Access to new tests could help curb cancer mortality rates
Cancer presents multiple conundrums. How, for example, have we been able to make such extraordinary advances in cancer treatments and still have a mortality rate that is unacceptably
Stephen C. Coye is president of the New York State Grange. high? Nearly 34,000 New Yorkers are projected to die of cancer this year alone. And why is it that people in rural areas have a lower cancer incidence rate but are more likely to die from the disease once they have it?
To answer these questions, we have to delve into the state and accessibility of cancer screening.
When it comes to saving lives, the world’s most innovative cancer treatments won’t make much of a difference if a cancer isn’t detected early enough. When a cancerous tumor is found at an early stage, five-year survival rates are approximately 90 percent. When a cancer has had time to spread, those survival rates plummet. Unfortunately, our ability to screen for cancers has been limited by both technology and geography.
There are dozens of cancers but we have the capability to screen for only five of them — breast, cervical, colorectal, lung, and prostate. People are dying of liver cancer, stomach cancer, pancreatic cancer and many other variations of the disease because the screening doesn’t exist to detect them at an early stage. Consequently, roughly seven of every 10 cancer deaths are from one of those types that can’t yet be detected early.
Lack of access to cancer screenings is exacerbated in our rural areas. People who live in New York’s less-populated areas
may not have major health centers within easy driving distance, so colonoscopies and mammograms aren’t as accessible as they are in Manhattan or Brooklyn. As an example, the state Health Department found that in a 10-county rural area of northern New York, Medicaid beneficiaries had a noticeably lower rate of colorectal screenings than enrollees in other parts of the state. This helps explain why our rural citizens tend to have higher cancer mortality rates even with fewer per capita cases — their cancers aren’t being detected early.
There is a scientific development that may help address this problem. Largescale clinical testing has been taking place with new technologies that can detect dozens of cancers, with impressively high accuracy and a very low false positive rate. Researchers have found that cancerous tumors shed unique DNA particles in the bloodstream. These simple blood tests can identify those DNA signatures and identify the type and location of a cancer, even if the patient isn’t symptomatic.
This is profoundly important from two standpoints. It is a significant complement to the cancer screenings that currently exist and holds the promise to save countless lives. It is also easy to bring a noninvasive blood draw to rural clinics.
Hopefully, Food and Drug Administration approval of these multi-cancer early detection technologies is not too far off. When that occurs, it is critical that these tests be accessible to those who can benefit most from them. Senior citizens represent an important starting point. They comprise the age group most susceptible to cancer, and our rural areas — with limited access to cancer screenings — tend to skew older. The problem is that Medicare does not offer immediate coverage of new Fda-approved cancer screening tools and the bureaucratic processes required to gain coverage can potentially take years to complete.
Legislation introduced in both houses of Congress would address this problem and allow Medicare to offer coverage for this innovative screening, making it accessible for millions of older Americans. Lawmakers should pass this bill expeditiously so that the pathway is there as soon as the FDA approves these new cancer screening technologies for use. We have been at a loss for answers as to how to significantly reduce cancer mortality rates, particularly in our rural areas. Hopefully, help will soon be on the way.