Additional strategies designed for African-American and Hispanic audiences included annual efforts for Minority Cancer Awareness Weeks and NCI’s early detection campaigns—Spike Lee’s Do the Right Thing and Una communidad saludable. Para toda una vida. NCI also worked with the YWCA and the Auxiliary of the National Medical Association to conduct community outreach with free and low-cost mammograms in poor urban areas.

At the same time, the Centers for Disease Control and Prevention (CDC) became active in improving access to mammography. In 1990, CDC block grants created the country’s first national screening program for cervical and breast cancers. Nearly half of all screening tests provided have been for women of racial and ethnic minorities.

Activists played a key role in lobbying for regulatory changes and pressuring government agencies to put breast cancer high on their agendas. As noted, the Komen Foundation played a key role in NCI’s early efforts, initiating White House Breast Cancer Summits and the successful Race for the Cure, the largest series of 5-kilometer runs/fitness walks in the world, raising more than $300 million.

In response to concerns that many providers were using mammography procedures of insufficient quality, Congress enacted the Mammography Quality Standards Act in 1992, requiring all mammography facilities to meet quality criteria in order to operate. The Food and Drug Administration now certifies all mammography facilities in accordance with the act. Important gains also have been made in insurance coverage. In 1985, only two states, Illinois and Virginia, required health insurers to cover the cost of screening mammograms. As of March 15, 2000, all but five states required some insurance coverage. Legislation also has been proposed for Medicaid coverage of annual mammograms and enhanced reimbursement under the Medicare program.

National Breast Cancer Awareness Month—originating as an effort by pharmaceutical companies—is another annual breast cancer awareness promotion, occurring every October. The most ob-