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Revised 02 112197 <br /> Orange County <br /> NORTH CARD INA COMPREHENSIVE B FAST ND CERVICA—L CANCER CONTROL. PROGRAM <br /> CONTRACT ADDENDUM <br /> For the i2efiod Jab 1 1997- June 30, 1998 <br /> STATEMENT OF NEED <br /> CERVICAL CANCER: Between 1988 and 1992, 690 women in North Carolina died of preventable <br /> cervical cancer. The age-adjusted mortality rates for the period was 4.0/100,000. However the death rate among <br /> Native Americans is twice that of whites, while mortality among blacks is three times higher than whites.Cervical <br /> cancer deaths are preventable in most cases through early detection and treatment. North Carolina ranks ninth <br /> in the nation for cervical cancer deaths; twelfth in the nation for related deaths among white women, and fourth <br /> highest for black women. In 1997, 460 new cases of invasive cervical cancer are expected with as many as 150 <br /> projected deaths. <br /> BREAST CANCER: Breast cancer is the most commonly diagnosed cancer and the second leading cause <br /> .of cancer deaths among women in the United States. In 1992, 1127 women died of breast cancer in North <br /> Carolina making it the second leading cause of cancer deaths among women in the state. North Carolina's age- <br /> adjusted mortality rate for 1988-1992 was 29.2/100,000. Black women have higher mortality than white women <br /> from breast cancer. Women over age 50 years have a mortality rate from breast cancer about fifteen times greater <br /> than women under age 50. In North Carolina in 1997, more than 5140 new cases of breast cancer are expected <br /> and nearly 1250 projected deaths from breast cancer will occur. <br /> I. TARGET POPULATION <br /> A. All women provided services through this program will have gross incomes that are less than or <br /> equal to 200% of the federal poverty level according to schedules in effect at the beginning of the <br /> contract term. <br /> B. At least 75% of the women provided services will be aged 50 years or older. <br /> C. Services should be targeted to women of ethnic minorities, those uninsured or underinsured, or <br /> without a usual source of health care. <br /> 11. SERVICES TO BE PROVIDED <br /> A. The following comprehensive screening services will be provided to all age-eligible women in the <br /> BCCCP: <br /> 1. Clinical Breast Examination; <br /> 2. Screening Mammogram; <br /> 3. Pelvic Examination; <br /> 4. Pap Smear; and <br /> 5. Instruction in Self Breast Examination. <br />