The estimated 39 million Americans living below the poverty level have a relative cancer survival rate 10% to 15% below that of other Americans, he said. In general, he said, "we expect 50% of cancer patients to survive their disease." But at least half of the 178,000 persons expected to die in 1989 because their illness was not diagnosed and treated early will be poor, he said.

[Harold P. Freeman] said that less than 45% of those below the federal poverty line are eligible for Medicaid. The rest of those designated as poor by the national standard-which he said is an annual income of $11,200 or less for a family of four-"are too poor for Blue Shield but too rich for Medicaid."

Dr. Jeffrey P. Koplan, assistant surgeon general and director of the center for chronic disease prevention and health promotion for the federal Centers for Disease Control, similarly endorsed the report, saying: "Preventive services and adequate health care directed toward the disenfranchised can provide hope and health in place of devastation and disease."