The passage of the Breast and Cervical Cancer Mortality Prevention Act established a nationwide, comprehensive public health program to increase access to breast and cervical cancer screening services for women who are medically underserved. This act created the first opportunity for state health agencies to build a public health infrastructure for cancer control at the state and community levels. The Congress appropriated $30 million in fiscal year 1991 for the first year of this program. In the summer of 1991, the Centers for Disease Control and Prevention (CDC) used a competitive application process to fund the first eight states to establish early detection programs. Since then, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) has become a nationwide program with a budget of $100 million. Thirty-five states and nine American Indian Tribes are supported to implement comprehensive screening programs. Fifteen states, three territories, and the District of Columbia receive planning and infrastructure grants as part of the Capacity Building Program. The NBCCEDP surveillance data through January 31, 1995 shows that 556,003 screening tests have been provided to women who are medically underserved. The success of NBCCEDP has contributed to the growing pressure on state health agencies to focus more attention and resources on chronic disease prevention and control.