Guest guest Posted March 9, 2002 Report Share Posted March 9, 2002 What about the interval between the abnormal Pap and diagnosis of cancer? There are no resources to pay for colposcopy for undocumented women with abnormal pap smears, even though we are mandated to do pap smears as part of funded reproductive health care. Is this clearly unethical government policy legal, I wonder? Lily Kay CNM FNP MPH On Thu, 7 Mar 2002, wrote: > > " Along the US-Mexico Border, a Treatable Disease is Still a > >Killer " > > > > > >Associated Press (03.02.02)::Lynn Brezosky > > For women worldwide, the Pap smear has detected cell > >abnormalities that can be treated long before they develop into > >cancer. But mortality rates have held frustratingly steady in > >some regions plagued by poverty, language barriers and young > >motherhood. These rates indicate that women are not getting the > >Pap test or are not pursuing follow-up care when tests show > >abnormalities. > > The 19-county US-Mexico border area known as the Rio Grande > >Valley is one of these regions. Other trouble spots include five > >counties in Maine; 14 counties in rural Alabama; parts of West > >Virginia and California; and concentrations of Native-Americans > >in the Southwest and Alaska. Worldwide, almost 360,000 cases of > >cervical cancer were detected in 1990, with 190,000 women dying > >of the disease. Women in Third World countries have relatively > >high incidences of STDs, including the human papilloma virus, a > >precursor to cervical cancer. By the time the cancer is caught, > >it's often far advanced. > > The incidence rate for cervical cancer in the Rio Grande > >between 1995 and 1997 was 13.6 per 100,000 women. From 1994 to > >1998, that figure was 8.5 per 100,000 women nationwide. Just as > >much a factor is failure at continuing care. Even when a Pap > >smear comes back abnormal, a woman may forego follow-up. The > >results are a regional mortality rate of 3.8 per 100,000, > >compared to 2.3 per 100,000 nationwide. " They may be afraid; they > >don't want to know they're sick. But the message we have to > >convey is: 'Get the Pap,' " said Jane Delgado, president and CEO > >of the National Alliance for Hispanic Health. > > Under the Breast and Cervical Cancer Prevention and > >Treatment Act passed by Congress last year, states are eligible > >for federal Medicaid matching funds to provide free medical care > >to low-income women diagnosed with breast or cervical cancer. > >Texas plans to take advantage of the initiative. A state law > >effective Sept. 1 provides free breast and cervical cancer > >treatment to women who have no insurance but whose incomes are > >too high for Medicaid. > > > > > > To Post a message, send it to: Groups > > To Unsubscribe, send a blank message to: -unsubscribe > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 10, 2002 Report Share Posted March 10, 2002 I agree with you, I have always questioned the ethics of these policies. Some hospitals and private providers also have internatl policies that make it even more challenging. When I worked on this issue, we struggled to find funding for women to have both diagnostic mammograms and other kinds of expensive testing to determine their level/stage, etc, before fed funding kicks in! This is where we worked most with free clinics and volunteer docs who were sympathetic to this terrible dilemma. One thing that continues to happen is that women get very scared if they hear that they need more testing, they think they have cancer or worse, that they are dying, etc, and some have disappeared to follow-up, sometimes going to Mexico or seeking curanderas, etc in other states. As providers, we need to be careful when we explain these tests and follow up procedures to avoid this kinid of problems that result in people getting lost. A > What about the interval between the abnormal Pap and diagnosis of cancer? There are no resources to pay for colposcopy for undocumented women with abnormal pap smears, even though we are mandated to do pap smears as part of funded reproductive health care. Is this clearly unethical government policy legal, I wonder? > > Lily Kay CNM FNP MPH > > On Thu, 7 Mar 2002, wrote: > > > > " Along the US-Mexico Border, a Treatable Disease is Still a > > >Killer " > > > > > > > > >Associated Press (03.02.02)::Lynn Brezosky > > > For women worldwide, the Pap smear has detected cell > > >abnormalities that can be treated long before they develop into > > >cancer. But mortality rates have held frustratingly steady in > > >some regions plagued by poverty, language barriers and young > > >motherhood. These rates indicate that women are not getting the > > >Pap test or are not pursuing follow-up care when tests show > > >abnormalities. > > > The 19-county US-Mexico border area known as the Rio Grande > > >Valley is one of these regions. Other trouble spots include five > > >counties in Maine; 14 counties in rural Alabama; parts of West > > >Virginia and California; and concentrations of Native-Americans > > >in the Southwest and Alaska. Worldwide, almost 360,000 cases of > > >cervical cancer were detected in 1990, with 190,000 women dying > > >of the disease. Women in Third World countries have relatively > > >high incidences of STDs, including the human papilloma virus, a > > >precursor to cervical cancer. By the time the cancer is caught, > > >it's often far advanced. > > > The incidence rate for cervical cancer in the Rio Grande > > >between 1995 and 1997 was 13.6 per 100,000 women. From 1994 to > > >1998, that figure was 8.5 per 100,000 women nationwide. Just as > > >much a factor is failure at continuing care. Even when a Pap > > >smear comes back abnormal, a woman may forego follow-up. The > > >results are a regional mortality rate of 3.8 per 100,000, > > >compared to 2.3 per 100,000 nationwide. " They may be afraid; they > > >don't want to know they're sick. But the message we have to > > >convey is: 'Get the Pap,' " said Jane Delgado, president and CEO > > >of the National Alliance for Hispanic Health. > > > Under the Breast and Cervical Cancer Prevention and > > >Treatment Act passed by Congress last year, states are eligible > > >for federal Medicaid matching funds to provide free medical care > > >to low-income women diagnosed with breast or cervical cancer. > > >Texas plans to take advantage of the initiative. A state law > > >effective Sept. 1 provides free breast and cervical cancer > > >treatment to women who have no insurance but whose incomes are > > >too high for Medicaid. > > > > > > > > > > > To Post a message, send it to: Groups > > > > To Unsubscribe, send a blank message to: -unsubscribe > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2002 Report Share Posted March 11, 2002 In Wichita, KS, there are clinics where women can go and pay according to a sliding scale. I agree that it is very important to thoroughly explain to these women (in Spanish) what is to happen. Written info. in Spanish is also essential. I think this helps to allay fears, though it may not do away with them entirely. The more knowledge they have, the better it is. I have found the following to be good web-sites for information: www.gineconet.com http://www.gineconet.com/articulos/410.htm >>> aunterbe@... 03/10/02 01:05PM >>> I agree with you, I have always questioned the ethics of these policies. Some hospitals and private providers also have internatl policies that make it even more challenging. When I worked on this issue, we struggled to find funding for women to have both diagnostic mammograms and other kinds of expensive testing to determine their level/stage, etc, before fed funding kicks in! This is where we worked most with free clinics and volunteer docs who were sympathetic to this terrible dilemma. One thing that continues to happen is that women get very scared if they hear that they need more testing, they think they have cancer or worse, that they are dying, etc, and some have disappeared to follow-up, sometimes going to Mexico or seeking curanderas, etc in other states. As providers, we need to be careful when we explain these tests and follow up procedures to avoid this kinid of problems that result in people getting lost. A > What about the interval between the abnormal Pap and diagnosis of cancer? There are no resources to pay for colposcopy for undocumented women with abnormal pap smears, even though we are mandated to do pap smears as part of funded reproductive health care. Is this clearly unethical government policy legal, I wonder? > > Lily Kay CNM FNP MPH > > On Thu, 7 Mar 2002, wrote: > > > > " Along the US-Mexico Border, a Treatable Disease is Still a > > >Killer " > > > > > > > > >Associated Press (03.02.02)::Lynn Brezosky > > > For women worldwide, the Pap smear has detected cell > > >abnormalities that can be treated long before they develop into > > >cancer. But mortality rates have held frustratingly steady in > > >some regions plagued by poverty, language barriers and young > > >motherhood. These rates indicate that women are not getting the > > >Pap test or are not pursuing follow-up care when tests show > > >abnormalities. > > > The 19-county US-Mexico border area known as the Rio Grande > > >Valley is one of these regions. Other trouble spots include five > > >counties in Maine; 14 counties in rural Alabama; parts of West > > >Virginia and California; and concentrations of Native-Americans > > >in the Southwest and Alaska. Worldwide, almost 360,000 cases of > > >cervical cancer were detected in 1990, with 190,000 women dying > > >of the disease. Women in Third World countries have relatively > > >high incidences of STDs, including the human papilloma virus, a > > >precursor to cervical cancer. By the time the cancer is caught, > > >it's often far advanced. > > > The incidence rate for cervical cancer in the Rio Grande > > >between 1995 and 1997 was 13.6 per 100,000 women. From 1994 to > > >1998, that figure was 8.5 per 100,000 women nationwide. Just as > > >much a factor is failure at continuing care. Even when a Pap > > >smear comes back abnormal, a woman may forego follow-up. The > > >results are a regional mortality rate of 3.8 per 100,000, > > >compared to 2.3 per 100,000 nationwide. " They may be afraid; they > > >don't want to know they're sick. But the message we have to > > >convey is: 'Get the Pap,' " said Jane Delgado, president and CEO > > >of the National Alliance for Hispanic Health. > > > Under the Breast and Cervical Cancer Prevention and > > >Treatment Act passed by Congress last year, states are eligible > > >for federal Medicaid matching funds to provide free medical care > > >to low-income women diagnosed with breast or cervical cancer. > > >Texas plans to take advantage of the initiative. A state law > > >effective Sept. 1 provides free breast and cervical cancer > > >treatment to women who have no insurance but whose incomes are > > >too high for Medicaid. > > > > > > > > > > > To Post a message, send it to: Groups > > > > To Unsubscribe, send a blank message to: -unsubscribe > > > > Quote Link to comment Share on other sites More sharing options...
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