High-risk groups raise state's colon cancer challenge

By Michaela Gibson Morris/NEMS Daily Journal

Mississippi’s fight against colon cancer must be fought on many fronts, physicians say.
First and foremost the state needs to get more people to take colon cancer seriously and increase screening rates to see the gains other states have reaped over the past decade. Mississippi was the only state that didn’t reduce its death rate.
The state has bigger populations of people who are at increased risk for colon cancer: smokers, the obese and African-Americans, who are more likely to have advanced colon cancer, said Tupelo gastroenterologist Dr. John Phillips.
Dr. David Bridgers of Oxford said the high percentage of uninsured in the state doesn’t help. Medicare covers a screening colonoscopy; however, Mississippi Medicaid does not.
Folks with private insurance could end up paying $1,000 or more depending on the coverage for screening tests. The uninsured could pay $2,000 to $3,000.
Some people do get sticker shock for colonoscopies, which are more expensive than other screening tests because they require more medical personnel and equipment, and patients are sedated. However, if patients have a clear test with no polyps and have no symptoms, they don’t have to repeat the test for 10 years, Phillips said.
The cost of colonoscopies is small compared to the cost of surgery, chemotherapy, hospitalization and potential lost wages.
“A little prevention goes a long way,” Bridgers said.
During a colonoscopy, the entire colon is examined with a lighted scope while the patient is sedated. In addition to spotting invasive cancer, the procedure lets the doctor remove precursors to colon cancer.
“If you have a polyp removed, you’ve prevented colon cancer,” Phillips said.
Some states are developing programs to help get colonoscopies to more people. Colorado has a statewide program for the medically underserved; Georgia has a pilot project in four counties to reach the same population.
However, there’s no local mechanism in north Mississippi to raise money to help pay for colonoscopies for the medically underserved like the Komen North Mississippi Race for the Cure provides funding for mammograms.
Physicians with Digestive Health Specialists in Tupelo volunteer their time and services through the Antone Tannehill Good Samaritan Clinic, which serves the working poor of Lee County, Phillips said. Many gastroenterologists have charity care policies and provide free services to needy patients.
“Universal health coverage would help, but universal health coverage is not free,” Phillips said.
In the efforts to get colonoscopies to more people, both Phillips and Bridgers emphasized the need to make sure the physicians conducting the screenings are well-trained and meet national standards.
“You really need a gastroenterologist to do your screening,” because of the experience and training. “I did 2,000 cases before I finished my fellowship.”

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