Offering free breast cancer exams to low-income women is one thing. Getting them to sign up for them is another.
The state health department has had trouble getting enough eligible women to take advantage of the exams, so it will soon be enlisting the help of the YWCA.
Using its own money and federal funds, the YWCA plans to comb low-income neighborhoods, senior centers and churches to persuade Marylanders to sign up for free exams at clinics and hospitals. The nonprofit group will even provide vans to take the women to their mammograms and cancer education seminars.
The one-year pilot project will be launched in Baltimore and Prince George's County in November, said Jane Christie, executive director of the YWCA of Greater Baltimore. If successful, it would be used as a model for other states, she said.
Maryland ranks seventh in the nation in breast cancer deaths.
The YWCA's involvement is important because the organization has contacts in neighborhoods with "hard to reach" women who cannot afford exams for breast and cervical cancer, said Dr. John W. Southard, director of chronic disease prevention at the state health department.
"The Y has access to the American Indian, Latino and African-American communities that we want to reach, particularly older women," he said.
Said Ms. Christie, "We're not a frightening entity, which is different from a nurse in a white uniform."
She said the national YWCA organization will use a roughly $80,000 grant from the federal Centers for Disease Control to launch the Maryland project, and the YWCA itself will pump in more than $100,000.
An estimated 46,000 women nationwide are expected to die from breast cancer this year. Last year, the disease claimed 900 lives in Maryland, according to the American Cancer Society.
A disproportionate number of low-income women die from the disease because they cannot afford, or do not have access to, the exams that can detect cancer in its earliest, most treatable phase, said state Health Secretary Nelson J. Sabatini.
In Maryland, many hospitals offer free or low-cost mammograms to women with little or no health insurance, and the state will pay for screenings, diagnosis and treatment of uninsured women over age 50. A woman's risk of developing breast cancer increases with age.
Although the plan is still being devised, the YWCA expects to use a van and volunteers to work with churches and other groups to find high-risk women and convince them to sign up for free exams.
"We're good at rustling volunteers and working collaborately with women's sororities and other groups," Ms. Christie said.
Before they can sign the women up, they probably will have to correct common misperceptions about mammograms, a specialized breast X-ray that can detect cancer.
Lillian Brown, a 59-year-old widow in Baltimore, said she had heard rumors that a woman could get cancer from TC mammogram and that the exam would hurt.
But her doctor and others convinced her otherwise, and she took part in an education and screening program involving the YWCA and a Baltimore hospital last year.
"A lot of women, they're afraid if they never had it done," she said.
Mrs. Brown said her mammogram did not hurt, and now she urges other women to participate in the screenings.
"I would say to any woman to get it done."
Maryland has two screening programs, one funded by the Centers for Disease Control and Prevention and the other by a commission that monitors hospital costs.
All together, the programs have more than $5 million a year available for breast and cervical cancer screening and treatment.