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NORTH CAROLINA <br /> COMPREHENSIVE BREAST AND CERVICAL CANCER CONTROL PROGRAM <br /> CONTRACT ADDENDUM <br /> • <br /> NEEDS <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 /> 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 iii ' 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 /> 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 /> INTERVENTIONS <br /> BREAST SCREENING AND FOLLOW UP: 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 />