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Blair Horner: The Governor’s Too Limited Cancer Strategy

In his State of the Union address, President Obama designated Vice President Biden to lead the Administration’s “moon shot” to attack cancer.  Cancer touches the lives of all of us and is the second leading cause of death in America.  It is one term that covers a very wide range of diseases, including those of the lung, prostate, pancreas, breast and colon.

The President’s effort will hopefully make progress against that terrible disease.  Here in New York, Governor Cuomo advanced his own, though more limited, effort.

In his executive budget, the governor proposes to spend $91 million on a statewide campaign to boost the availability of breast and prostate cancer services.  Breast cancer is the leading form of cancer affecting women.  Prostate is a leading cancer in men.  Yet, neither are the leading causes of cancer deaths.  That terrible distinction is the result of lung cancer.  And the leading cause of lung cancer is tobacco use.

The state has the money to pay for programs to reduce smoking: it receives billions of dollars in revenues from the use of tobacco.  It would make sense to expand the state’s efforts – the state has a real health problem and the money to pay for an appropriate response.

Yet, the governor’s executive budget adds no new revenues to the state’s program designed to combat tobacco use.  Indeed, the state has slashed funding for that program, which now receives less than 50 percent of the funding it received a few years ago, and less than 20 percent of the amount recommended by the national experts at the U.S. Centers for Disease Control and Prevention.

In addition, there been budget proposals that not only put the state’s tobacco control funding at risk, but other cancer services as well.

New York State offers a Cancer Services Program (CSP) which provides breast, cervical and colorectal cancer screenings and diagnostic services at no cost to women and men, typically those who lack health insurance.  If the screening test finds something abnormal, diagnostic (testing) services are available for eligible women and men at no cost.  

If breast, cervical or colorectal cancer is found, eligible women and men may be able to enroll in the special cancer treatment program to receive full Medicaid health insurance coverage for the entire time they are being treated for cancer.

But that program has never been adequately funded, with experts stating that it only historically offered help to about 20 percent of the eligible population.  Even with the expansion of health insurance under the Affordable Care Act, the CSP is still not adequately funded to meet the needs of the uninsured.  In his executive budget, the governor proposes no new funding for this program.

The governor does, to his credit, propose $91 million to expand the state’s breast and prostate services.  And he proposes more money for Roswell Park Cancer Institute.  Yet, his budget does not propose any new funding for the CSP.

Ironically, the experts will state that colon cancer screening is a much more scientifically useful cancer-fighting tool than other cancer screening.  The national experts at the federal government’s U.S. Preventive Services Task Force regularly issue guidelines documenting the best available science to direct medical practice. 

In the case of cancer screenings, they rank the efficacy of the effort with a letter grade, an “A” being the service that provides the most benefits with the smallest risks.  According to the USPSTF, colon cancer screening ranks an “A,” grades breast cancer screening with a “B” and prostate screening gets a “D.”  That does not mean that breast cancer screenings are untrustworthy, it means that there is less benefit and greater risks with that type of screening compared to colon cancer screenings.

Yet, unless the governor and Legislature agree, there will be no additional resources for colon cancer screenings.  And, unless they agree, no additional funding for anti-smoking programs, which are the best way to combat the biggest cancer killer.

Does this mean that lawmakers should reject the governor’s cancer services program proposals?  Absolutely not.  It does mean that other cancers, some of which are more dangerous and some of which are better candidates for screening, must get help as well.

New York should follow the lead of the President.  The best way to tackle the scourge of cancer is to rely on the best scientific evidence and to take it on comprehensively.  The governor’s budget is only one step.  Much more needs to be done.

Blair Horner is the Legislative Director of the New York Public Interest Research Group.

The views expressed by commentators are solely those of the authors. They do not necessarily reflect the views of this station or its management.

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