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Supporting Annual Pap Test Screenings for Women
in the Medicare Program

September 27, 2000

The Honorable William Thomas
Chairman, Ways and Means Health Subcommittee
U.S. House of Representatives
Longworth House Office Building
Washington, D.C. 20515

Dear Chairman Thomas:

As the House Ways and Means Committee considers Medicare refinements with respect to the Balanced Budget Act of 1997 (BBA), the undersigned organizations strongly urge you to include language that would provide annual coverage of screening Pap tests and pelvic examination for Medicare beneficiaries. Representatives Clay Shaw and Karen Thurman have introduced the Providing Annual Pap Tests to Save Women's Lives Act of 2000, H.R. 4571, which would give all women in the Medicare program access to this life-saving test on an annual basis.

Currently, Medicare coverage of Pap test screening is only once every three years. In 1997, as part of the enactment of the BBA, Congress made important initial steps to increase a woman's chance of early detection of cervical cancer by providing annual Pap tests and pelvic exams for women who meet certain "high risk" criteria. However, because early detection is key for survival of cervical cancer, we believe it is imperative that Congress take the next step in preventive health care for our nation's women Medicare beneficiaries by providing coverage of annual Pap test screenings. As you know, in 1997 Congress realized the importance of preventive screening for cancer in the BBA by authorizing annual prostate cancer screening for men over the age of 50. Women in Medicare deserve the same opportunities for early detection of cervical cancer.

No cancer screening test in medical history has proved as effective for early detection of cancer as the Pap test. Since its introduction shortly after World War II, death rates from cervical cancer have decreased 70 percent in the United States. However, despite the Pap test's unparalleled record of success, studies show that of those women who die of cervical cancer, 80 percent had not had a Pap test in the five years preceding their deaths. A January 1999 report on cervical cancer by the Agency for Healthcare Research and Quality found that cancer deaths, cancer cases and the percentage of false negatives are reduced with annual screening tests.

In light of the critical role Pap test screening and pelvic examinations play in the health and well-being of all women, we urge you to include language that would fill the void that currently exists in preventive health care for Medicare women across the country. Please feel free to contact any of the organizations listed below if we can provide any additional information to you or your staff.


College of American Pathologists
American College of Obstetricians and Gynecologists
American Osteopathic Association
American College of Osteopathic Family Physicians
American Society of Reproductive Medicine
American Medical Women's Association
American College of Physicians - American Society of Internal Medicine
American Society of Cytopathology
American College of Nurse-Midwives

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