You might be one of 800 women in Hawaii walking around with breast cancer and you don't know it. And whether you can be cured depends largely on how soon you find out and start treatment. Every day that goes by with cancer undetected is a day that the cancer can spread and your chance of survival diminishes. If only you had known the importance of early detection.

October is National Breast Cancer Awareness Month and this year its organizers will celebrate 25 years of promoting awareness, education and prevention of the disease.

Timely screening and self-examination are the keys to surviving breast cancer. That's because cancer grows and progresses in "stages." According to the most recent American Cancer Society statistics, breast cancer, in its early stages, has a 98 percent cure rate.

Conversely, the odds of survival decrease as a woman moves into the latter stages of the disease. Late-stage treatment also requires prolonged and debilitating interventions. It is physically more punishing and emotionally more painful, as well as being more expensive, with increasingly uncertain results.

At a time when the nation is embroiled in discussions over health care reform, those in Washington, D.C. would be well served to take a page from breast cancer prevention advocates. Early detection through screening and self-examination allows doctors and patients to begin early treatment. In fact, early detection and early treatment is the basis for quality health care no matter what the disease. But it is especially true in breast cancer, because it is so treatable in its earliest stages.

Based on known diagnosis rates, more than 800 women in Hawaii could have breast cancer right now with no knowledge of their condition. It doesn't have to be that way.

In 2008, we screened 85.1 percent of our female members ages 42-69 in Hawaii. That gave Kaiser Permanente Hawaii the highest ratings in the nation for breast cancer screening rates, according to the National Committee for Quality Assurance's Quality Compass[0xae] report for 2009. Unfortunately, there are still a significant number of women in Hawaii who have not been screened for breast cancer.

To promote community awareness and screening, Kaiser Permanente has removed co-pays and co-insurance from health insurance policies for breast-cancer-screening candidates, which results in a higher standard for all HMO plans in Hawaii. To provide greater access in more rural areas, we've built the nation's first wireless mobile health vehicle with digital mammography to make it easier for women to receive screening services at shopping areas, community centers and employer worksites. And clinical trials to improve treatment options and supportive care to our patients are now available.

Our ultimate goal is for Hawai'i to become the No. 1 state in the nation saving women's lives through early breast cancer detection. It will be difficult, but we are convinced it can be done. But it will take more than just quality health care. Women between the ages of 40-69 also need to take control of their own health, by conducting self-examinations, scheduling an annual mammogram and seeing their doctors annually.

Our community should be proud to know that the best medical care system for mammography screening in the nation is right here in our state at Kaiser Permanente. We will never be satisfied until every mother, sister, wife and daughter is safe from breast cancer. Neither should you.