BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 359|
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THIRD READING
Bill No: AB 359
Author: Nava (D)
Amended: 7/15/09 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 11-0, 7/8/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley, Wolk
SENATE APPROPRIATIONS COMMITTEE : 13-0, 8/27/09
AYES: Kehoe, Cox, Corbett, Denham, Hancock, Leno, Oropeza,
Price, Runner, Walters, Wolk, Wyland, Yee
ASSEMBLY FLOOR : 77-1, 06/02/09 - See last page for vote
SUBJECT : Breast and cervical cancer
SOURCE : Santa Barbara County
DIGEST : This bill permits a provider for the Every Woman
Counts breast cancer screening program to employ digital
mammography commencing January 1, 2010, and to be
reimbursed by the Every Woman Counts program.
ANALYSIS : Existing law creates, under federal law, the
National Breast and Cervical Cancer Early Detection Program
and authorizes the Centers for Disease Control and
Prevention to administer grants to states for screening
services for eligible underserved women, age 40 years and
older, and requires the Department of Public Health to
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provide for breast and cervical cancer screening services
under the grants in #1) above, at the level of funding
budgeted from state and other resources during the fiscal
year (FY) in which the Legislature has appropriated funds
for this purpose. These screenings are provided under the
Every Woman Counts (EWC) Program and are not deemed an
entitlement. Provides that analog mammography is covered
by the EWC Program.
Background
Digital mammography . One of the most recent advances in
x-ray mammography is digital (computerized) mammography.
Digital mammography is similar to standard (analog)
mammography in that x-rays are used to produce detailed
images of the breast. Digital mammography uses essentially
the same mammography system as analog mammography, but the
system is equipped with a digital receptor and a computer
instead of a film cassette.
To date, studies of digital mammography and standard analog
mammography have shown that digital mammography is
generally comparable to analog in terms of detecting breast
cancer. In 2001, the National Cancer Institute (NCI)
initiated a large trial to compare the two types of
mammography. NCI released preliminary findings which
showed no difference in detecting breast cancer for the
general population of women. However, NCI reported that
women who had dense breasts, were younger than age 50, or
had reached or were near menopause, may benefit from
digital, rather than analog mammography. A study published
in the March 2001 issue of Radiologic Clinics of North
America also found that the use of digital mammography can
lead to fewer callbacks (repeat mammograms) than analog
mammography. Other reported benefits of digital
mammography include:
1. Improved contrast between dense and non-dense breast
tissue.
2. Faster image acquisition.
3. Shorter exam time.
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4. Easier image storage.
5. Physician manipulation of breast images for more
accurate detection.
6. Transmittal of images over phone lines or a network for
remote consultation with other physicians.
Digital mammography systems cost between one and one-half
to four times as much as standard analog mammography
systems. While procedural time saved by using digital
mammography over standard analog mammography justifies part
of the cost for facilities that perform several thousand
mammograms each year, studies are currently underway to
determine whether the high cost of digital mammography is
justifiable in terms of its benefits in detecting breast
cancer.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 9/1/09)
County of Santa Barbara (source)
American Cancer Society
American College of Obstetricians and Gynecologists,
District IX/CA
American Federation of State, County and Municipal
Employees, AFL-CIO
California Commission on the Status of Women
California Communities United Institute
California Health Collaborative
California Primary Care Association
California Radiological Society
City and County of San Francisco
Medical Oncology Association of Southern California, Inc.
ARGUMENTS IN SUPPORT : Proponents state that, as more and
more providers transition to digital mammography equipment,
analog mammography becomes less available and women who
depend on this screening through the Every Woman Counts
Program face an access issue. Proponents further state
that, this bill ensures that a screening option is still
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available in the absence of analog mammography. Proponents
contend that early breast cancer screening leads to early
diagnosis which means a much higher survival rate, and this
bill ensures that women have access to this basic screening
tool.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Tom
Berryhill, Blakeslee, Blumenfield, Brownley, Buchanan,
Caballero, Charles Calderon, Carter, Chesbro, Conway,
Cook, Coto, Davis, De La Torre, De Leon, DeVore, Duvall,
Emmerson, Eng, Evans, Feuer, Fletcher, Fong, Fuentes,
Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore,
Hagman, Hall, Harkey, Hayashi, Hernandez, Hill, Huber,
Huffman, Jeffries, Jones, Knight, Krekorian, Lieu, Logue,
Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,
Nestande, Niello, John A. Perez, V. Manuel Perez,
Portantino, Price, Ruskin, Salas, Saldana, Silva,
Skinner, Smyth, Solorio, Audra Strickland, Swanson,
Torlakson, Torres, Torrico, Tran, Villines, Yamada, Bass
NOES: Nielsen
NO VOTE RECORDED: Bill Berryhill, Block
DLW:do 9/1/09 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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