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Forward in an era of reform : new directions for cancer screening
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    Background -- Impact of health care reform on NBCCEDP -- Public health roles in cancer screening -- Expanded roles in clinical preventive services and community-clinical linkages -- CDC program preparation for health care reform.

    In 1990, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) was established to increase breast and cervical cancer screening among low-income, uninsured, and under-insured women. Twenty years later, NBCCEDP has a substantial infrastructure across the nation and effective systems to reach underserved communities and assure timely follow-up and treatment.

    Health care reform through the Affordable Care Act (ACA) will increase access to breast and cervical cancer screening services for many low-income, underserved women through expanded insurance coverage and eliminating cost-sharing. Other provisions of the ACA and the American Reinvestment and Recovery Act (ARRA, the stimulus bill) will also improve delivery of these essential services by improving health care quality and driving wider adoption of electronic health records. However, all ACA provisions will not be implemented until 2015 and some effects will take longer. Currently, even with adequate health insurance, many women will still face substantial barriers to obtaining breast and cervical cancer screening such as geographic isolation, limited health literacy or self-efficacy, lack of provider recommendation, inconvenient times to access services, and language barriers.

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