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Mountain residents most likely to have killer cancer




CHARLESTON, W.Va.

Residents of rural Appalachia are more likely than residents of other regions to die from the second most common form of cancer, a grim distinction partly attributable to the widespread lack of health insurance.

Throughout rural Appalachia, colorectal cancer rates tend to be higher than the national average.

The federal study found that Appalachian states of West Virgnia, Kentucky, Ohio, Tennessee and Mississippi rank in the top 10.

About 22 West Virginians per 100,000 residents die every year from colorectal cancer, the federal Agency for Healthcare Research and Quality reported recently, putting West Virginia behind every other state and the District of Columbia. In Kentucky, the rate 22.7 per 100,000 residents.

Nationally, the average fatality rate is 17.8 per 100,000. Roughly 150,000 new cases of the cancer will be diagnosed nationwide this year, the American Cancer Society estimates, and roughly 50,000 people in 2008 will die from the disease.

That’s especially frustrating for doctors and health care advocates because colorectal cancer not only has a high survival rate if detected early, but can actually be prevented if screenings detect abnormalities that may become cancerous.

Yet only about 40 percent of patients across the country are screened appropriately, according to the West Virginia Comprehensive Cancer Program. There are multiple reasons for that: embarrassment, lack of awareness and false ideas about the disease.

The main reason more West Virginians are not screened is a lack of health insurance, said Nancy Roach with the Colorectal Cancer Coalition, a national group working to boost screening rates. More than 245,000 West Virginians are uninsured.

Insurance isn’t the only barrier. In a rural state like West Virginia, some patients have to travel long distances to see a doctor.

The coalition hopes to help remedy that situation by pushing for passage of a bill in Congress that would establish a screening and treatment program through the federal Centers for Disease Control for low-income, uninsured and poorly insured individuals who don’t qualify for Medicare.

The initiative is needed, advocates say, because the cost of screenings can be high – a colonoscopy usually costs about $1,500 – although there are less expensive blood tests that can also be used to detect cancer.

“There are some areas within West Virginia that have a fairly low screening rate,” said Dr. Wade Douglas, assistant professor of surgical oncology at the Edwards Comprehensive Cancer Center in Huntington. “The more populated areas have higher rates, but in rural areas people have a hard time getting access to care.”

That’s a familiar problem for Pam Seijo. She was diagnosed with colorectal cancer at the age of 39; doctors gave the Beckley resident a year and a half to live.

“They told me it was inoperable, and they told me to go home and get my life in order,” she said.

Seven years later, after surgery and in the midst of ongoing chemotherapy, Seijo has become a dedicated campaigner working with the state comprehensive cancer program to persuade people of the need to be screened appropriately for the disease.

“I personally don’t want any family to have to endure what my family went through,” she said.

One of her surgeries took her out of state, and she has seen neighbors in Beckley travel an hour and a half for regular appointments at treatment centers.

She also knows about the cost of treatment. If she didn’t have insurance, she doesn’t know how she could have afforded her treatment, which she estimates has cost roughly $375,000.

“I understand people who don’t have insurance being scared,” she said.

On the Web: Colorectal Cancer Coalition: www.fightcolorectalcancer.org


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