Arkansans are less likely to get cancer than the rest of the United States population as a whole. That’s certainly good news in a state that ranks near the bottom of most U.S. health rankings.
But that news is tempered by this — those Arkansans who do develop cancer are more likely to die from it than their U.S. counterparts, according to the federal Centers for Disease Control and Prevention.
In fact, the chance of an Arkansan of any age dying from cancer has changed little over the last 40 years. From 1968 to 2010, in the 45-64 age group, U.S. rates dropped from 280 cancer deaths per 100,000 people to 200 deaths, while in Arkansas, rates went from about 260 deaths per 100,000 people to 245.
Arkansas is in the group of states with the lowest incidence of cancer — 387 to 440 per 100,000 population, compared to the group of states with the highest incidence rate — up to 509 per 100,000 population.
But Arkansas is in the highest group when it comes to death from cancer — 185 to 207 per 100,000 population, compared to the lowest group, which had a death rate as low as 120 per 100,000 population.
The reasons for that are many, said Joseph Bates, M.D., the Arkansas Department of Health’s deputy state health officer.
The state’s agricultural nature — 54 of its 75 counties are considered rural — makes access to preventive screenings and regular checkups, as well as specialty care, a struggle. Arkansas ranks among the lowest states in providing preventive services to its citizens. Poverty makes the burden heavier. The average annual household income for the state’s 2.9 million people is $38,000.
“Poverty and lack of transportation affect whether people get screened for cancer,” Bates said. “They may have little sick leave, so their pay is docked or they may get fired if they take off work. They may have to find child care. One in four adults age 18 to 64 has no health insurance.”
Cancer is the second biggest killer of Arkansans after heart disease. Lung, breast/prostate and colorectal cancers are the most prevalent.
Lung cancer is almost always a result of smoking, Bates said, adding that tobacco is the real No. 1 cause of cancer death in Arkansas. About 26 percent of Arkansas adults smoke and about 22 percent of youths smoke. The rate of boys using chewing tobacco is rising.
“Tobacco is our big devil,” Bates said. “In addition to lung cancer, it can cause cancer of the lip, tonsil, larynx, tongue, esophagus, pancreas, kidney and urinary bladder. Women who smoke have a greater chance of getting cervical cancer.”
Colorectal cancer could almost be eliminated if everyone age 50 could have a colonoscopy and then have repeated ones as necessary. Most colon cancers arise from polyps that can be removed before they become cancerous.
When it comes to treatment, more research is needed to determine which cancers will eventually cause harm to the patient.
“We are beginning to redefine cancer. Not all cancers grow and cause disease and death,” Bates said. “Some progress and kill, some don’t change very much, and some regress. This is a new understanding of the biologic behavior of cancer that has come to be understood in recent years.”