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Cancer : crf_cpest


Cigarette Restitution Fund
Cancer Prevention, Education, Screening and Treatment Program
Local Public Health Component

The Cancer Prevention, Education, Screening, and Treatment Program (CPEST) provides and administers grants to local health departments and academic centers to reduce cancer mortality and cancer disparities in Maryland.


The Maryland Cigarette Restitution Fund (CRF) was established in 2000 by the Maryland General Assembly (SB896/HB4125) to reduce the cancer incidence and mortality in Maryland. The legislation required the establishment of a local public health component to coordinate efforts in each jurisdiction. The local public health component of the CRF is the Cancer Prevention, Education, Screening, and Treatment Program (CPEST).

The purpose of the CPEST Program is to reduce cancer mortality in Maryland and to reduce disparities in cancer outcomes among whites and ethnic minorities. There are seven targeted cancers identified as priorities under the Maryland Cigarette Restitution Fund Program (CRFP). CRFP funds may be used to provide prevention, early detection, and/or treatment services for the targeted cancers. The seven-targeted cancers are lung and bronchus, colorectal, breast, cervical, prostate, skin (melanoma), and oral cancers.


Beginning in 2001 to 2013, the Department of Health and Mental Hygiene has provided grant funding, based on the formula in the law, to each of the 23 local health departments and Johns Hopkins Institutions and the University of Maryland Medical Group for cancer prevention, education, screening, and treatment. In 2011, each of the 24 local health departments and the University of Maryland Medical Group received grant funding for cancer control.

Of the 24 local health departments, 23 have chosen to focus on colorectal cancer using predominantly colonoscopy as their screening procedure. Several of the grantees have selected to also screen other targeted cancers, such as breast, cervical, oral, prostate or skin cancers. The University of Maryland Medical Group provides breast and cervical cancer screening services. Eligibility for colorectal cancer screening is usually restricted to the following requirements:

  • Ages 50-64
  • Uninsured or underinsured
  • Below 250% of the Federal Poverty Limit
  • County, City, or Maryland Residence

Payment for other cancer screening test(s) or for treatment may be covered in some programs if an individual meets eligibility requirements. All services are subject to the availability of funds

During fiscal year 2013 (July 1, 2012- June 30, 2013), the funds for each local health department ranged from $135,459 to $1,223,000, depending on the incidence and mortality of the targeted cancers within each jurisdiction.


The following information is based on activities that occurred since the inception of the program through June 2013:

Education and Outreach

Conducted 43,873 sessions, educating 1,360,830 persons in the general public, of whom 51% were minorities.
Conducted 5,294 sessions, educating 73,560 health care professionals.

Screening and Diagnosis


22,696 Colonoscopies
8,353    Fecal Occult Blood Test (FOBT)
187       Sigmoidoscopies


5,302 Digital Rectal Examinations
5,769 Prostate Specific Antigens
5,865 Prostate Specific Antigens and/or Digital Rectal Examinations


10,615 Oral Cancer Screenings


11,778 Mammograms
12,288 Clinical Breast Exams


7,348 Pap tests

Skin Exams

2,698 Skin Screenings

  • Awarded over 1,000 subcontracts and mini-grants to local vendors to screen and provide outreach and education.
  • Formed and maintained Community Health Coalitions in 23 counties and Baltimore City to advise the local health officers regarding the best strategies to control cancer.
  • Complied annual inventories of publicly funded cancer programs for each local jurisdiction.
  • Developed an annual comprehensive cancer plan in each jurisdiction.
  • Developed infrastructures, wrote protocols and most jurisdictions began screening for colorectal cancer in the final quarter of fiscal year 2001.

The CPEST Program has created the following initiatives to assist local jurisdictions in carrying out their mission:

  • Created grant guidance documents and reviewed grant applications, budget modifications and expenditures. Awarded grants since 2001 to local health departments and academic centers.
  • Established contract templates for hospital, laboratory, pharmacy and provider contracts.
  • Developed standard Patient Informed Consent forms.
  • Conducted training, technical assistance, and consultation on the targeted cancers through monthly teleconferences, site visits, new staff orientation, outreach staff training sessions, quarterly regional meetings and state wide meetings since 2001.
  • Developed Minimal Clinical Elements for colorectal and prostate cancer in cooperation with the Medical Advisory Committee.
  • Developed Minimal Clinical Elements for oral cancer in cooperation with the Office of Oral Health.
  • Created education and clinical databases from which county specific updates are generated to assist counties to evaluate their programs.

Information about cancers targeted by the CRF

Maryland Colorectal Cancer (CRC) Program Information
Maryland Oral Cancer Program Information
Maryland Prostate Cancer Program Information
Maryland Skin Cancer Program Information

Local Health Department Cancer Programs 

Jurisdiction Contact Number​
Allegany County
Anne Arundel County
Baltimore City
Breast and Cervical Program
University of Maryland Medical Group
Baltimore County
Calvert County
Caroline County
Carroll County
Cecil County
Charles County
Dorchester County
Frederick County
Garrett County
301-895-3111 (toll-free)
Harford County
Howard County
Kent County
Montgomery County
Prince George's County
Queen Anne's County
St. Mary's County
Somerset County
Talbot County
Washington County
Wicomico County
Worcester County


Colorectal Cancer Screening
Education and Training Materials
Frequently Asked Questions