ACS CAN report finds nearly half of all states falling short on legislative solutions to prevent, fight cancer

Jul 29 2010

Nearly half of all states are falling short on legislative solutions to prevent and fight cancer, according to a new report released today by the American Cancer Society Cancer Action Network (ACS CAN). However, despite budget crises in several states, some state lawmakers still made positive progress in the fight against a disease that will kill an estimated 569,000 people in the United States this year.

The new report, How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality, was released today at the National Conference of State Legislatures annual meeting in Louisville, KY. The report finds that 23 states have reached benchmarks on none or only one of the six legislative priority areas measured by ACS CAN, the advocacy affiliate of the American Cancer Society. No state has met all of the benchmarks for effective cancer-fighting policies.

The report also provides an overview of how passage of the new health care law, the Affordable Care Act, will dramatically change the landscape of state health policy in the coming years.

"In the best interests of their constituents, state legislators should support laws and policies that help people fight cancer by emphasizing disease prevention, making health care affordable and accessible and focusing on patient-centered care during and after treatment," said Christopher W. Hansen, president of ACS CAN. "This duty is all the more important with passage of the Affordable Care Act. Cancer advocates will be working with state legislators to ensure that the new health care system is as strong as possible for people with cancer and their families."

How Do You Measure Up? measures state policies and provides a blueprint for effective legislation on six priority areas: breast and cervical cancer early detection program funding; access to care for the uninsured; colorectal screening coverage laws; smoke-free laws; tobacco prevention program funding; and tobacco taxes.  Failure to address these issues places barriers in front of those who seek proper preventive care, diagnosis and treatment of cancer.

A color-coded system is used to identify how well a state is doing.  Green represents the benchmark position, showing that a state has adopted well-balanced policies and good practices; yellow indicates moderate movement toward the benchmark and red shows where states are falling short.  

No state reached a benchmark in all six issues and only one state – Hawaii – reached benchmarks in five of the six priority legislative areas in the fight against cancer. Seven states – Alabama, Florida, Idaho, Mississippi, Oklahoma, South Carolina and Tennessee – did not meet the benchmark on any of the six issues, and another 16 received high marks on only one issue.

In addition to the six focus areas on which states were rated, the report examines how states are measuring up on issues such as the affordability of health coverage in the individual market and through Medicaid. It also details efforts on pain management as well as state investments in nutrition and physical activity promotion.

"As advocates, we have the responsibility to educate the public on how to prevent and treat cancer effectively, but we cannot do it unless state and local policymakers take action," said Robert E. Youle, a cancer survivor and volunteer chair of the ACS CAN board of directors. "The most effective solutions will save countless lives and potentially millions of dollars in health care costs, and in many cases, it costs a state little or nothing to do the right thing."

Despite budget pressures this past year, some state lawmakers have made positive progress in the fight against cancer. Since July 2009, when the report was last published, 11 states and the District of Columbia have passed tobacco tax increases, bringing to 47 the total number of states with tobacco tax increases since 2002 and increasing the current national average to $1.45 (up from $1.28 in 2009). Research has consistently shown that every 10 percent increase in the price of cigarettes reduces youth smoking by 7 percent and overall cigarette consumption by about 4 percent.

New York now has the highest tax in the nation at $4.35 per pack and is also the first state with a tobacco tax over $4. South Carolina's historic 50-cent increase came after a decade-long battle. Until recently, the state had the lowest tobacco tax in the nation and had not passed an increase since 1977. Missouri now has the lowest tax in the nation at 17 cents.

Early in the year, North Carolina became the first major tobacco growing state to implement a 100 percent statewide smoke-free restaurant and bar law. Three states (Kansas, Wisconsin and Michigan) implemented 100 percent comprehensive smoke-free laws protecting workers and patrons from the hazards of secondhand smoke, bringing to 35 the number of states, in addition to the District of Columbia and Puerto Rico that now require 100 percent smoke-free workplaces and/or restaurants and/or bars. Additionally, more than 3,000 municipalities have local laws in effect that restrict where smoking is permitted. Combined, this represents nearly 79 percent of the U.S. population.

In addition to passing these measures, many state legislatures fought hard to preserve coverage for lifesaving cancer screenings and treatments and to stave off attempts to cut state funds that support these programs, such as the National Breast and Cervical Cancer Early Detection Program. Medicaid coverage for cancer treatments also came under attack, and many state legislatures voted to protect programs that help ensure quality cancer care for those who desperately need it. For example, Idaho successfully increased funding for the Women's Health Check, the state's Breast and Cervical Cancer Screening Program – a major victory considering the current economic climate in the state.

Other findings in the report:

• Only nine states have reached the benchmark in providing screenings for breast and cervical cancer early detection.
• Twenty-seven states and the District of Columbia have laws that ensure private insurance coverage for the full range of colon cancer screenings tests.
• Ten states spend more than 50 percent of the CDC recommended funding level towards tobacco prevention. Thirty-one states and the District of Columbia spend less than 25 percent of the CDC recommended funding level.
• Minnesota, Wisconsin, Massachusetts, and Hawaii are the only four states that met the benchmark with uninsured rates of 11 percent or lower. Texas has the nation's highest uninsured rate of 28 percent, and Massachusetts has the lowest rate of 6 percent. The national average is 16 percent.

In 2010, it is estimated that more than 1.5 million people in the United States will be diagnosed with cancer. With the knowledge we have today, we could prevent 60 percent of cancer deaths in the United States, if everyone in America were to stop smoking, get screened for cancer, eat a healthy diet and exercise regularly.