Colorado State Study Looks At Cancer And Poverty

Main Category: Cancer / Oncology
Article Date: 09 Dec 2008 - 4:00 PDT

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A report released today by the Colorado Cancer Coalition and the Colorado Comprehensive Cancer Program of the Colorado Department of Public Health and Environment recommends that efforts should be made to reduce health disparities in disadvantaged populations by ensuring that Colorado residents, regardless of income, have access to quality health education, cancer screening and cancer treatment.

The report, "Cancer and Poverty in Colorado: 1995-2006," is a study of the relationship between cancer and poverty in the state. The report found that in Colorado poverty continues to be an important factor associated with the risk of getting cancer, having cancer diagnosed at a later stage and dying due to cancer. According to the report:

-- Poorer Coloradans are more likely to have the behaviors or risk factors that lead to increased cancer risk, such as obesity, smoking, poor diet and lack of exercise.

-- The inequities of the health care system put poor people at a tremendous disadvantage in the fight against cancer. Poor people are less likely to get properly screened for cancer, although early detection is a crucial component in fighting its development. Poor people also are likely to have poorer health insurance coverage or no coverage, and coverage plays a crucial role in an individual's course of cancer.

Jillian Jacobellis, director of the Prevention Services Division at the state Health Department, said, "We are not saying poverty causes cancer, but this report illustrates how poverty is related to the onset and course of cancer in Colorado. The findings underscore the need for attention to our health care system, to our system of health care coverage and to assisting low-income populations in making healthy choices."

The publication of "Cancer and Poverty in Colorado: 1995-2006" continues a series of the department's reports that examine Colorado health data on cancers, health behaviors and deaths. Findings from the report may be useful for policy-makers, health care professionals and community groups in developing and evaluating prevention and intervention strategies, identifying high risk populations, and prioritizing resource allocations for cancer-related services.

Ned Calonge, chief medical officer at the state Health Department, said, "Colorado is one of the first states to have looked closely at the relationship between poverty and cancer. We know that early diagnosis and regular screening can lead to better survival. However, those in the lower socioeconomic groups and those having no health insurance or only Medicaid coverage are more likely to be diagnosed with cancers at a later stage of disease, where prospects for survival are worse."

Although there has been some overall improvement in cancer rates and preventive behaviors between the periods of 1995-2000 and 2001-2006, the report found that the underlying relationship between poverty and cancer first identified in 2003 remains unchanged.

-- Coloradans with lower incomes were more likely to smoke tobacco; be obese; be less physically active; and not participate in screening tests for breast, cervical or colorectal cancer.

-- For most cancers, Coloradans who lived in poorer neighborhoods and had no health insurance were more likely to have had a more advanced stage of cancer at the time of diagnosis.

-- For most cancers, Coloradans who lived in poorer neighborhoods were more likely to die within the first five years following cancer diagnosis.

The report also showed that the relationship between poverty and cancer weakened among those over age 65, the age at which Medicare coverage begins for most elderly Americans.

"For those 65 years and older, when Medicare covers screening tests for colorectal cancer for nearly everyone, there is less of a difference in late-stage diagnosis between those living in low-poverty and high-poverty areas," explained Tim Byers, associate director of the Cancer Center at the University of Colorado, and a member of the Colorado Cancer Coalition. "Once patients are diagnosed, their level of health coverage shapes the course and aggressiveness of their cancer treatment. Simply put, the worse your coverage, the more likely your cancer will kill you."

While solutions to the problems caused by poverty are complex, the report concludes that focusing efforts on reducing tobacco use, preventing obesity, encouraging physical activity and increasing access to cancer screening and appropriate cancer treatment can help reduce suffering and death from cancer among low-income populations in Colorado.

The report also recommends

-- enhanced funding of programs that encourage adoption of healthy behaviors, increase access to preventive health services for early detection of cancer and increase access to timely initiation of effective cancer treatment right after cancer diagnosis;

-- surveillance of cancers based on routine reports on health statistics that, where possible, report data according to poverty levels rather than only by race/ethnicity.

Data for the report was provided by the Colorado Central Cancer Registry and the Health Statistics Section at the Colorado Department of Public Health and Environment.

To contact the Comprehensive Cancer Program or the Colorado Central Cancer Registry at the Colorado Department of Public Health and Environment, call 303-692-2520or visit www.cdphe.state.co.us/pp/ccpc/index.html.

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