Variability in mammography screening legislation across the states

Area of Science:

• Public Health
• Health Policy
• Cancer Screening Legislation

Background:

• Over half of US states had laws mandating health insurer coverage for mammography screening and breast cancer care prior to the National Breast and Cervical Cancer Screening Act (NBCCSA) of 1991.
• Existing state laws often extended coverage beyond federal mandates, including services for mammography and post-diagnosis care.

Purpose of the Study:

• To examine the variability and extent of state-level mammography screening legislation.
• To identify factors potentially influencing the comprehensiveness of state breast cancer screening laws.

Main Methods:

• Data collection involved telephone interviews with six NBCCSA program directors/coordinators.
• A review of existing documents from the Institute for Women's Policy Research was conducted.
• State laws were analyzed using data from the Centers for Disease Control and Prevention and the American Cancer Society.

Main Results:

• Significant variability was observed in state legislation related to mammography screening and breast cancer care.
• States with lower age-adjusted breast cancer mortality rates among Black women and fewer women above the federal poverty threshold tended to have less comprehensive legislation.
• A notable disparity existed in some states between health insurance coverage provisions and the scope of legislation ensuring post-diagnosis care.

Conclusions:

• State legislative approaches to breast cancer screening and care demonstrated considerable variation.
• The NBCCSA has improved access to timely mammography screening and earlier diagnosis since its passage.
• Continued state-level efforts are crucial to ensure comprehensive breast cancer treatment access for all women.