Download cancer control program - Pennsylvania Department of Health

1998-1999 Annual Report
Commonwealth of Pennsylvania
cancer
control
program
Message
from the Secretary
I am pleased to present the 1998-99
State Fiscal Year Annual Report of the
Pennsylvania Department of Health’s
Cancer Control Program. This Report
highlights initiatives the Department
has undertaken in the areas of breast,
cervical, lung, prostate, skin, and
colorectal cancers.
• Funding of prostate cancer studies,
The fact that the numbers of both
newly diagnosed cases of cancer and
cancer deaths are dropping is a tribute
to all the organizations involved in
cancer control and research. We must
continue our collective efforts and
explore every opportunity for further
progress. Here in Pennsylvania some
of our successful initiatives include:
services initiated through our
statewide HealthyWoman Project.
• Eleven researchers funded by
Pennsylvania’s Breast and Cervical
Cancer Income Tax Checkoff Option
are working on cutting-edge research
to reduce the burden of cancer.
• Continuing commitment to educate
the public regarding the importance
of breast and cervical cancer screening, with expanded media efforts to
include skin cancer awareness.
• 271,553 hits since 1995 at the
Helping People Cope: A Guide for
Families Facing Cancer website at
www.oncolink.upenn.edu/
psychosocial/books/cope
• Ongoing promotion of Operation
Hat Check, the Cancer Prevention
and Control Program’s skin cancer
initiative designed to promote sunprotective hats.
• Skin cancer awareness activities continued in all state-funded immunization clinics.
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the promotion of colorectal cancer
screening, initiation of a worksite
cancer screening demonstration
project, and support for youth and
adult tobacco cessation.
• Breast and cervical cancer screening
Nationally, Governor Tom Ridge is
playing a prominent role in the
National Dialogue on Cancer (NDC).
He is leading an NDC initiative
through the National Governors’
Association to facilitate the sharing of
cancer prevention, education, research,
and early detection best-practice models among the states. You can learn
more about the National Dialogue on
Cancer by visiting its website at
www.ndoc.org.
We are very proud of the successes of
the Cancer Control Program and hope
you enjoy reading about these initiatives. We invite you to learn more
about the Department and its programs
by calling 1-877-PA-HEALTH or visiting the Department of Health website
at www.health.state.pa.us.
Robert S. Zimmerman, Jr.
Secretary of Health
Chair’s Message
Every day we learn more about cancer as scientists continue to unravel the
complexities of this disease. As we approach the end of the decade and
prepare to face the challenges of the new millennium, it is clear that Pennsylvania will
continue to be a leader among states in the fight against cancer. For two decades, the
Pennsylvania Department of Health Cancer Control Program has been developing
cutting-edge initiatives to address the needs of Pennsylvanians. The initiatives that you
will read about in this Annual Report exemplify how we have mobilized energy and
resources to make measurable health improvements in Pennsylvania.
The Board and I look forward to working with Governor Ridge, the
American Cancer Society and the National Governors' Association
to develop a National Dialogue on Cancer. With Governor Ridge's
leadership, we will set the tone for an effective cancer control
agenda for the state and the nation.
I am confident that through our continued commitment we will
make a difference in the lives of Pennsylvanians. Let us all continue
to do our part in the fight against cancer.
Mary Simmonds, M.D.
Chair
Pennsylvania Cancer Control, Prevention and Research Advisory Board
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More than 40,000 Pennsylvanians used
the breast and cervical cancer research
line on their income tax returns in 1997,
donating over $280,000 for breast and
cervical cancer research. In 1997,
Governor Tom Ridge signed Act 7,
which enabled individuals to contribute
to breast and cervical cancer research by
either donating a portion of their state
refund or contributing directly to the
Department of Health. Because of
Pennsylvania taxpayers' generosity, 11
cancer researchers received funding to
fight these deadly diseases.
"Breast and cervical cancer remain
major threats to the lives and health of
women in Pennsylvania and to the wellbeing of their families and friends," said
Pennsylvania First Lady Michele Ridge
at a news conference with the Governor
to announce the grant recipients. "That's
why so many concerned citizens work
to educate the public about early detection and treatment of cancer, and why
the importance of cancer research cannot be emphasized enough."
State Distributes Funds for
Breast and Cervical Cancer Research
Microtubule-Stabilizing Agent (+)Discodermolide as an Anti-Breast
Cancer Agent
Kent W. Hunter, Ph.D., Fox Chase
Cancer Center, Genetic Mapping of a
Putative Mammary Tumor Susceptibility
Gene in a Mouse Model
Abass Alavi, M.D., University of
Pennsylvania, Imaging Breast Cancer
with a Dedicated Positron Emission
Tomography Instrument
Michael Cascio, Ph.D., University of
Pittsburgh, Molecular Basis of TCRMucin Interaction
Phouthone Keohavong, Ph.D.,
University of Pittsburgh, p53 Mutations
as Biomarkers for Breast Cancer: The
Topographic Genotyping of Fixative
Breast cancer is the leading cancer diagnosed among Pennsylvania women.
More than 10,700 women were diagnosed with breast cancer in 1996.
The first income tax checkoff grant
recipients are:
Isabella Verdinelli, Ph.D., Carnegie
Mellon, Department of Statistics,
Beyesian Procedures for Breast Cancer
Clinical Trials
Raghbir S. Athwal, Ph.D., Temple
University School of Medicine, Cloning
and Characterization of a Cellular
Senescence Gene for Breast Cancer
Jean J. Latimer, Ph.D., MageeWomens Research Institute/MageeWomens Hospital, DNA Repair and
Somatic Mutation in Breast Cancer
Victor Vogel, M.D., University of
Pittsburgh, Effect of the Selective
Estrogen Response Modulator
Raloxifene on MRI Density of the Breast
in Premenopausal Women
Billy W. Day, Ph.D., University of
Pittsburgh, Evaluation of the Novel
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Treated Breast Biopsy Specimens
Hannah Rabinowich, Ph.D.,
University of Pittsburgh, Regulation of
Death and Survival of Lymphocytes in
the Presence of Fas Ligand-Expressing
Breast Carcinoma Cells
Michael F. Verderame, Ph.D.,
Pennsylvania State University College
of Medicine, The Role of the Protein
Tyrosine Kinase pp60c-src in Breast
Cancer Progression to Estrogen
Independence
Pictured at the Income Tax Checkoff
Grant Awards Press Conference at the
Fox Chase Cancer Center are
Governor and Mrs. Ridge,grant
recipients, and other dignitaries.
State Supports Community-based
Tobacco Prevention Coalitions
More than 22,000 Pennsylvanians die from tobacco-related diseases each year, causing tremendous
emotional toll on individuals and families and creating an enormous drain on the Commonwealth's
medical and health resources. To combat tobacco
use and treat tobacco related illness, the
Commonwealth has invested in state tobacco prevention and control programs that are comprehensive and make use of community partnerships.
In January 1997, the Pennsylvania Department of
Health granted a $2.8 million, five-year contract to
the American Cancer Society, Commonwealth
Division, to establish the Pennsylvania Tobacco
Prevention Network. The Network organizes and
supports statewide, community-based tobacco use
prevention and control coalitions. Composed of
youth and adult volunteers, the coalitions work to
reduce the impact of tobacco use in their communities through youth and adult networks. Network
support of these coalitions includes mini- (less than
$5,000) and maxi- ($5,000 - $20,000) grants to
address the issues of clean indoor air (such as secondhand tobacco smoke), youth access to tobacco
products, medical and other advocacy issues, travel,
school, and sports programs for youth, and training.
Currently, there are 60 community-based tobacco
use prevention coalitions in the Commonwealth.
Initially, the Network awarded over 100 mini- and
ten maxi-grants totaling $462,897. An additional
ten maxi-grants totaling over $174,000 were
awarded for clean indoor air and counter tobacco
advertising. The Network also hosted a statewide
youth conference attended by over 450 youth and
adults and collaborated with STAT (Stop Teenage
Addiction to Tobacco), a nationally recognized
advocacy training organization, for the delivery of
three community workshops. In addition to facilitating ten regional coalition meetings and workshops, the Network developed an alternative sponsorship program so that Pennsylvania's 4-H program would not have to accept tobacco industry
financial support. Approximately $100,000 is also
available to the state's Cooperative Extension agents
through this effort.
Department Funds New Tobacco Initiatives
Working with local and regional partners is one of the most effective ways that
the Department of Health reaches the public about the dangers of cigarette
smoking. In Pennsylvania, 24% of those age 18 and older smoke cigarettes.
Almost 30% of high school seniors, 18% of ninth-graders, 7% of seventhgraders, and 2% of sixth-graders reported that they smoke at least one cigarette
every day. The Department of Health recently awarded contracts to two community partners to prevent and reduce addiction to tobacco.
The Health Promotion Council of Southeastern Pennsylvania, Inc., received a
three-year contract to implement an intensive smoking cessation program in
Delaware County targeting youth and adults. Specific goals are to develop,
implement, and evaluate a recruitment strategy to encourage youth and adults to
enroll in smoking cessation programs. The effort will also include tobacco-cessation programs for youth, strategies for maintenance of tobacco use cessation,
and a system for physicians' offices to initiate conversations with smoking
clients to encourage them to quit.
The Coalition for a Smoke-Free Valley, through Lehigh Valley Hospital, also
received a three-year contract for a variety of approaches to help persons who
use tobacco break their addiction. These include:
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Providing youth cessation and prevention initiatives
Instituting adult intervention/professional education
and consultation services
Promoting smoke-free policies in the workplace
and public venues
Promoting local tobacco addiction services
Collecting, analyzing, and disseminating tobacco-use
related data and information
State Looks at the Cost of Smoking
The availability of timely, accurate, and useful information is a key factor in
planning and implementing public health projects. Data collection permits a
broad assessment of local health status as well as the development of community priorities and partnerships with the Department of Health.
During the past fiscal year, the Department's Bureau of Chronic Diseases and
Injury Prevention funded the Pennsylvania State Data Center to gather information illustrating the health and economic costs of smoking for the people of
Pennsylvania.
The project was conducted in three phases. In phase one, the Data Center surveyed 850 people. Phase two included a report on the health and economic costs
of smoking at the state level and fact sheets on the health and economic costs of
smoking at the county level. The final phase focused on a report on the health
and economic costs of smoking by Pennsylvania state legislative district.
This effort required the careful development of a plan for data collection and
sharing, which recognizes and supports both the need for a core of comparable
data and the need for communities to have flexibility in their ability to collect
and study data. The Department is currently analyzing the data for planning
future initiatives. The data will also be made available to government programs
and community partnerships.
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Program Provides Free Breast and Cervical
Cancer Screening Year Round
PAP Testing in STD Clinics
Targets High-Risk Women
The Cancer Control Program has participated in the National Breast and
Cervical Cancer Early Detection
Project since 1994. Administered by
the Centers for Disease Control and
Prevention, this project was established
to provide needed breast and cervical
cancer screening services to women
who were unable to access such services because of inability to pay for the
services.
The Cancer Control Program has a long history of supporting efforts to reach
Pennsylvania's underserved populations
through effective public health programs.
As a part of this effort, the Program provides funding to the Department's Sexually
Transmitted Disease (STD) Program for
Pap testing of high-risk women.
pelvic examinations, and Pap tests.
Procedures such as ultrasound and colposcopy are also covered.
Through nine major service providers
with over 200 screening sites, more
than 8,000 women received potentially
life-saving cancer screening tests
through the HealthyWoman Project
during this past year.
Now in its sixth year of funding, the
Commonwealth's HealthyWoman
Project provides breast and cervical
cancer screening services to women 40
to 64 years of age with no or limited
insurance and low-to-moderate
incomes. Services include clinical
breast examinations, mammograms,
breast self-examination education,
State Monitoring Former Employees of the
Drake Chemical Company
Since 1994, the Cancer Control
Program has funded the Drake Health
Registry Study, an important preventive public health project that monitors
former employees of a small chemical
manufacturing plant in Lock Haven,
Pennsylvania. The Drake Health
Registry provides free notification,
screening, and diagnostic services to
detect early signs of bladder cancer in
407 workers who are at high risk for
bladder cancer because of possible past
exposures to certain chemicals at the
plant. The Registry maintains a database that provides epidemiological
analysis of morbidity and mortality
among the workers, who were
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employed by the now defunct Drake
Chemical Company and its predecessor, the Kilsdonk Company.
To date, the Drake Health Registry has
identified seven men diagnosed with
bladder cancer. Since the former
employees are aging and many are
approaching the 20-year period for
developing bladder cancer, this is a
critical period for monitoring. Most of
the workers still live within a 50-mile
radius of Lock Haven. Funding for this
study is expected to continue for at
least two additional years.
According to a 1997 survey to determine
the behavioral health risks of Pennsylvania
adults, women with less education and
lower incomes were significantly less likely
to have had Pap tests. Although all sexually
active women are at risk for cervical cancer,
the disease is more common among women
of low socioeconomic status, those with a
history of multiple sex partners or early
onset of sexual intercourse, and smokers.
Many of the women who use these free,
confidential STD clinics have had multiple
sexual partners or sexually transmitted
infections, making them an extremely
important population to target for cervical
cancer screening.
In 1998, 47 of the 82 STD clinics in the
state participated in cervical cancer screening. These clinics saw a total of 17,309
women, and 2,537 (14.7%) received Pap
tests. These numbers represent a modest but
noticeable increase over the past year. By
reaching more women in this underserved
population, the Department aims to increase
awareness about the importance of Pap testing and, as a result, compliance with recommendations for screening.
Facing Breast Cancer
In Pennsylvania
The Pennsylvania
Department of Health fosters
education as part of its goal
to prevent and ultimately
eradicate breast cancer in
Pennsylvania. With these
goals in mind, the
Department-through the
Pennsylvania Breast Cancer
Coalition-sponsors the traveling photo exhibit "67
Women - 67 Counties:
Facing Breast Cancer In
Pennsylvania."
The exhibit provides an
excellent focal point around
which to organize regional
education and information
forums, celebrating and recognizing the life, courage,
hope, and dignity of women
living with breast cancer in
Pennsylvania. This touching
tribute provides a reminder
of the emotional and physical toll of breast cancer on
women and their families
and features at least one
woman from each county,
including women of all ages,
races, and backgrounds.
Currently in its fifth year of
touring, the exhibit has been
displayed in nearly 30 communities. In the 1998-1999
fiscal year, the exhibit was
displayed in the following
counties: Allegheny,
Clearfield, Philadelphia,
Luzerne, Snyder, Blair, and
Armstrong.
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The Great Solar
Survival Test
Through multi-faceted community
education campaigns, the
Department is raising
Pennsylvania's awareness about
the need for sun protection year
round. The sun is a contributing
factor in approximately 90% of all
skin cancers, which is the most
common form of cancer in the
United States. An estimated one
million cases of skin cancer will
be diagnosed in the United States
in 1999. The following programs
are part of the Department's goal
of educating the public about the
risks for skin cancer.
Media Campaign
The Department's Cancer Control
Program is developing a skin cancer media campaign to increase
awareness of risk factors for skin
cancer and to help people pass
"The Great Solar Survival Test."
The "Test" is a way of reminding
the public about what they can do
to protect their skin from the damaging rays of the sun. Tips include
using sunscreen, seeking shade
from 10 a.m. to 4 p.m., and wearing sun-protective hats, sunglasses,
and clothing.
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Operation Hat Check
Now in its second year, Operation
Hat Check focuses on promoting
the use of specially-designed hats
to protect the face, ears, and back
of the neck from sun exposure to
individuals who spend significant
time outdoors due to work or other
activities. More than 10,000 hats,
sunscreen, and lip balm are distributed every year to individuals who
work or spend a significant
amount of time outdoors.
Individuals also receive educational materials about additional ways
to protect themselves from the
sun's harmful rays.
Immunization Clinics
In December 1998, the
Department expanded its skin cancer initiative statewide to all statefunded immunization clinics. A
skin cancer awareness questionnaire is completed by a parent or
adult who brings the child in for
immunizations. Clinic staff
reviews the responses and provides educational material to the
parent. At a subsequent visit, the
adult completes a post-test evaluation to determine how much information has been retained and utilized. More than 3,500 surveys are
being analyzed.
Grade Schools and Day
Care Centers
It is a well-known fact that most
damage to the skin occurs by the
time a person reaches 18 years of
age. As a result, the Department
has contracted with the University
of Pittsburgh Cancer Institute to
develop skin cancer modules for
use in elementary schools (kindergarten through sixth grade) and for
presentations to groups of young
adults in a variety of settings.
Day Care Centers
As part of the Department's skin
cancer initiative targeting children,
their parents, and caregivers, the
Department surveyed all 3,048
state-certified day care centers in
the state to determine baseline
information on sun safe
knowledge and behaviors. An
excellent return rate of over 60%
should provide important information about protecting children from
the sun to child-care groups. The
University of Pittsburgh is currently analyzing the survey results. A
summary report will be provided
to the day care centers to help
them make their facility more "sun
safe."
County and Municipal
Health Departments
Nine of Pennsylvania's county and
municipal health departments are
under contract to the Department
to conduct a variety of skin and
colorectal cancer programs, replicating many of those developed by
the Department. The wide-ranging
efforts include educational programs and media campaigns to
improve public awareness, knowledge, and attitudes about risk factors for skin and colorectal cancers, with a special emphasis on
those at high risk. The Allentown
Health Bureau conducted an educational program with 36 lifeguards employed by the city's
Recreation Department to stress
the importance of sunscreen, hats,
sunglasses, shade, and clothing to
help protect their skin. Bucks
County Department of Health is
using a puppet show with preschool children to teach them
about the benefits and dangers of
the sun.
Rose Marie McDaid, age five months and 20 days,
shows off the first Infant Sun Awareness
Promotion Hat at the Forest County State Health
Center. Lending a helping hand is her grandfather,
retired Bill McDaid of Tionesta.
8
Twelve Years of Cancer Data Now Available
Cancer Incidence Data
The Pennsylvania Cancer Registry
(PCR) now has 12 years of cancer
incidence data. State-specific incidence and mortality data are published annually in the Pennsylvania
Cancer Incidence and Mortality
report, which includes the most recent
five years of data. Data from this and
other statistical reports are available
on the Department of Health's web
site at
www.health.state.pa.us/hpa/Stats/stat_
res.htm. Requests for additional cancer data should be directed to:
Director, Division of Health Statistics,
Pennsylvania Department of Health,
555 Walnut Street, 6th Floor,
Harrisburg, PA 17101-1900, or call
(717) 783-2548.
The National Program of
Cancer Registries
The PCR has participated in the
National Program of Cancer
Registries (NPCR) since 1994.
Administered by the Centers for
Disease Control and Prevention
(CDC), the NPCR was established by
Congress to promote statewide, population-based registries that collect uniform data elements in a standardized
format and meet national standards
for completeness, timeliness, and
quality. Through combined efforts of
the PCR and reporting facilities,
Pennsylvania has made significant
progress in meeting NPCR goals.
PCR Activities and Accomplishments
The PCR conforms to recognized
national cancer registry data standards
by collecting all recommended data
items and using established codes,
definitions, and record layouts for
transmitting and accepting cancer
data. Completeness calculations
reveal the PCR is 97.8% complete for
1995 data. Cancer is reported by all
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acute-care hospitals in the
Commonwealth. PCR staff led the
development of an electronic system
for reporting by private pathology laboratories. This system is used for
reporting by two major laboratories in
Pennsylvania with implementation in
the remaining laboratories anticipated
by July 2000. Efforts are underway to
adopt this electronic system as a
national standard for laboratory
reporting to central cancer registries.
The PCR employs eight certified
tumor registrars to collect, process,
and insure the quality of cancer data
collected and to perform case finding
and re-abstracting audits at reporting
facilities. Eighty percent of PCR cases
are reported electronically. Software
for the remaining 20% is being developed in conjunction with the CDC;
hospital implementation is to begin in
July 1999. The PCR is currently providing assistance to the CDC in the
development of Registry Plus, a PCbased central cancer registry computer
system to be implemented by the PCR
over the coming year. PCR staff is
also involved in developing a module
to automate tumor linkage consolidation functions for incorporation into
Registry Plus. This system will
increase data editing capabilities by
incorporating all recommended edits
and associated data fields and will
facilitate more timely processing of
cancer cases and production of incidence statistics.
Department Funds New Research Projects
The Department of Health supports
research that addresses some of
Pennsylvania's most pressing health
problems. The following are new studies funded by the Department of Health
through the Cancer Control Program.
Prostate Cancer
Prostate cancer is the most common
type of cancer diagnosed among
Pennsylvania men. One in five
American men will contract prostate
cancer, which kills nearly 40,000
Americans each year. The Cancer
Control Program has awarded the
University of Pittsburgh a contract to
use data to develop and evaluate methods for monitoring medical care factors
related to prostate cancer detection and
treatment. The study will gather data
on prostate cancer occurrence rates and
survival, study causes of death after
prostate cancer diagnosis, and determine prostatectomy occurrence rates
and hospital mortality after radical
prostatectomy. The investigation will
also survey 600 men (60-79 years old)
with localized prostate cancer and ask
about information received at time of
diagnosis, treatment selected, and
health-related quality-of-life outcomes.
Survey results will shed light on the
extent to which prostate cancer survivors recall receiving the information
needed to make informed decisions
about treatment. Other expected outcomes include identifying areas of
large occurrence where the Cancer
Control Program may direct specific
interventions.
The Cancer Control Program funds two
prostate cancer studies at the Fox
Chase Cancer Center. The first study
will establish a Prostate Cancer Risk
Registry, which offers a wide range of
services, including the opportunity to
investigate areas of controversy surrounding prostate cancer screening
risks and benefits. The multifaceted
study includes recruiting high-risk individuals for the Registry, establishing
and expanding the computerized database system, identifying hereditary patterns of prostate cancer, and developing educational tools for primary care
physicians at the community and public health level. Registry services will
include risk analysis, screening, DNA
testing, and assistance with treatment
decision making. The second study will
look at patients diagnosed with earlystage prostate cancer to determine factors affecting treatment decision making and sources of information to make
decisions. The goal is to develop written materials and design an intervention which facilitates decision making
and to help inform primary care urologists about the informational and psychological needs of newly diagnosed
patients.
Colorectal Cancer
Colorectal cancer affects men and
women equally and is the third leading
cancer in Pennsylvania. Nearly 10,000
cases of colorectal cancer occur in
Pennsylvania per year with more than
3,500 deaths each year. Through a contract with the Department of Health,
the University of Pittsburgh will test
the feasibility of promoting flexible
sigmoidoscopy as a screening procedure for colorectal cancer on a community-wide scale. Data will focus on
screening outcomes, including compliance with colorectal cancer screening
recommendations, identity of
providers, and satisfaction with screening flexible sigmoidoscopy.
Worksite Cancer Education
The Department of Health has awarded
the Fox Chase Cancer Center a contract to improve employee participation
in cancer education and screening and
to modify behavioral risk for many
types of cancer. The study will develop
a series of worksite educational and
screening programs; it also includes an
annual analysis to determine changes
in employee use of screening.
Pennsylvania Cancer Control, Prevention
and Research Advisory Board Membership
Mary Simmonds, MD, Chairperson
Rodrigue Mortel, MD
Robert S. Zimmerman, Jr.,
Secretary of Health
Michael Rackover, PA-C, MS
Judith Baillis
Samuel Bruner
Karen Robinson, RN, MN
Christine Szarka, MD
Joyce Wilhelm, RN, MSN
Julia Bucher, RN, PhD
Patricia Halpin-Murphy
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1998-99 Cancer Control {Program Funding
Pennsylvania Department of Health (state funds)
Centers for Disease Control and Prevention (federal funds)
Contracts and grants
Personnel/Operating
Special Initiatives
Breast and Cervical Cancer Research
Breast and Cervical Cancer Early Detection
Prevent Block Grant
$ 3,595,000
$ 2,162,000
$ 2,000,000
$ 272,937
$ 3,275,000
$ 303,000
Fiscal Year 1998-1999 Contracts
American Cancer Society
$ 221,774
University of Pittsburgh
Bucks County Health Department
$ 48,000
Erie County Health Department
$ 24,330
Skin cancer initiative
$ 236,246
Montgomery County Health Department
$ 37,797
Drake bladder screening
$ 149,603
Philadelphia Department of Public Health
$ 91,922
Wilkes-Barre City Health Department
$ 27,794
$ 23,000
Annual report
$ 8,000
Special contract
$600,000
York City Bureau of Health
Prostate and colorectal studies
$ 402,350
Fox Chase Cancer Center
Breast cancer research projects
$ 124,964
Breast cancer research project
Pennsylvania State University
PA Cancer Pain Initiative
Special contract
Breast cancer research project
$ 84,523
$ 600,000
$ 25,000
University of Pennsylvania
Census/registry analysis
Special contract
Breast cancer research project
Northeast Regional Cancer Institute
$ 25,970
$ 600,000
$ 24,924
$ 200,000
Thomas Jefferson University
Special contract
Pap testing in STD clinics
Jeanes Hospital
$ 500,000
$ 45,900
$ 500,000
Allentown Health Bureau
$ 21,166
Bethelem Health Bureau
$ 23,000
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Two prostate cancer projects; one work site
$ 716,902
$ 23,049
Lehigh Valley Hospital/Coalition for
a Smoke-Free Valley
$ 125,000
Health Promotion Council of Southeastern PA
$ 117,981
Allegheny University of the Health Sciences
$ 100,000
The Neiman Group
$ 600,000
The Pennsylvania Breast Cancer Coalition
$ 80,835
Penn State Data Center
$ 64,226
Magee-Womens Research Institute
$ 25,000
Carnegie Mellon University
$25,000
Temple University School of Medicine
$25,000