitals have shied away from a state program to make low-cost breast-cancer screening widely available, apparently fearing they could not afford to continue it when the program is over.

The newly formed Governor's Cancer Control Council yesterday discussed ways of improving the participation in a state that leads the country in cancer death rates.

The council has set a premium on extending the availability of mammography to more Maryland women, because the technique will detect many breast cancers at an early stage when they are more curable than after the cancer has spread.

Four years ago, the state Health Services Cost Review commission offered hospitals the chance to recoup the costs of offering low-cost breast cancer screening through higher overall rates for three years. The program requires hospitals to offer a mammogram for $45 instead of the usual $100 or more, establish outreach programs to draw in poor women and others at high risk for breast cancer, and provide follow-up care for those with abnormal mammograms. After three years of higher rates, the state expects participating hospitals to continue the screening on their own.

But in Anne Arundel County,which has the second-highest breast cancer death rate in Maryland, no hospital has applied, said Marsha Bienia, chief of the division of cancer control for the state health department.

Only one hospital, Calvert Memorial in Prince Frederick, has completed the three-year program and, while it is continuing to make mammograms available at low prices under its wellness program, the hospital has cut back its efforts to draw high-risk women into the hospital, she said.

Three hospitals are in the second year of the program, and eight others are either beginning the program or have submitted an application toparticipate. Another 10 to 15 have indicated some interest, Ms. Bienia said.

Paul Averill, program director of the Maryland Cancer Consortium, said some hospital administrators say they don't want to start the service because they don't want to risk backlash from their community if they discontinue it.

Hoping to entice more Maryland hospitals to offer low-priced breast-cancer screening programs, the staff of the state hospital rate-setting commission will recommend extending the offer of seed money from three to five years at the next meeting Oct. 9, said John M. Colmers, commission executive director.

Allowing hospitals to recoup losses through rate increases for five years would give them the time to find other financial means of carrying on the breast-cancer screening programs, said Richard H. Wade, vice president of the Maryland Hospital Association. He predicted that a five-year financial incentive program would double hospital participation in the screening programs.

If that doesn't work, Christian H. Poindexter, chairman of the governor's cancer commission, suggested that hospital executives be invited to a 15-minute session with Gov. William Donald Schaefer in Annapolis for a personal invitation to join in the breast-cancer screening program.

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