Legislation Can Help Reduce Urban-Rural Cancer Disparities in Texas

by Mike Easley

Cancer is a relentless enemy. Even with recent advances we have seen in oncology treatments, over 600,000 Americans will die of it this year. And more than 41,000 of those deaths – more than double the population of Plainview, to put it in perspective – will occur in Texas. The evidence tells us that cancer is not an equal opportunity killer. Cancer patients in the rural parts of our state, for example, are significantly more likely to die than those in urban and suburban areas.

Recently, Congressman Jodey Arrington introduced legislation to help address this rural-urban disparity. He’s seeking to address the primary factor that causes rural Texans to have higher cancer burden – too many cases diagnosed at advanced stages when treatment is far less likely to be effective.

The National Grange recently published research examining cancer incidence, diagnosis and death rates in four states, Texas among them. The study found that, while cancer mortality declined in both urban and rural areas between 2011 to 2020, it declined much faster in urban areas. As a result, mortality rates were 14 percent higher in Texas over this period and the gap between the two worsened over this decade. This is even more concerning when you consider that the occurrence of cancer was relatively similar for urban and rural areas.

So why are people dying of cancer at higher rates in rural areas despite having similar rates of cancer? This is explained by another critical finding in the study; people in rural areas are having their cancers diagnosed at a comparatively later stage. In Texas, according to the research, rates of new cancer cases diagnosed at a late stage were 13.3 percent higher in rural areas compared to urban ones.

It isn’t hard to understand why this is happening. If you live on a ranch or in a small town far from a major population center, you are less likely to be able to get a cancer screening. That has been the case for some time. In rural areas, access is poorer and many may lack the ability to drive long distances to a health center that offers important screenings such as mammograms or colonoscopies. Fewer screenings mean more late-stage diagnoses and, tragically, more preventable deaths.

This is where Congressman Arrington’s legislation comes in. A new technology has been developed that can detect multiple types of cancer by analyzing a patient’s blood sample. They are called multi-cancer early detection (MCED) tests and they represent a major breakthrough in doctors’ cancer screening capabilities. MCED tests give doctors the ability to complement the limited cancer screening tools available today and to test for many more types of cancer that are going undetected because there hasn’t been a way to find them until now.

Because these tests require only a blood draw, they can be administered more easily in any rural health clinic. The Food and Drug Administration is currently reviewing MCED tests, and prestigious American health systems are starting to adopt them.

When the FDA gives the green light, it is important that those most vulnerable to cancer have timely access to this new screening tool. While older people are most at risk of developing cancer, Medicare – which is how most older Americans get their health insurance – can’t cover new preventive care products and services in any meaningful timeframe. Congressman Arrington’s bill, the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, would ensure a pathway for swift coverage of these tests. That means Texans over the age of 65 will not have to wait – for up to a decade or more – for the bureaucratic process to resolve itself as their cancers go undiagnosed.

Congressman Arrington has led this effort over the last two years and garnered the support of over 300 members of Congress from both parties. Rural Texans and rural Americans are cheering him on. Congress has both a window of opportunity and an obligation to pass his bill this year. It’s vital that they get it done because cancer isn’t going to stop claiming lives, and rural Texans who are at greater risk need this protection.

Mike Easley is president of the Texas Rural Health Association. Online at www.trha.org.