Cancer Death Rates Decline, But Income Is A Factor In Survival

Advances in early detection and cancer treatments have resulted in a 27 percent decline in cancer deaths in the U.S. in the last 25 years, but those benefits are slow to trickle down to those who are lower on the socioeconomic scale, according to a report by the American Cancer Society. In the nation’s poorest counties, the cancer mortality rate is 20 percent higher than in the most affluent counties, and “the difference is much larger for cancers that are the most preventable: cervical, colorectal and lung,” said Rebecca Siegel, strategic director of Surveillance Information Services at the American Cancer Society and an author of the study. Robert Ciemniewski, 57, a longtime smoker from Connecticut, was on the wrong side of the statistical divide when he walked into the emergency room in 2017 with breathing difficulties from what he thought was pneumonia. He did have pneumonia, but he also had advanced lung cancer. Ciemniewski had not had a health checkup since 2013, when he quit his job as a mailman to care for his ailing mother.

Care Coordinators Cut Costs, Improve Health Outcomes, But Are Underused

A few years ago, patient navigators at Project Access-New Haven set out to see if they could change the course of health care treatment for some Medicaid patients who frequently used emergency rooms.

They contacted emergency departments at Yale New Haven Hospital and its Saint Raphael campus and enrolled 100 patients in their study in 2013. Those selected had visited emergency rooms four to 18 times in the past year for chest pain, abdominal pain or chronic migraines, among other ailments. The navigators at Project Access coordinated health care for the patients. They scheduled appointments with primary care physicians, provided reminders, accompanied patients to physician visits and followed up to ensure compliance with the prescribed treatment. The preliminary results were eye-opening: “We saw an average cost reduction of $153 per member per month,” said Dr. Roberta Capp, assistant professor, Department of Emergency Medicine at the University of Colorado Denver, and lead investigator of the study.