It’s hard to believe but today marks 12 years since I started writing these Friday blogs, which means there have now been 625 articles. My first contribution was entitled “To Screen or Not to Screen? That is the Question!”, which concluded with the statement, “Since breast cancer kills 500,000 globally every year, early diagnosis by breast screening could save the lives of many women.” As I pointed out six weeks ago, the WHO has just released its Global Breast Cancer Initiative, laying out a roadmap to save 2.5 million women’s lives by 2040, where the emphasis is on early detection.

In South Africa, the government in 1998 promulgated legislation known as the Medical Schemes Act, in which 271 conditions were defined as qualifying for Prescribed Minimum Benefits (PMBs). This means that all health insurance companies must cover the costs related to the diagnosis, treatment, and care of qualifying conditions. These include breast cancer screening, diagnosis and treatment which encompasses surgery, chemotherapy, and radiation therapy. However, only 16% of South African women have health insurance, while the majority are reliant on a public healthcare system that is chronically underfunded.

In the USA, where 90% of the population has health insurance – 50% through their employer and 40% through government – the support for breast cancer screening and treatment varies considerably. In many cases, if a woman has a mammogram, which is covered by her insurance plan, and the radiologist recommends a follow-up examination because she has dense breast tissue, she must pay for the procedure out of her own pocket. Perhaps understandably, many women do not follow up and are therefore at risk.

On 13 December 2022, two members of Congress – Rosa DeLauro and Brian Fitzpatrick – introduced legislation, the Find It Early Act. Joining them at the announcement were journalist Katie Couric and JoAnn Pushkin, executive director of DenseBreast-info, who are both breast cancer survivors (see all four below right). DeLauro said, “As we all know, when it comes to surviving cancer, early detection is key as 99 percent of women who receive an early diagnosis survive it.”

She continued, “I was diagnosed with breast cancer on June 21, 2022, [and] that became my reality.” The legislation, if passed, would mandate all insurance providers to cover additional screenings including mammograms, ultrasound, and MRI, with no cost-sharing. Since the Find It Early Act has not yet moved forward and been approved by Congress, Pushkin yesterday sent out a request to all DenseBreast-info’s subscribers, encouraging them to contact their member of Congress to seek support for the Act. Here’s hoping they succeed!