If Governor Beebe signs it into law and the bill receives appropriations, Arkansas will soon have one of only a few statewide colorectal cancer programs in the nation.

 

Rhonda Henry-Tillman, MD, said Arkansas will be the ninth state to have a statewide program targeting the prevention, early detection and treatment of colorectal cancer, and that several other states that are developing such programs are already using Arkansas' proposed program as a model.

 

Henry-Tillman is a surgical oncologist who heads the cancer control unit at the University of Arkansas for Medical Sciences' (UAMS) Winthrop P. Rockefeller Cancer Institute and a professor in the UAMS Department of Surgery. For the past nine years, he has helped shepherd the proposed Arkansas Colorectal Cancer Prevention, Early Detection and Treatment Program into reality.

 

The work started in 2000 with a small grant from Pfizer, Inc. to provide screenings for underinsured and uninsured low-income Arkansans at 10 clinics scattered throughout the state's Delta regions along the northeastern to southeastern border and in Central Arkansas. "Everyone was so receptive to that program," Henry-Tillman recalled, saying that apparent need helped propel a coalition of the medical community to work toward expanding that program for the entire state.

 

These things take time, however. In 2005, the Arkansas General Assembly requested more evidence-based data to determine the level of need for such a program. The Arkansas Colorectal Cancer Act of 2005 provided the mechanisms for a thorough study of the state's capacity for a state-operated program, in terms of need, facilities, likelihood of use, and projected cost-savings.

 

Henry-Tillman said the results from that study, presented to this 87^th General Assembly, unequivocally backed up the need for and efficacy of more colorectal cancer resources. "We found that if resources were provided in the state, more recommendations would be made for screening and more people would comply with screenings if they had that option. In our study, almost 80 percent of people who were offered the resources complied with getting the screening."

 

She said that when resources covered it, the vast majority of physicians (about 90 percent) referred for colonoscopy.

 

Moreover, Henry-Tillman said, such a program would save and better allocate Arkansas tax dollars, saying that spending $1000 on a screening, which can actually prevent the development of cancer, is preferable to spending the average of $310,000 an advanced diagnosis could cost the state. "How many more people can you prevent with that $310,000? You can sure prevent it a lot in more people. We found that if you're taking people from a Stage 3 colorectal cancer to a Stage 1 or preventing the disease, there's a potential of 54 percent reduction in cost for this disease. That's one of the problems with our healthcare system now; we spend so many dollars on disease and late-stage disease and end-of-life care, that there aren't many dollars that can go to preventive health or early disease matters."

 

The American Cancer Society estimates that 1,500 new cases of colorectal cancer will be diagnosed among men and women in Arkansas this year and that 600 men and women will die of colorectal cancer in Arkansas.

 

Henry-Tillman said that the Arkansas Colorectal Cancer Prevention, Early Detection and Treatment Program would affect approximately 285,000 to 300,000 Arkansans between the ages of 50 and 64.

 

The bill easily passed both chambers. Its backers, including sponsor Sen. Joyce Elliott of Little Rock, are currently awaiting word on Governor Beebe's decision and on whether they will get the $5 million in requested appropriations to start the program. Henry-Tillman said that if the bill does not receive adequate funding to begin the whole program, she and others at UAMS, the Department of Health, the American Cancer Society and the Arkansas Cancer Coalition are pursuing other partial funding opportunities to at least get the screening component off the ground.

 

The program model is based on the Arkansas BreastCare program's structure. Primary care physicians will be educated about the program and can refer their patients who are displaying symptoms or are of the appropriate age but who do not have resources to cover screenings like colonoscopy to any physician who does the procedure and agrees to the Medicare/Medicaid reimbursement levels, paid by the program.

 

Because it is a statewide program, patients from any part of the state will be able to see any available program provider in their area, and likely will not have to travel too far for the screening.

 

Henry-Tillman said this is an exciting potential development for the state, and that she has been heartened by the overwhelming support of the legislators, none of whom voted against the bill.