State urged to spend tobacco money on cancer war

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The state needs to provide additional incentives to lure doctors to rural areas of the state, adequate Medicaid funding to combat low physician reimbursements and cultural experts to fight skepticism toward the need for breast cancer screening, wrote Howell Clyborne, a hospital vice president.

The suggestions came in response to state Sen. Verne Smith's request that the hospital system and state officials provide ideas to combat breast cancer.

Smith, a Greer Republican who chairs a Senate panel dealing with Medicaid and health funding, made his request after The Greenville News published a series of articles about the disease last month.

The News reported that hundreds of South Carolina women are dying each year from breast and cervical cancer, but lawmakers have not used the $1 billion windfall from the makers of one of the leading causes of cancer to help fight the disease.

Glenda Sims, who provides a free breast cancer screening clinic in Spartanburg, said she likes the hospital's ideas. "I could support that," she said. "Any assistance would be welcomed."

South Carolina's breast cancer rate is higher than three out of the four largest states, according to the American Cancer Society. White women in the state are more likely to develop breast cancer, yet black women are more likely to die of the disease, the organization says.

Black women in South Carolina also are 60 percent more likely to be diagnosed with cervical cancer than white women, according to the Cancer Society.

Smoking increases the risk of both forms of cancer, according to the American Cancer Society.

Though $336 million in the state's tobacco settlement receipts has thus far been targeted on health-related issues — about $218 million to fund Medicaid — none has been directed toward cancer, other than indirectly paying for treatments covered under Medicaid, The News reported.

Meanwhile other states, most notably Georgia, have spent portions of their tobacco funds to combat cancer. Georgia has committed $400 million of its tobacco settlement money to fight the disease and has already used some of the money to hire top cancer scientists, buy mammography machines and pay for educational campaigns.

Smith, whose wife is a breast cancer survivor, said he wants the hospital system and other groups to continue working on suggestions but not to depend on the state to provide everything.

"I need for more people to work with what's available to them now to improve the situation," he said.

Smith said little of what's left from the state's tobacco settlement receipts is available until the state's bonds are paid off in about 16 years.

Clyborne wrote that the hospital system provides more than $70 million annually for treatment of the poor.

"We also look to federal and state governments to assist us in this endeavor," he wrote.

Clair Boatwright, a spokeswoman for the state Department of Health and Environmental Control, said her agency also is working on a detailed response to Smith's request. She said DHEC Commissioner Earl Hunter shares Smith's concern about the incidence of breast cancer in the state."In light of Gov. Sanford's interest in disease prevention, this presents an incredibly good opportunity for an investment with potential for immediate returns because more money invested in prevention not only improves the quality of life for patients but is also the best use for the state's limited resources," she said.

The hospital system has increased its number of mammography machines to 12 and has added a radiologist whose job it is to read just GHS mammography results, Clyborne wrote. As a result, women using the hospital system should not have to wait more than a week for a screening, though they may have to wait for a month for diagnostic exams.

"Other facilities in the state, however, are not as able to provide such access," he wrote. "Some women may wait up to three months for a mammogram or not have access to one near their home at all."

The tobacco fund could buy machines for rural and underserved areas of the state, he wrote.

While the hospital system has added pathologists with expertise in breast cancer, he wrote, other areas of the state lack such specialists and residents don't have the means to travel to areas that do.

Portions of physicians' student loans could be forgiven if they agree to work in South Carolina, Clyborne suggested, which might increase the number of doctors working in rural areas.

Because a growing number of doctors will not see Medicaid patients because of low reimbursement rates, Clyborne suggested increased Medicaid funding.

He also suggested finding those in the black community who can help overcome skepticism about breast cancer examinations. Sims said that is a critical issue.

"The more we can educate and break down barriers, to eradicate some of that skepticism that exists for whatever reason, that's going to be the key to getting people screened," she said.

Clyborne also suggested using the tobacco fund to reinstate the state's cancer aid program, which was ended this summer. The 65-year-old program provided outpatient treatment, testing and chemotherapy for poor cancer patients.

He suggested moving money for the program to Medicaid, which might qualify it for additional federal dollars, something other states have done.

Smith said one of the biggest problems the state has in battling breast cancer is convincing women to take advantage of screening and examination resources available to them.

"I think that is something that everybody needs to work on — hospitals, physicians, the whole health care system, the state and the news media," he said.