Vermont is among four states that appropriated no money for breast and cervical cancer screening programs in 2013 or 2014, according to recent report.

That may be, but the state is still performing those screenings, said Nicole Lukas of the Department of Health. Lukas manages the Ladies First cancer screening program for uninsured or underinsured women in Vermont.

The program is funded by a federal grant from the Centers for Disease Control and Prevention, which requires a state match. Vermont meets that requirement by paying providers the Medicare Part B rate for participants cancer screenings.

As a result, the state doesn't need a separate appropriation to pay for the program. The CDC makes similar grants to programs in every state through the National Breast and Cervical Cancer Early Detection Program.

The report was authored by the American Cancer Society's advocacy arm the Cancer Action Network, which released state-by-state report cards this week that show Vermont earning good overall marks, but lagging in state support for women's cancer screenings and its physical education requirements.

The full report can be found here.

"(The Vermont Cancer Action Network) has a long history of working closely with the Department of Health to help promote Vermont's Ladies First program, but currently the program only reaches approximately one in five eligible Vermont women aged 50-64," Jill Sudhoff-Geurin, the organization's government relations director, said in an email.


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More than 5,025 Vermont women will lack access to cervical cancer screenings, and 2,103 women will lack access to breast cancer screenings in 2014, even with expanded preventive services of the Affordable Care Act, according to estimates Sudhoff-Geurin provided.

Lukas said she had not seen those estimates, and was not sure how Sudhoff-Geurin arrived at her numbers. Sudhoff-Geurin said the estimates come from CDC data and unpublished data collected by the American Cancer Society.

"There is a population of low-income rural Vermonters who aren't accessing any kind of care, and that's a challenge absolutely," Lukas said.

It's a difficult population for health officials to reach, but it's also one that the Department of Health is focused on, Lukas said.

The department has researched audience engagement using focus groups and other outreach tools and found that many low-income rural Vermonters access information online via mobile devices rather than computers, Lukas said.

To that end, the Ladies First program is retooling its website to be mobile friendly, she said.

Lukas acknowledged, as the report states, that federal support for women's cancer screenings has dwindled in recent years. In addition, the sunset of the Catamount health plan has also impacted the Ladies First program, Lukas said.

People covered by Catamount were eligible for free screenings through Ladies First, but women covered by Medicaid aren't. That leaves out many people formerly covered by Catamount who entered Medicaid when the Affordable Care Act expanded that program's income eligibility limits.

"We have a close relationship with Medicaid and we're working with Vermont Health Connect to do in-reach, so even if we're not paying for their screening, we can help that population increase screening rates," Lukas said.

The group also works with Vermont's community health centers and free clinics to raise awareness and find women eligible for free screenings.

The preventive screenings are important, the report says, because the survival rate for breast cancer is 99 percent if detected early but drops to 24 percent if diagnosed at a later stage.

Cervical cancer is completely preventable if caught early, but the survival rate drops to 16 percent with a late diagnosis, according to figures from the American Cancer Society.

Despite the efficacy of screenings, only 51 percent of women in the U.S. received a mammogram in the past year and 83 percent have had a pap test in the past three years.

The rates are significantly lower for the uninsured at 17 percent and 63 percent, respectively, according to the report.