Frequently Asked Questions

General Questions

What are the risk factors for cancer?
The risk of developing cancer increases as we grow older. Most cancers affect adults 40 years of age and older. Among the known risk factors for cancer, tobacco stands out. Cigarette smoking is associated with more than 85% of all lung cancers and with a substantial proportion of cancers of the bladder, mouth and throat, stomach, pancreas and others. Diet is also a risk factor; higher cancer rates are seen in people who eat a diet high in fat and low in fresh vegetables and fruits. It is estimated that diet and tobacco together may account for approximately 2 out of every 3 cancer deaths.

Does the environment cause cancer?
The answer depends in part on how environment is defined. Many cancer researchers use the word to mean hereditary factors, and therefore, consider things such as tobacco use, diet, alcohol, a woman's age when she has her first child, lifestyle factors, infections and exposure to sunlight. In this very broad sense, it is likely that a large percentage of cancers are environmental in their origin. However, if environment is defined more narrowly as one's surroundings, then the percentage of cancers that can be attributed to the environment is probably small. Most geographic differences in cancer rates seem to result more from the differences between people than from anything in their physical surroundings.

Maryland Department of the Environment

What are signs and symptoms of the various cancers?
Many cancers do not have obvious signs and symptoms until the cancer has spread. It is best to have regular screenings as recommended by the American Cancer Society, the National Institutes of Health, the United States Preventive Services Task Force, the National Comprehensive Cancer Network, and other organizations. Contact your healthcare provider or local health department for additional information.

Breast and Cervical Cancer Program

What are the requirements for participating in the Breast and Cervical Cancer Program?
A woman is eligible for the program's clinical services if she is: 

  • ​Age 40 t0 64 years or 65+ and does not have Medicare Part B
  • A Maryland resident
  • Meets income requirements - at or below 250% of Federal Poverty Guideline. This amount varies by family size
  • Is uninsured or has insurance that does not fully pay for the services provided by this program

A woman may be eligible for the program’s patient navigation services if she meets age and income requirements, is fully insured, but needs help with arranging  breast and cervical cancer screening services (for example, scheduling appointments, transportation, or translation services).​ 

Where can I get a low cost or free clinical breast exam and Pap test if I don't qualify for Breast and Cervical Cancer Program?
Many Federally Qualified Health Centers (FQHCs) provide these services on a sliding fee scale which is based upon income and family size. Local health centers may be found through a search of the Health Resources and Services Administration Website. The Family Planning Department of your Local Health Department may also provide these services for eligible women.
The American Breast Cancer Foundation's Key to Life Program funds breast cancer screenings and diagnostic tests (no funds are available for Pap tests). Contact the Foundation via their website:​ or by calling 1-877-KEY-2-LIFE.

I don't have any health insurance. If I am diagnosed with breast or cervical cancer is there a program that will pay for treatment?
The Maryland Breast and Cervical Cancer Diagnosis and Treatment Program will pay for a diagnostic work-up and treatment for people who qualify for the program.

CRF Cancer Prevention, Education, Screening, and Treatment Program

I do not have Health Insurance. What can the Center for Cancer Prevention and Control (CCPC) do to help me?
The CCPC provides funds to local health departments to provide direct services. Your local health department will be able to provide you with information about age-related cancer screening procedures. Each program has specific eligibility requirements addressing age, income, and insurance coverage, etc.

How do the local Health Departments pay for the screenings?
The State of Maryland receives funds via the Master Settlement Agreement from the tobacco companies and distributes a portion to the Maryland Cigarette Restitution Fund Program and to each local jurisdiction throughout the state based on cancer incidence and mortality. Each local health department conducts outreach with private healthcare providers to perform cancer screening exams.

Do all of the counties address the same cancers and offer the same procedures?
No, there are seven targeted cancers that may be addressed under the Maryland Cigarette Restitution Fund. Local programs decide which cancers they will target with input from their community cancer coalitions. These coalitions are comprised of individuals in the community who have an interest in decreasing the cancer incidence and mortality in their communities.

What are the seven targeted cancers?
The seven cancers targeted by the Maryland Cigarette Restitution Fund chosen due to high incidence and mortality rates across the state and the ability to detect early are: breast cancer; cervical cancer; colorectal cancer; lung cancer; oral cancer; prostate cancer; and, skin (melanoma) cancer.

Do all of the programs pay for screening, diagnosis, and treatment for these cancers?
No, local programs select which targeted cancer or cancers to address. Some programs address more than one cancer. Some local programs pay for screening only and others pay for some treatment services. Local programs do not receive the same amount of funds and therefore do not always provide the same level of service. The local community cancer coalitions provide input about which cancers are addressed and in what manner.

How can a person become a member of the coalitions?
Contact your local health department for further details. You may participate as a representative of an agency, a private business, or as a member of the community. Everyone's input is welcome.

Do local health departments provide cancer education and outreach to community groups?
Local health departments provide varying levels of community outreach and education. Please contact your local health department for more information.

How can we get cancer education print materials for our upcoming community event?
The National Cancer Institute and the American Cancer Society provide a number of educational materials for the general public. Your local health department may be able to provide some print materials on a case-by-case basis.

Maryland Cancer Registry

What is the Maryland Cancer Registry?
The Maryland Cancer Registry (MCR) is a computer-based cancer incidence data system maintained under the direction of the Maryland Department of Health and Mental Hygiene (DHMH) through a contract with a vendor. Data in the registry are used to monitor trends in cancer incidence; identify differences in cancer incidence by age, sex, race, and geographic location; plan and evaluate cancer prevention and control programs in the State; and provide a valuable resource for cancer research.

What if I'm concerned about the number of cancer cases in my neighborhood?
Cancer is common enough that one can expect to see many cases, usually a combination of common and less common types, in any neighborhood. The number of cases that can be expected to occur will depend on the mix of the ages and the ethnic origins of the individuals who live in the neighborhood. For example, in a community of about 1,000 people which includes many young families and persons of all races, one can expect that about 1 to 10 new cases of some type of cancer will be diagnosed every year. In a retirement community of 1,000 people, one can expect many more cases per year, between 12 and 35. The number will also be higher if the neighborhood includes many people with a history of smoking or consuming a lot of alcohol. Because over 50 percent of people diagnosed with cancer will still be alive at least five years after their diagnosis, the number of people in a neighborhood who have ever had cancer will be several times higher than the number of new cases. Cases of cancer among individuals, like many other events, do not necessarily occur in a regular fashion throughout the community; they may appear in little groups among neighboring houses, or people in the same office. This does not necessarily mean that they have the same underlying cause; the grouping may have occurred by chance.

Maryland Cancer Cluster Brochure

What if I'm still concerned?
You can call your local health department. The local health department will coordinate with the Cancer Registry staff to evaluate whether the cancers you are concerned about conform to the usual types and numbers that can be expected to occur in the neighborhood, or whether they seem unusual.

Cancer Surveillance

What is Cancer Surveillance?
Public health surveillance is the ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. It involves the tracking of rates at which people are affected by cancer and is closely integrated with the timely dissemination of information to those who need it.

How are Cancer Surveillance Data Used?
Cancer surveillance utilizes data such as the occurrence of cancer (incidence), cancer deaths (mortality), risk factors for the development of cancer (e.g., smoking, overweight, fruit and vegetable intake), cancer screening behaviors (e.g., the use of mammography, colonoscopy, or Pap tests), and diagnostic and treatment services in the population. Cancer data and information have many uses including planning, policy-making activities, such as resource allocation, evaluation of cancer prevention and control efforts, and applied research into the reasons behind the numbers.

What Databases are Used for Cancer Surveillance in MD?
There are multiple programs and organizations that actively collect and report data for cancer incidence, morbidity, stage, survival, and risk behaviors. Cancer data are collected through state health agencies, federal agencies, academic institutions, and national, voluntary and private sector organizations. See Maryland Cancer Related Database Summaries.