Source: National Cancer Institute: State Cancer Legislative Database Program, Bethesda, MD, 2009

Building 31, Room 10A48 • 31 Center Drive, MSC 2580 • Bethesda, Maryland 20892-2580 • 301 496 5217 • 301 402 1225 fax • http://www.scld-nci.net

The SCLD contains information synthesized from state-level laws and resolutions. The SCLD does not contain state-level regulations; executive orders; 

measures implemented by counties, cities, or other localities; Attorneys General opinions; or data addressing the implementation of state laws — all of 

which may vary significantly from the laws reported here.

Forty-nine states and the District of Columbia 

(collectively, “states”) had enacted laws addressing 

private insurance coverage for at least one type of 

cancer screening, as of March 31, 2009. The bar chart 

above illustrates the number of states with laws requiring 

specified private health insurers to cover, or offer to 

cover, screening for: (1) breast cancer, (2) cervical cancer, 

(3) colorectal cancer, (4) ovarian cancer, and (5) prostate 

cancer. Four states—Delaware, Georgia, Illinois, and

North Carolina—have enacted laws addressing 

screening in each of these areas.

Breast Cancer. All states except Utah have enacted 

legislation requiring private insurers to cover, or offer 

to cover, breast cancer screening procedures, such as 

mammography and clinical breast examinations. 

Cervical Cancer. Twenty-seven states (53 percent) 

require private insurers to cover, or offer to cover, 

cervical cancer screening procedures, such as clinical 

examinations, Pap smears, or other screenings of 

cervical cytology.

Colorectal Cancer. Thirty-two states require private 

insurers to cover, or offer to cover, colorectal screening 

procedures, such as barium enemas, colonoscopies, 

fecal occult blood tests, or sigmoidoscopies. 

Ovarian Cancer. Five states—Delaware1, Georgia2, 

Illinois2, Minnesota2, and North Carolina2—have 

enacted legislation requiring private insurance coverage 

in certain circumstances for ovarian cancer screening, 

such as CA-125 serum tumor marker testing, transvaginal 

ultrasound, or clinical examinations. 

Prostate Cancer. Thirty-three states (65 percent) have 

enacted laws requiring private insurers to cover, or offer 

to cover, prostate cancer screening procedures, such 

as clinical examinations, digital rectal examinations, or 

prostate specific antigen tests.

Unspecified Cancers. California3 and Minnesota4 have 

provisions requiring private insurers to cover generally 

medically accepted/routine cancer screening procedures.

1. Delaware requires coverage for cancer antigen-125 (CA-125) monitoring 

subsequent to treatment. 

2. Georgia, Illinois, Minnesota, and North Carolina require coverage for at-risk 

women. 

3. Along with laws addressing insurance coverage for breast, cervical, and 

prostate cancer screening, a separate California law requires private insurers 

to cover all generally medically accepted cancer screening tests. The law 

does not provide a definition of generally medically accepted cancer 

screening tests. 

4. Minnesota requires private insurers to cover routine screening procedures 

for cancer, explicitly including breast cancer, cervical cancer, colorectal 

cancer, and ovarian cancer. No definition of routine screening procedures 

for cancer is given in the law. 

National Cancer Institute

U.S. DEPARTMENT 

OF HEALTH AND 

HUMAN SERVICES

National Institutes 

of Health

Cancer Screening

State Cancer Legislative Database Fact Sheet July 2009

Office of Government and Congressional Relations

States with Laws Mandating Private Insurance Coverage, 

or the Offer of Coverage, for Cancer Screening Services 

(enacted as of March 31, 2009)

0

10

20

30

40

51

Breast Cancer Cervical Cancer Colorectal Cancer Ovarian Cancer Prostate Cancer

50

27

32

5

33
States with Laws Mandating Private Insurance Coverage, or the Offer of Coverage, 

for Cancer Screening Services (enacted as of March 31, 2009)

1. Along with laws addressing insurance coverage for breast, cervical, and prostate cancer screening, a separate California law requires coverage for all generally medically accepted 

cancer screening tests.

2. Delaware requires coverage for cancer antigen-125 monitoring of ovarian cancer subsequent to treatment. 

3. Georgia, Illinois, Minnesota, and North Carolina require coverage for ovarian cancer screening for at-risk women.

4. Minnesota requires private insurers to cover routine screening procedures for cancer, explicitly including breast cancer, cervical cancer, colorectal cancer, and ovarian cancer. 

Source: National Cancer Institute: State Cancer Legislative Database Program, Bethesda, MD, 2009.

Breast Cancer Cervical Cancer Colorectal Cancer Ovarian Cancer Prostate Cancer

Alabama l l l

Alaska l l l l

Arizona l

Arkansas l l l

California1 l l l

Colorado l l l

Connecticut l l l

Delaware l l l l2 l

District of Columbia l l l l

Florida l l l l

Georgia l l l l3 l

Hawaii l

Idaho l

Illinois l l l l3 l

Indiana l l l

Iowa l

Kansas l l l

Kentucky l l

Louisiana l l l l

Maine l l l l

Maryland l l l

Massachusetts l l

Michigan l

Minnesota4 l l l l3

Mississippi l

Missouri l l l l

Montana l

Nebraska l l

Nevada l l l l

New Hampshire l

New Jersey l l l l

New Mexico l l l

New York l l l

North Carolina l l l l3 l

North Dakota l l

Ohio l l

Oklahoma l l l

Oregon l l l l

Pennsylvania l l l

Rhode Island l l l l

South Carolina l l l

South Dakota l l

Tennessee l l l

Texas l l l l

Utah

Vermont l l

Virginia l l l l

Washington l l l

West Virginia l l l

Wisconsin l

Wyoming l l l l

TOTAL 50 27 32 5 33