Across the country, people who live in rural areas are more likely to be diagnosed with late-stage colon cancer than city dwellers, according to a new study published in the Journal of Rural Health.
Patients living in counties far from populated cities and suburbs were 1.23 times more likely to be diagnosed with non-curable, stage 4 colon cancer than people living in urban areas, according to the research. That’s despite rural residents having lower rates of developing the disease.
Treatment outcomes are also worse for rural patients, with various studies finding they have an 8% to 15% greater chance of dying from colon cancer.
That comes as no surprise to Dr. Hope Tinker, a primary care physician working in the small central Missouri town of Fayette.
There aren’t enough doctors in rural Missouri, said Tinker, who also does rounds at rural nursing homes. And that shortage means people don’t seek medical care until it’s too late.
“Especially with something like colon cancer, where we know that if you catch the precancerous problems then that’s a very treatable disease,” Tinker said.
Tinker says delaying care can mean the difference between having precancerous problems successfully treated and dying from cancer.
More physicians and clinics in rural areas "would improve access to care. And that’s the basic deal with these colon cancer deaths. When it’s harder to get in to see doctors, then people delay care,” Tinker said.
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The American Cancer Society recommends that people begin screening for colon cancer at age 45 — and sooner for those with a family history of the disease. Colon cancer is 90% curable when detected early, according to the organization.
Colon cancer death rates may be a bellwether, suggesting that other diseases may have disproportionately high rates in rural areas.
Colon cancer is a good marker, said Dr. Robin Blake, professor emeritus of Family and Community Medicine at the University of Missouri. “The same thing is likely going on with other diseases like hypertension, diabetes and other forms of cancer,” she said.
Blake said the state expanding Medicaid in Missouri would encourage people to get preventive care.
“Since the politicians in Jefferson City declined to expand Medicaid, there have been five rural hospitals that have closed in Missouri,” Blake said.
“Rural physicians who could be catching things like the early stages of colon cancer are dependent on Medicaid reimbursements to see patients and stay in practice.”
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