The Schwarzenegger Administration and the California Department of Public Health have embraced the holiday season with a new set of proposed rules that will abandon low-income women and increase the likelihood their breast cancer will be undiagnosed, which can lead to increased disease and death.
According to the California Cancer Registry, breast cancer is the most commonly diagnosed cancer across the sexes, and it is the most common cause of cancer death. The Registry estimates that in 2010, more than 22,000 California women will be diagnosed with primary breast cancer, and 4,200 women (mothers, wives, sisters, and daughters) will die from the disease. As with most illnesses, early detection is the key. When breast cancer is detected early, the 5-year relative survival rate is 98%, but declines to 23% when cancer has metastasized or spread to other parts of the body. For decades now, governments and advocates at all levels have encouraged women age 40 and older to implement a regimen of self exams and mammograms to assist with early detection.
Consequently, a recommendation issued last month by the U.S. Preventative Services Task Force that women below the age of 50 no longer needed to receive regular mammograms sparked a hailstorm of outrage. President Obama's Administration moved quickly to assure people that "our policies remain unchanged."
You can imagine my surprise and the surprise of others, health advocates, grassroots organizations and everyday people, when we received word earlier this month that the California Department of Public Health (CDPH) issued a new set of "guidelines" to counties concerning the Every Woman Counts program - the state's arm for breast cancer screening for low-income women 40 years of age and older. According to the memo, effective January 1 the Department will: 1) cease enrolling women under the age of 50; and 2) freeze enrollments for women age 50 and older until July 1, 2010.
By all accounts, this directive was issued with absurdly short notice and no public oversight. Additionally, on the heels of the recommendations issued by the federal Task Force, these new guidelines are suspect, at best. To make matters worse, Department spokespeople have issued conflicting and confusing statements about the condition of Proposition 99's Breast and Cervical Cancer Fund (the voter approved special fund that supports Every Woman Counts) and its ability to support the population it serves.
Let it be said here: not only has CDPH just issued a death sentence to low-income women under the age of 50, but they have also created a two-tiered response to breast cancer screening in California. State law requires all private carriers to provide mammography screening for women age 40 and older. The Legislature, speaking for all Californians, specifically deemed early cancer detection to be a priority life-saving measure for women in California.
These new guidelines tell poor women across the state that, because of their income (the fact that they rely upon a federal and state funded program), under the Every Woman Counts program - they don't. Maybe a name change is in order. How about the "Almost Every Woman Counts" program?
On behalf of the Legislature, breast cancer advocates, and your neighbors I say: Shame on the Department of Public Health. Shame on them for issuing this directive in the dark of night. And, shame on them for being unable to then clearly articulate the reasons for these changes.
In the coming weeks, I will be organizing a meeting of people who care about women and their health. The Department and the Administration should see this gathering as an opportunity to clear up these confusions, discuss the future management of the Every Woman Counts program, and re-establish their priority to saving lives in California. If not, I anticipate that I, the Legislative Women's Caucus and thousands of breast cancer survivors across California will be demanding a very open, very public, audit of this vital program. If you have not yet witnessed the "army of pink" that amasses for Walks for the Cure and other breast cancer advocacy events across the state, you will, it will be something no one will be able to ignore.