Kentucky will get money to increase colon cancer screenings in Louisville and Appalachia, which lag behind recent success

By Melissa Patrick
Kentucky Health News

Kentucky will receive about $2.6 million in federal money over five years to help fight colon cancer by encouraging people to be screened for it, with a focus on populations in Louisville and Appalachia.

“Those regions have large numbers of underserved, underscreened residents,” Gov. Steve Beshear said at a press conference. Screening rates are lower among African Americans, men, the poor and the less educated.

Lt. Gov. Crit Luallen, a colon-cancer survivor, said “Colon cancer is the one cancer we can prevent through early screening and detection. And if it is caught early, it can be treated effectively.”

According to the federal Centers for Disease Control and Prevention, the five-year survival rate for colon cancer is 90 percent when it is found and treated early. In 2013, the last year for which data are available, Kentucky ranked first in colon cancer and fourth in colon-cancer deaths, according to the Colon Cancer Prevention Project.

This Kentucky Cancer Consortium graph shows the
deaths from cancers with evidence-based prevention
or early detection methods in Kentucky in 2005-09.

Kentucky has both the highest rate of new cancers and deaths from cancer in the nation, many of them preventable through early screening and detection. But preventive screening among those who have recently gotten insurance for the first time and those without insurance is not the norm, partly because people who have been accustomed to getting health care only when something seems wrong often don’t understand the importance of preventive screening or that these services are provided free of charge if they have Medicaid or private insurance.

recently reported CDC study found that Americans with insurance or with higher incomes were up to three times more likely than those without coverage or with lower incomes to receive preventive screenings and services, which has certainly been the case with Kentucky’s expanded Medicaid population.

A Department for Medicaid Services report found that preventive screenings rose sharply in 2014 among Medicaid recipients in Kentucky: colorectal cancer screenings rose 108 percent to 35,633; breast cancer screenings rose 111 percent to 51,292; cervical cancer screenings rose 88 percent to 78,281;cholesterol screenings rose 111 percent to 170,514; preventive dental services rose 116 percent to 159,508, to name a few. This increase in preventive care is expected to improve the future health outcomes of Kentuckians and to help decrease future cost by catching problems earlier.

Kentucky has made great strides in fighting colon cancer.

In 2002, the Kentucky Cancer Consortium began an initiative that brought more than 60 different agencies and organizations together to fight colon cancer. At the time, Kentucky’s colorectal-cancer screening rate was next to lowest in the nation, said Dr. Tom Tucker, senior director for cancer surveillance at the University of Kentucky‘s Markey Cancer Center and director of the Kentucky Cancer Registry.
Seven years later, the screening rate rose from one-third of the eligible population (those are 50 or older) having ever been screened to nearly two-thirds. This caused a 24 percent decrease in the incidence of colorectal cancer and a 28 percent drop in deaths from the disease, Tucker said.
“A 24 percent decrease in incidence means that each year 230 Kentucky residents who would have been diagnosed with colorectal cancer no longer get the disease,” he said.
“This is a remarkable public-health accomplishment,” Tucker said. “But we are clearly not done,” since the state still ranks first in colon cancer. “The new grant just announced by the governor will be an essential resource in helping us reach this last one-third of the eligible Kentucky population with lifesaving colorectal screening.”
Since 2012, Kentucky has also provided colorectal screenings to the uninsured through a partnership with the nonprofit Kentucky Cancer Foundation, which matched $1 million in state funds in both 2012 and 2014 to pay for the program.

This year, the legislature passed a law to make sure doctors are coding colonoscopies as screening and not diagnostic, to make sure patients are not charged for the procedure.
Another effort to combat cancer in Kentucky is through the Horses and Hope Program, led by First Lady Jane Beshear, who, along with the Kentucky Cancer Program, Kentucky One Health and the University of Louisville‘s James Graham Brown Cancer Center, is working to raise $1 million for a mobile cancer screening unit which will provide free or reduced-cost cancer screenings across Kentucky.
“Kentucky has transformed into the state with the broadest number of colon-cancer screening options and the lowest barriers for colon-cancer screening,” said Dr. Whitney Jones, founder of the Colon Cancer Prevention Project and co-founder of the Kentucky Cancer Foundation. “Hopefully, we will be one of the first Southern states, if not the first state, to screen 80 percent of our population by 2018.”
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