Cancer Education Programs Need Not Be Expensive

FORT LAUDERDALE, Fla--Cancer education and screening in the worksiteneed not be an expensive venture, several speakers said at a sessionon costs at the Industries' Coalition Against Cancer (ICAC) conference.

Carolyn Messner, ACSW, of Cancer Care, Inc., a social work agencyproviding free guidance to cancer patients and their families,has set up lunch-time cancer education programs at various workplacesat an average cost of only about $1 per attendee.

But such low costs are only possible if the speakers waive theircustomary fees. "You need to cultivate pro bono speakersfor these workshops," she said. "You have to make themfeel important, acknowledge their contribution, and provide speakervisibility."

Robert Zullo, MD, corporate medical director for Employee Health,Merck & Co., described how his company reduced the numberof smokers at Merck worksites in the United States with a programthat costs only $75 per employee.

A nonsmoking policy was initiated in 1988. "It's a totalsite ban, and at some large sites that means a smoker may haveto walk over a mile to the gate to have a cigarette," hesaid.

Smoking Declined by 20%

The ban was accompanied by smoking cessation programs and educationseminars to help smokers quit. Dr. Zullo said that, by 1991, asurvey showed that the incidence of smoking had declined by about20%. In addition, 45% of the smoking population said that theMerck policy had motivated them to quit or cut down their smoking.

Unlike these "shoestring" cancer prevention projects,onsite mammography screening does not come cheaply. For its program,the Coors Brewing Company did not purchase the equipment itself,but estimates that the vendor spent some $200,000 to set up themammography unit, and the company's ongoing expense of operationis around $25,000 a month.

"Over the 10 years of this program, it has cost Coors closeto $800,000 to offer these screenings, plus between $10,000 and$11,000 more as a result of further required testing," saidwellness specialist Mary Greenwood, MS. But she estimates thatthe company has saved close to $5 million due to early diseasedetection.

Through the years, 51 malignancies have been found through theprogram, and all but four have been early detections. The currentcost of treating an early detection is about $28,000, she said,compared with $193,000 for treating late-stage disease.

To make women aware of the program, the company uses a networkingsystem of 45 women placed strategically around the company. "Wechose them for where they worked," she said. "We wantedwomen who would be in touch with lots of other women and who wouldliterally talk each other into going to get a mammogram."

Female workers are bombarded with the message, in the weekly newspaper,through lectures, workshops, lunch programs, BSE clinics, showercards, and posters. Ms. Greenwood noted that the posters are placednot only in the women's restrooms but also in the men's, sinceCoors' workforce is 77% male and the program is open to spouses.

'Roses Are Red'

One memorable promotional event centered on Valentines Day: Theposters in the restrooms read: Roses are red, violets are blue,to show I care, I scheduled a mammogram for you. "I don'tknow if these guys were really hard up for valentines or what,but they just jumped on this," Ms. Greenwood said. The mammographyunit was booked solid for several months afterwards.

Ernst Wynder, MD, president and chief medical director, AmericanHealth Foundation, advocates health education programs beginningin the preschool years, since behavior patterns, especially eatinghabits, are established early in life.

Dr. Wynder noted that he came to the United States from Germanyand still retains the tastes developed there as a child: "Inever did learn to like peanut butter, but in my part of Germany,we ate noodles with sugar and gooseberries, and my mouth watersas I mention it to you today."

He suggested that every school child should be given an annualhealth survey to ascertain attitude, knowledge, and behavior.The American Health Foundation is sponsoring a program that providesan individualized "health passport" to children, showingtheir disease risks based on their diet and other health habits."Their behavior changed more effectively with the passportsthan if we had given them only words," he said.