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NORTH C;tROLINA <br /> <br />COMPREHENSIVE BREAST AND CERVICAL CANCER CONTROL PROGRAM <br /> <br />CONTRACT ADDENDUM <br /> <br />NEEDS <br /> <br /> CERVICAL CANCER: Between 1980 and 1987, 1400 women in North <br />Carolina died of preventable cervical cancer. The age-adjusted <br />mortality rates for the white population are 3.5/100,000 and 10.6 <br />for the black population. For Native Americans, the rate is twice <br />as high as for whites. <br /> The mortality percentage for women age 35 and older has <br />increased from 91% in 1985 to 94% in 1989. <br /> <br /> BREAST CANCER: In 1989, 1099 women died of breast cancer in <br />North Carolina making it the leading cause of cancer deaths in <br />women in the state. North Carolina's mortality rate of <br />26.4/100,000 ranks twenty third in the United States. In race- <br />adjusted mortality rates, white women are 25.6/100,000 and black <br />women are 30.7/100,000. For both races, mortality rates are much <br />higher among older women. In 1986-1987, for example, the mortality <br />for women less than 50 years was 6.4 while that for those 50 and <br />older was 91.4/100,000. <br /> <br /> TARGET POPULATION: Older and minority women in North Carolina <br />are least likely to be screened and most likely to die. The target <br />population includes women who are at or below 200% of poverty, are <br />older, are un-/underinsured and are minorities, including Native <br />Americans. Women who are or have been sexually active, or have <br />reached the age of 18 years are eligible for cervical cancer <br />screening. Women who are 40 years and older are eligible for <br />breast cancer screening. <br /> <br />INTERVENTIONS <br /> <br />BREAST SCREENING AND FOLLOWUP: A Clinical Breast Examination <br />(CBE) and instruction on Self Breast Examination will be provided <br />to each woman screened. Clinical Breast Examination (CBE) will be <br />performed every three years for women 20 - 40 years old and yearly <br />thereafter. Between the ages of 40 and 49 one screening mammogram <br />is allowed every other year, unless the woman is high risk. For <br />women 50 years and older, screening mammograms are provided <br />annually. The woman is considered to be at high risk for breast <br />cancer if one or more of the following conditions apply: <br /> <br /> <br />