EDITORIAL: Cancer stats carry message

ANYONE WHO HAS HAD CANCER or known someone with a cancer diagnosis can appreciate the title of the American Cancer Society report released this week: The Cancer Burden in New York State. But this report uses the charts, graphs and data summaries to suggest ways to address the financial and social costs of cancer as well as ways to reduce the incidence of this disease and the deaths it causes.

The study concentrates on the four most prevalent forms of cancer in the state in 2004 to 2008: prostate, breast, lung and colorectal, which together account for more than half the reported cases of cancer in this county and half the cancer deaths. The authors also urge readers not to place too much confidence on the samples involve only a small number of people, which may be the case for some Columbia County data.

Taking a broader view, the reports finds the rate of death–mortality–for men and women from all types of cancer, not just the four mentioned above, is lower statewide than the national average. That makes it easy to imagine that living in a beautiful and relatively unpolluted upstate county means you aren’t exposed to whatever causes cancers… except that the data say otherwise. The lowest rates of both the incidence of all types of cancer and cancer mortality are found in New York City. When you leave the city out of the equation, upstate rates overall are higher than the national average.

The report attributes this disparity in large part to the city’s efforts to reduce all forms of tobacco use, whereas efforts have waned upstate, where smoking rates remain high. With that in mind, the authors exclude New York  City cancer rates when comparing cancer rates in upstate counties like ours with the rest of the state. In other words, you can’t blame the city for what ails us here.

Let’s turn, though, to some good news: Compared to the rest of upstate New York, Columbia County ranks well below the statewide average in both the incidence of all types of cancer combined and mortality from the disease. Narrowing the focus, that welcome news is also true for breast cancer, with fewer cases diagnosed and fewer women dying from the disease compared to the rate for all of the state outside of New York City. The statistics for prostate and colorectal cancer are more mixed.

The bad news is that the incidence of cancer overall has increased in the county since the 1990s, and the specific figures are not ambiguous for lung cancer in men, for whom both the incidence and the mortality rates are well above the upstate average. The report includes a map of the rate of smoking in each county, and while we don’t have the highest in the state, at 23% of the population, there are a lot of people still smoking here. The report suggests that most of them are probably folks who can least afford the habit or the medical care they’ll need if their habit makes them ill.

The Cancer Society also says it’s not only poor people who get hit hard by the costs of healthcare following a cancer diagnosis. The report cites a survey that found 25% of cancer patients said they used “all or most of their savings” on their cancer care.

The report’s public policy recommendations say that we could lower cancer death rates if, for instance, the rest of us New Yorkers would get as serious about fighting smoking as New York City. Among other points the report also voices support for the type of state health insurance exchange initiated by Governor Cuomo. The exchanges are part of the federal Affordable Care Act, also known as Obamacare.

Last week, the Republican majority in the House of Representatives, including Congressman Chris Gibson (R-20th), voted symbolically, again, to repeal the healthcare act. So the question raised by this report is whether the House majority has an alternative plan for lowering cancer rates and providing more comprehensive care.

This isn’t an abstract political point. The people of this county are old compared to the state average, and after 65 is when most cancer diagnoses occur. The report says that each week in Columbia County eight people are diagnosed with cancer and three others die of the disease. Surely no law can eliminate cancer, but abolishing one that expands access to testing and treatment is the worst possible way to make progress in combating this scourge.




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