Low-income women in at least 20 states are being turned way for free cancer screenings, or they are being placed on interminable waiting lists, as unemployment hovers at 10 percent and more people go without health insurance, according to the Associated Press.

Candidates who would have normally qualified for free mammograms and Pap smears during better economic times were rejected between July 2008 through April 2009, according to an unofficial survey of programs across the nation, AP reported, citing the American Cancer Society's Action Network. It was unknown exactly how many women were turned away.

The issue is particularly worrisome to the African American community. Black women are 40 percent more likely to die from breast cancer than white women, despite a decade-long decline in overall death rates, according to the American Cancer Society. Part of the problem is detection, which is caused by a lack of affordable health care; poor diet; and exercise routines, genetics, environmental factors, among other things, medical experts say.
This year in New York, for example, screenings were limited to high-risk patients and excluded women under 50 due to budget constraints. New York used to offer the services for free.

While the percentage of diagnoses due to mammograms is unknown, the American Cancer Society says women have a 98 percent survival rate when the cancer is detected at its earliest phase, stage 1. Chances of survival decreases to about 84 percent during stages II and III, and just 27 percent at stage IV, the most advanced level. Test costs vary, with mammograms averaging about $100 and Pap screens up to $200.

News of the screening shutouts comes on the heels of a recent controversial report by the U. S. Preventive Services Task Force, which recommended that mammogram screening begin at the 50 and be conducted at two-year intervals. The American Cancer Society balked at the recommendation and stood by its long-standing position that annual exams should start at 40.