Located along the Kentucky River on the western side of the Appalachian Mountains, Owsley County had one of the highest percentage increases of cancer mortality per capita in the U.S. from 1980 to 2014, according to a recent study in the Journal of the American Medical Association. Deaths per 100,000 people went up 45.6 percent. But this small, rural county provides just a snapshot of the larger cancer epidemic in Appalachia. According to new research out of the University of Virginia, cancer incidence has declined in much of the country since 1969 — but not in rural Appalachia. In rural Appalachian Kentucky, the cancer mortality rate is 36 percent higher than it is for urban, non-Appalachian people in the rest of the country; in rural Appalachian Virginia it is 15 percent higher; in those areas of West Virginia, 19 percent. People in much of rural Appalachia are more likely to die within three to five years of their diagnoses than those in both urban Appalachian areas and urban areas across the U.S. [...]
Although people outside of Appalachia may not know about the region’s cancer crisis, researchers and community organizations in the region have been studying and fighting cancer for decades, focusing efforts on four cancers with the highest incidence and mortality rates: lung, colorectal, cervical and breast. Unhealthy lifestyle factors undoubtedly contribute to these numbers. About 42 percent of Owsley County adults smoke, compared with about 26 percent of adults in Kentucky and 15 percent in the U.S. overall. More than 34 percent of adults in Kentucky are obese, and nearly 70 percent are overweight. [...]
However, the biggest issue, experts said, is lack of access to care — whether it’s preventive screenings or cancer treatment. If one of Owsley County’s 4,600 residents needs to visit the doctor, they have three choices: the health department or two clinics. But doctors are not always available or working, and opportunities for screening vary. For instance, mammograms are only offered once a month at the clinics, and colon cancer screenings are referred out of the county, and cervical cancer screenings are done weekly at the health department and daily at the clinic, Lucas said. The three regional hospitals are at least a 30-minute drive away on narrow, curvy mountain roads. The Markey Cancer Center in Lexington is a far drive for people in rural Appalachia.
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