Mayor Thomas M. Menino

Boston's Crusade Against Cancer Targets Breast Cancer

Mayor Meninoís concern about the quality of life in his city relates directly to his emphasis upon community health. Understanding the importance of preventive health care led him to mount an extensive cancer screening initiative, Bostonís Crusade Against Cancer, as described below.

Bostonís Crusade Against Cancer

Two years ago, Mayor Menino decided it .was time to take concerted action against .the number one killer of adults in Boston: cancer. Furthermore, at least 30 percent .of the new cancers diagnosed each year are preventable. Thus was born the Crusade Against Cancer Ė a partnership between the Boston Public Health Commission and the American Cancer Society to launch an intensive, multifaceted campaign to reduce deaths by cancer in Boston. In order to oversee the increased activity, the public health commission hired a new director of cancer prevention. The following initiatives are a partial list of the Crusade programs that relate directly to reducing breast cancer.

New Policy: 4 Hours Off

This first-in-the-nation policy allows every employee of the City of Boston to use up to four hours each year for cancer screenings. Affecting an estimated 20,000 person workforce, these four hours will not be counted toward a personís sick, personal or vacation time. In addition to encouraging employees to be screened, the city has gone one step further and arranged for breast cancer screenings to be done on site at Boston City Hall .at pre-determined times. Among the growing number of city employees who take advantage of this benefit have been several women diagnosed with breast cancer. This early diagnosis may save their lives. Mayor Menino has also urged other large employers Ė ranging from local companies to the nationís largest employer: the federal government Ė to adopt this policy. This past summer Mayor Menino wrote a letter encouraging President Clinton, an advocate of preventive health, to set an example for the nation by offering federal employees a similar benefit. Vice President Gore responded to the mayorís invitation by directing the Federal Personnel Department to look into adopting this policy.

Community and Expert Input

In 1998 the Mayor convened a panel of .cancer experts, including survivors, to serve as the Cancer Control Task Force, whose mission it was to determine how to ensure equal access to information and services for all Bostonians. This group considered the most recent statistics on the rates of cancer and cancer mortality in Boston and assessed the obstacles to information, screening, and treatment faced by Boston residents. At a community conference in November of 1998, the task force released recommendations to the mayor that included a call for an intensified information campaign, transportation assistance for chemotherapy and radiation patients, and widespread implementation of a time-off policy for cancer screenings.

Transportation to Treatment:
Taxi Voucher Program

Cancer patients who are undergoing .treatment such as chemotherapy should .not have to worry about a ride home; for some patients transportation problems can impede regular treatment. This past summer the Boston Crusade launched a taxi voucher program to provide transportation to or from the hospital for people receiving treatment for cancer. The funds for this program come primarily from the hospitals and from donated vouchers from the taxicab companies.

Mammograms for All Women:
Reducing Disparity in Breast Cancer Mortality

Boston has taken great strides to make mammography accessible for every woman in the city of Boston. The Crusade enlists the strategy of a longstanding public health commission program, Breast Friends, as well as new initiatives such as a mammography van and a community action plan to improve community-based cancer prevention among African American women.

Breast Friends

As detailed in last yearís U.S. Conference .of Mayorís Best Practices for Breast Cancer Awareness Outreach Strategies, the Breast Friends Program of the Boston Public Health Commission educates women in Boston about the risk of breast cancer and encourages women over 40 to get a mammogram. Trainings are conducted in informal, friendly home settings, known as Breast Friends Parties. To make the process easier and less intimidating, Breast Friends staff refer clients directly to mammography services in Boston. Since 1994, over 1,500 women have participated in Breast Friends House Parties in English, Spanish, Haitian Creole, Vietnamese and Chinese, and soon, Cape Verdean. Eighty-five percent of these women have gone for a mammogram after attending a Breast Friends Party.

Mammography Van

This past summer, the Boston Crusade Against Cancer unveiled a new, full service mammography van. Bostonís mammography van is operated in close connection with a local health care provider and Bostonís .community health centers, enabling all women Ė regardless of income or insurance status Ė to get this life-saving procedure.

In its first four months out on the road, .close to 1,300 women have received mammogram exams on the van. For 22 percent .of the women, this was their first screening. Results and a population breakdown follow:

  • 3.5 percent of women screened .positive for suspicious impressions;

  • A malignant impression was found .in one woman, enabling her to get .immediate care for a previously un-.diagnosed condition.

  • Close to 30 percent of the women screened on the van are African American; 25 percent are Hispanic; 11 percent .are Asian; and 22 percent are white.

REACH 2010:
New Demonstration Grant Targeting African American Women with Cancer Screening and Treatment

To address the growing disparity in breast and cervical cancer screening and mortality between African American and White women in Boston, the Boston Public Health Commission has partnered with .a broad coalition that includes physician/ researchers, community members, and the Boston chapter of the National Black Leadership Initiative on Cancer. The Centers for Disease Control and Prevention awarded Boston a demonstration grant to build an inclusive coalition and conduct research in order to improve the model for cancer prevention among African American women.

Media and Public
Information Campaign

To be effective, current information about life choices that reduce the risk of cancer must be presented to Bostonians using a .variety of avenues. The Crusade sought and found a media partner in Bostonís Channel 5, which is featuring cancer as its "HealthBeat" project for 1999, running more than twelve different public service announcements and devoting an episode of its "Chronicle" newsmagazine to the Crusade. Four radio sponsors have each agreed to double their .exposure of cancer-related topics.

Cancer Awareness Brochure

Foremost among the public awareness efforts is an engaging, bilingual informational brochure, which the Crusade is .mailing to every household in Boston. Distribution of the brochure, which includes detailed advice on cancer prevention and available resources, will be especially intensive in low-income neighborhoods.

For more information, please contact:

John Rich, MD
Medical Director
Boston Public Health Commission
telephone: 617/534-5395 or

Janet McGrail, Director,
Office of Cancer Prevention
Boston Public Health Commission
telephone: 617/534-9650


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