Download BasisandPurposeAttachment2006-00156

STATEMENT OF BASIS AND PURPOSE
AND SPECIFIC STATUTORY AUTHORITY FOR
Rules for Breast And Cervical Cancer Screening Program (6 CCR 1015-11)
Adopted by the State Board of Health on
June 21, 2006
Basis and Purpose. These rules implement the requirements of 25-4-1505, C.R.S.,
concerning breast and cervical cancer screening. The executive director of the
department has appointed an advisory board which is recommending these guidelines for
the services of the program and such rules and regulations as may be necessary to effect
the purposes of this part 15. These rules set forth program services and goals to reach
the greatest number of eligible persons. As discussed below, breast and cervical cancer
morbidity and mortality can be reduced if diagnosed early.
House Bill 05-1262 that went into effect on June 2, 2005 provided funding for the
program. Starting in FY 2005-06, section 24-22-117 (2) (d) (I), C.R.S. provides that
sixteen percent (16%) of the tobacco excise tax revenue will be allocated to the Cancer,
Cardiovascular disease, and Chronic Pulmonary Disease Prevention, Early Detection, and
Treatment Fund established by the legislation. Beginning in FY 2005-06 , fourteen
percent (14%) of the amount appropriated to the Fund shall be annually allocated by the
Department to Breast And Cervical Cancer Screening pursuant to Section 25-4-1505,
C.R.S., and to the Department of Health Care Policy and Financing for the Breast And
Cervical Cancer Treatment Program established in Section 26-4-532, C.R.S. This
amount increases annually by 2 percent (2%) up to twenty percent (20%) for the 2008-09
fiscal year and each fiscal year thereafter, not to exceed five million dollars ($5 million).
Specific Statutory Authority. These rules are promulgated pursuant to the following
statute: 25-4-1505(1), C.R.S.
Major Factual and Policy Issues Encountered.
Breast cancer is the single most common life-threatening cancer diagnosed in Colorado
women and the second leading cause of cancer deaths among women in the state. Breast
cancer incidence rates have risen in Colorado over the last two decades partly due to an
increase in mammography screening and an aging population.
However, breast cancer mortality can be reduced by about one-third by annual
mammography combined with clinical breast examination and appropriate and timely
follow-up treatment for women age 50 and older. Mammography leads to early diagnosis
and treatment, which results in decreased mortality. For women aged 40-49, the evidence
that screening mammography reduces mortality from breast cancer is weaker. Because
funds are not available to provide mammagraphy for all eligible women 40-64 years of
age, the priority is for older women, and only those women 40-49 who are at higher risk
D:\493727783.rtf
1
Cancer of the cervix is the 13th most commonly diagnosed cancer among females in
Colorado. Cervical cancer mortality declined by more than 70% in the U.S. since
adoption of the Pap test (Pap smear) in the 1940s. Despite it being one of the most
preventable cancers, each year Colorado has about 160 new cases and 50 deaths. Women
who do not get regular Pap tests are at higher risk for death from invasive cervical cancer.
Additionally, the burden of cervical cancer varies for certain ethnic groups. In 2001,
incidence and mortality rates for Hispanics in Colorado were more than twice those of
non-Hispanic whites.
Colorado’s aging population is projected to double in size from 440,000 currently to 1.1
million by 2030. The need for prevention and screening to identify breast and cervical
cancer in its early and most treatable stage has never been greater.
Alternative Rules Considered and Why Rejected.
The agency did not consider alternative rules because the majority of the standards
established in the rule are mandated in statute.
D:\493727783.rtf
2