Before the coronavirus changed our lives, Indiana already had serious health challenges. This year, we can expect to lose more than 13,000 of our fellow Hoosiers to cancer. We are among the ten states in the country with the worst cancer mortality rates and we are also above the national average of cases for a variety of cancers, including kidney, lung, and cervical cancer. As COVID-19 has dominated our news and attention, cancer continues to be a pervasive, albeit sometimes less visible, killer – and has been for far too long.
We now must consider that the coronavirus is going to worsen that threat. A reputable health data firm found that the number of pap smears, mammograms, and colonoscopies were down significantly during the height of quarantine. This is distressing because we know that if cancer is detected early, the five-year survival rate is excellent. But if it is not found before it has spread, only one of five patients will live to see that five-year mark. If we are not screening for cancer early, more people die.
But even with screenings in place, our death rate is still too high. There is a built-in barrier that impedes our efforts to successfully fight cancer. Of the more than 100 known cancer types, there are only five that have available screenings: breast, cervical, colorectal, prostate, and “high risk” lung cancer. More than three of every four cancer deaths in the United States are from variations of the disease that are not subject to these screenings, often because the technology does not exist or has not been proven effective. Indiana is feeling the consequences of this gap. Pancreatic, liver, and esophageal cancers – all of which lack screenings – are among the top ten causes of cancer-related deaths in our state.
As we look toward the future, we need to invest in our capability to improve detection of this terrible disease earlier so lives can be saved.
The good news is that there is forward momentum on this front, coming in the form of a new technology that utilizes our understanding of the human genome and data science to detect and analyze the unique signatures of cancer in our blood. With one blood draw, many different cancers can be detected, including many of those without screenings today. This would be a game-changing innovation, both in the ability to find more cancer earlier and in the ease and swiftness with which the test can be administered.
Right now, companies are getting encouraging results from some of the largest clinical trials we have ever seen in genomic medicine. When this technology eventually receives Food and Drug Administration approval, it seems obvious to agree that it should be widely available, especially to those who are most susceptible to cancer – older Americans. However, the government program that provides health insurance for millions of seniors is limited in the new preventative services, like breakthrough multi-cancer early detection screenings, that it can cover. Without action from Congress, it could take a decade or more for Medicare beneficiaries and their doctors to have access to these groundbreaking tests.
We spare no effort when it comes to fighting cancer in this state. Dozens of prominent businesses, government institutions, and non-profit organizations are all involved in the state’s comprehensive cancer control plan and those efforts are showing results in the form of a decline in cases. But too many of our friends and neighbors are still going to die too young because of limitations in the science of health screening. That science may be on the verge of evolving and we should be getting ready now to make these tools accessible to Hoosiers as soon as they’re proven safe and effective.
Jim Merritt is a former State Senator in the Indiana General Assembly.