Poor women, especially black women, were disproportionately affected by cervical cancer due to frequent pregnancies, inadequate medical care, and poor hygiene. This caused Macfarlane to originally plan to open her cancer detection clinic to women living in poor areas of Philadelphia, although her associates and the WMCP disapproved of this plan because they thought that a free administering of examinations would reduce the amount of patients who paid for their private medical services. Therefore, the WMCP required that the volunteer examinees for the cancer detection clinic had recommendations from their physicians, prohibiting poor women from being volunteers because they could not afford a private physician.