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Column: Bill Would Address Cancer Threat Common to Rural North Carolinians

April 20, 2021
In The News

We know there are certain controllable factors that affect our risk of developing cancer. Whether you smoke, what you eat and drink, and how often you exercise can all play a role.

We are also aware that some factors are out of our control, like family history of the disease. What most people do not know, however, is that our ZIP code has an effect on how we experience cancer.

While those of us who live in rural areas are not as likely to get cancer as people in cities, we are more likely to die if we get it. With approximately 40 percent of North Carolinians living in rural areas, this is a fact that deserves our close attention.

We can’t change the fundamental nature of rural living, but changes in cancer screening technology could mean significant progress in closing the rural-urban cancer care gap. And legislation introduced in Congress recently by our own Congressman, U.S. Rep. Richard Hudson, along with his colleagues on both sides of the aisle, is one of the keys to getting us there.

Research from the Centers for Disease Control and Prevention has found that people living in rural areas have lower cancer incidence rates but higher mortality rates. The discrepancy has many causes; among them is simple proximity to health care services.

One of the most troubling realities is that those who live far from population centers are less likely to get screened for cancer. As a result, too many cancers are found late, when outcomes are worse. A report issued by the Geographic Health Equity Alliance found that rural women are less likely to have mammograms or be screened for cervical cancer than women in urban areas, and older adults living on farms or in small towns across the country have lower rates of screening for colorectal cancer.

This all makes intuitive sense. If a clinic or doctor’s office is a significant drive away, we’re less likely to utilize those services until they’re needed. And the closest rural physician office may not have the capacity to do cancer screenings, necessitating an even longer trip for routine checks.

The result is that a higher proportion of people in rural North Carolina are discovering cancers later, when treatment may be less effective. All told, cancer takes the lives of far too many North Carolinians — more than 20,000 just this year, in fact.

There is hope.

Right now, large-scale clinical trials are underway on a new kind of cancer screening that has the potential to make a profound difference in our ability to detect cancer at an earlier stage and enable the kind of treatment that can increase survival rates. This technology, which would complement existing screenings, can detect the unique DNA signatures of many types of cancer with a single draw of blood.

That is a profound improvement on the status quo. Today, only five cancers — breast, colorectal, cervical, “high risk” lung and prostate — have available screenings. With almost three-quarters of all cancer deaths attributable to forms of the disease for which there are no screenings, this blood test represents real hope for all of us.

For rural North Carolina communities, in particular, this technology can flip the script. A blood draw is about as simple a procedure as possible in today’s health care system. The capability exists in practically every doctor’s office today. We’re talking about the potential to begin markedly changing the distressing statistics about cancer deaths everywhere.

The Food and Drug Administration will soon have the chance to evaluate these tests. But that’s not the final hurdle. Without action by Congress, the demographic most at risk for cancer — seniors — will not have ready access to this important advance. That’s why Hudson introduced the Medicare Multi-Cancer Early Detection Coverage Act, and that’s why passing this bill is essential.

By granting Medicare the ability to cover multi-cancer early detection, H.R 1946 could help change the trajectory of a cancer diagnosis. We are proud to stand with more than 300 advocacy organizations — including many of our fellow Grange chapters that prioritize rural health — from across the country in support of this bill.

Those of us who know and love living in the small towns and farmlands of this country aren’t willing to give them up, but the price for this standard of living shouldn’t be a greater likelihood of death from cancer. Thanks to Rep. Hudson, who understands the importance of supporting small-town North Carolinians, solutions are on the horizon. We should be ready to put them to use saving lives.

Betsy Huber is president of the National Grange, and Jimmy Gentry is president of the North Carolina Grange.