**GAO-09-384**                      Published: May 22, 2009. Publicly Released: Jun 22, 2009.                  

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## Highlights

Tens of thousands of women die each year from breast or cervical cancer. While screening and early detection through mammograms and Pap tests--followed by treatment--can improve survival, low-income, uninsured women are often not screened. In 1990, Congress authorized the Centers for Disease Control and Prevention (CDC) to fund screening and diagnostic services for such women, which led CDC to establish the National Breast and Cervical Cancer Early Detection Program. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 was also enacted to allow states to extend Medicaid eligibility to women screened under the Early Detection Program and who need breast or cervical cancer treatment. Screened under the program is defined, at a minimum, as screening paid for with CDC funds. GAO examined the Early Detection Program's screening of eligible women, states' implementation of the Treatment Act, Medicaid enrollment and spending under the Treatment Act, and alternatives available to women ineligible for Medicaid under the Treatment Act. To do this, GAO compared CDC data on women screened by the Early Detection Program from 2002 to 2006 with federal estimates of the eligible population, surveyed program directors on the 51 states' (including the District of Columbia) implementation of the Treatment Act, analyzed Medicaid enrollment and spending data, and conducted case studies in selected states.

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## Topics

Health Care

Breast cancerCancerCost analysisData collectionDisease detection or diagnosisEligibility criteriaEligibility determinationsstate relationsGrants to statesHealth care programsHealth care servicesHealth insuranceMedicaidMedically necessary treatmentsMedically uninsuredProgram evaluationProgram managementWomenPolicies and proceduresProgram goals or objectivesProgram implementation