Officials warn statistic may be tied to fewer screenings
by Ken Alltucker – Mar. 29, 2011
The Arizona Republic
Arizona’s cancer rate is the lowest in the nation, and the state’s cancer-death rate is lower than that of all but two states, according to a new national study.
The report paints a favorable picture for Arizona’s cancer-fighting efforts, and the lower rates may reflect the state’s youthful demographics and many residents’ active lifestyles.
But state health officials warn that too many Arizona cancer cases are diagnosed when the disease has advanced beyond its initial stages.
Too many people skip, ignore or can’t afford recommended tests that could detect cancer earlier, health officials say.
“That is our major concern,” said Wayne Tormala, chief of the Arizona Department of Health Services’ Bureau of Tobacco and Chronic Disease.
“We know screenings are low and most cancers get detected beyond their earliest stages. If we detect cancers early, a lot of them are very manageable.”
The survey, called the “United States Cancer Statistics Incidence and Mortality Report,” is based on phone interviews and other data from the National Cancer Institute and Centers for Disease Control and Prevention. It found that 378 out of every 100,000 Arizona men and women had cancer in 2007, the most recent data available.
The national cancer rate was 465 cases per 100,000.
Arizona’s favorable ranking did not surprise David Veillette, president and chief executive officer of Cancer Treatment Centers of America in Goodyear.
“I think we are younger, more active and certainly more aware of our surroundings,” Veillette said. “We know we are out in the sun a lot, so we lather up (with sunscreen) appropriately.”
The 2010 census found that 25 percent of Arizona’s population was 17 and younger.
The report found that prostate cancer is the most commonly diagnosed cancer in Arizona, followed by breast, lung, colon and uterus cancers.
Lung cancer is the state’s most prolific killer among cancers, trailed by breast, prostate, colon and pancreatic cancers.
Arizonans are less likely than the typical American to be diagnosed with the top 10 most common types of cancer, with one exception. The state’s thyroid-cancer rate slightly exceeds the national average.
Arizona’s ranking may have been helped by what the survey did not include: basal- and squamous-cell carcinomas.
The American Cancer Society estimates more than 2 million people are diagnosed with these common types of skin cancer each year, but just a small percentage of cases are fatal.
Melanoma, a deadly skin cancer if not treated early, is diagnosed less often in Arizona than the national average, according to the report.
While state officials are pleased with Arizona’s ranking, they say Arizonans can be more vigilant.
Breast, prostate and colon cancers are often highly treatable if detected early through routine screens. Of 11.7 million people who have survived cancer, about half had breast, prostate or colon cancer, according to the CDC.
But Arizona residents are more likely to skimp on recommended screening such as annual mammograms for women beginning at age 40 or prostate exams every one or two years for men aged 45 and older.
Three out of five women skipped a recommended mammogram last year, and more than two out of five men did not get a prostate-specific antigen test, which can detect prostate cancer, according to a state Department of Health Services risk survey.
The state survey found that 42 percent of adults over 50 have never received a recommended colonoscopy, a test that examines the large intestine and rectum.
Colon cancer is typically treatable if caught early, but one out of three Arizonans with colon cancer will die this year, according to the ADHS.
“Colorectal cancer is the prime example,” said Dr. Peter Lance, the Arizona Cancer Center’s chief cancer-prevention and control officer. “If you diagnose it early, then surgery alone is nearly always curative.”
Health officials acknowledge that access and affordability remain sizable obstacles for many. About one out of five Arizona residents has no health insurance, and that figure will grow based on proposals to scale back Medicaid coverage for the working poor and childless adults.
“There is no question with the Medicaid issues and the number of uninsured increasing, that is inevitably going to have a negative impact on cancer (treatment),” Lance said.
Still, Arizona health-care providers aren’t shying away from spending big bucks for technology and advanced cancer treatment.
The Arizona Cancer Center will open a new cancer unit at St. Joseph’s Hospital and Medical Center this summer, and it plans to build a six-story center in downtown Phoenix. Banner Health is opening a 120,000-square-foot cancer clinic this year in Gilbert.
The Cancer Treatment Centers of America will expand its Goodyear hospital on an adjacent 42-acre site.
Cutting-edge drug treatments and diagnostic tools based on an individual’s genetic makeup also are becoming more commonplace in oncology practices across the Valley.
“It is what I call the cancer wars,” said Roger Hughes, executive director of St. Luke’s Health Initiatives. “It is highly competitive. Everybody is out looking to market to that population.”