UICC World Cancer Congress 2006

•Objective: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) is a federally-funded effort designed to increase both access to and the quality of breast and cervical cancer screening for uninsured, low income women; priority populations include women age 50-64, culturally or geographically isolated women, and those who have never or rarely been screened for cervical cancer. The NBCCEDP operated through Cooperative Agreements with states, tribal governments or consortia, and territories. •Methods: Although each NBCCEDP grantee must offer the same screening and diagnostic services, collect standardized data and meet quality standards, the ways in which the programs are designed and operated are not prescribed. Consequently, among the 68 current grantees there are many different systems through which women are recruited, served and followed-up. Each of the basic types of structure – centralized, decentralized, and a hybrid of the two – has both advantages and disadvantages. The economic impact of these organizational decisions are being explored through an analysis that was piloted in 2005 and will collect NBCCEDP-wide data early in 2007. •Results: Increased emphasis on performance-based funding decisions has resulted in various grantees further refining/streamlining their systems and developing more cost efficient operations. The economic analysis will further inform program management decision-making.