El Paso Targets Low Income Women for Breast Cancer Screening
In First Year of Program, Screening and Mammography Available Throughout City

A high percentage of El Paso's residents live in low socioeconomic communities and cannot afford the cost of preventive health care. Too often, women living in these communities were being diagnosed with breast cancer in the later stages of the disease when treatment is costly and less effective. Today, however, El Paso is ensuring that these women are being reached with early breast cancer screening services.

Fast Start for Outreach and Screening
In the summer of 1997, the Mayor and the City Council recognized the need to improve screening services aimed at early detection and prevention of breast cancer. By September, the Mayor and Council had provided Community Development Block Grant funds, augmented by general fund monies, to the El Paso City-County Health and Environmental District to establish a Cancer Screening Program. Within the program, in the area of breast cancer specifically, the program goals were to provide underserved El Paso women with clinical examinations, individual breast self-examination instruction, and client referral to local medical facilities - the Texas Tech Medical Center and Thomason General Hospital - for screening mammography. Just one month after funds for the initiative were provided, the Health and Environmental District's Westside Health Center scheduled the first appointments for client screenings. To build on this success, the District quickly enlisted the local media to help raise awareness of the program and increase participation in it. Promotional visits also were made to local businesses, shopping centers, and schools, and flyers on the program went to local factories, the community college, federal housing projects, churches, and senior citizen centers.

Rapid Expansion of Services
By December, the District was able to reach out to special populations, extending screening services, with emphasis on breast cancer, to the City's shelter for battered women. A bus transported women from the shelter to the Westside Health Center where the newly-formed cancer screening team - consisting of a registered nurse, medical aide, and clerk - was based. In addition, and for the first time, breast cancer screening was provided to residents of the smaller towns in El Paso County.

Three months later, screening services were extended throughout the City. Beginning in March, other community health centers became screening sites by hosting visits of the cancer screening team. As women with little access to transportation found that they could obtain breast cancer screening services in their own neighborhoods, the number of monthly visits to the health centers increased. Mammography, however, continued to be provided in only one location, the County's hospital, and the Health District soon realized that it, too, should be neighborhood-based.

In July, the District entered into an agreement with the Texas Tech Medical Center for its University Breast Care Van to offer mammography at four community health centers. The centers schedule appointments for clinical breast cancer exams to coincide with the van's arrival. Officials in El Paso report that the response to this service has been excellent, as women needing mammograms no longer must seek appointments at two different facilities; all screening services now are available in their neighborhoods. The Komen Foundation has supported the mammograms for under-served women with funds raised during its yearly "Race for the Cure" event. The women who qualify for this support are low income, under-insured and uninsured.

Early Program Successes
Because large numbers of women are responding to El Paso's breast cancer initiative, cancers are being identified in their earlier stages when treatment can be more effective. From September 1997 to June 1998, 846 women received clinical examinations at four of the Health District's community health centers. In a three-month period at one of these facilities - the Rawlings Community Health Center, centrally located in the City - 93 women were provided clinical breast screenings. Four of the women had abnormal screenings and were referred for diagnostic mammography; two of the women were diagnosed with breast cancer, underwent surgery, and are receiving appropriate follow-up care.

Mayor Ramirez and the City Council are providing funding to support the cancer screening program for the coming year, and the Mayor is promoting greater outreach through the City's involvement in the Pink Ribbon Wreath Ceremony and National Breast Cancer Awareness Month in October, events widely covered in the mass media.

Additional information on El Paso's Cancer Screening Program is available from Dr. Jorge C. Magana, Director of the El Paso City-County Health and Environmental District, at (915) 771-5701.

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