EARLY DETECTION: PROGRAM TARGETS BREAST, CERVICAL CANCER

Jari Southard, a nurse with the Cape Girardeau County Health Department, has a deal for women: free clinical exams, mammograms and pap smears.

But Southard said even when the services are free, women are reluctant to participate.

"People say, `It's not happening to me' or `I'm too young' or `Nobody in my family has breast cancer,'" Southard said.

Her job is to persuade women that early detection of breast or cervical cancer can save their lives.

"Two out of three women with breast cancer don't have a family history of breast cancer," she said. "And we are seeing cervical cancer at an earlier age."

Southard coordinates the Breast and Cervical Cancer Control Project in Cape Girardeau County.

A statewide program, the Missouri Breast and Cervical Cancer Control Project offers women medical tests at no cost if they meet age and income guidelines.

Women 25 or older may get a pelvic exam, Pap test and clinical breast exam.

Women 50 or older can get a pelvic exam, Pap test, clinical breast exam and mammogram.

The income guidelines are based on annual income and size of the family. For example, a woman in a family of two with an annual income of $20,720 qualifies. A woman in a family of four with an annual income of $31,200 qualifies.

Even women with insurance may qualify for the free exams, if the insurance doesn't cover prevention or if the woman hasn't met a deductible.

"The program is set up just like a doctor's office," Southard said. "You call for an appointment, see the nurse practitioner for an exam and then get a referral for a mammogram."

The exam is required before a mammogram can be ordered.

"Early detection means a much better outcome," Southard said.

"The survival rate is much higher and treatment is not as extensive if the cancer is caught in early stages."

In fact, the American Cancer Society released statistics this year that show the breast-cancer death rate declined 5.6 percent between 1990 and 1994, largely due to early detection.

The American Cancer Society also recommends a healthy lifestyle -- exercise, a diet high in fruits and vegetables (and low in fat), modest alcohol intake, and no smoking -- to help reduce the risk of breast cancer.

On average, women who have one drink a day have an 11 percent higher risk of breast cancer than women who don't imbibe.

Women who eat more than five servings of veggies daily have half the risk of developing breast cancer than do women who eat less than three, according to the Journal of the National Cancer Institute.

In fact, one study found that 70 percent of the women subjects who ate a daily mixture of cruciferous vegetables (cabbage, broccoli, brussels sprouts, cauliflower) showed significant reduction in an estrogenic compound believed to cause breast cancer.

Numerous studies also point to the preventive benefits of working out. One such study found that women who do cardiovascular exercise (running, walking, swimming, biking, etc.) 3.8 hours or more a week are less than half as likely to develop breast cancer as are women who get no exercise.

Fifteen to 20 percent of all breast-cancer cases are hereditary, with 5 percent of all breast cancers linked to genetic mutations. But even if you've inherited these mutations, your risk factor is only 56 percent -- considerably lower than the 85 percent suggested by earlier research.