After 28 years, breast cancer not the most diagnosed cancer in Jackson County

The number of local cases of lung cancer surpassed breast and other types of cancer in 2013, according to an annual report from Schneck Medical Center’s cancer center.

A total of 45 cases of lung cancer were documented in 2013, and 28 (62 percent) were in men. All of the cases were linked to smoking, said Sally Acton, director of cancer and pain services at Schneck.

The number is a drop from the 50 cases of lung cancer reported for 2012. It’s also the first decrease in lung cancer diagnoses the hospital has seen since 2010.

Breast cancer had been at the top of the list since 1986, when the hospital first started collecting cancer data. The number of breast cancer cases at Schneck fell by 17, however, going from 52 in 2012 to 35 in 2013.

Data for 2014 won’t be compiled and reported until late this year.

“It’s not as much that lung cancer went way high as it was we didn’t have as much breast cancer that year,” Acton said.

On the surface the news looks good, but there are negative factors that could be influencing the numbers, she said.

In all, the hospital recorded 273 cases of cancer in 2013, with 236 being diagnosed and/or treated at Schneck. Following lung and breast cancer on the list were prostate and colorectal cancers and non-Hodgkin’s lymphoma.

One trend Schneck and other hospitals are seeing is that not as many people are having regular health screenings, especially mammograms, which can lead to early cancer detection.

A lower number of screenings typically means fewer cases of cancer are diagnosed, said Rita Baker, director of diagnostic imaging at Schneck. It doesn’t mean there’s less cancer out there, just that it hasn’t been detected yet, she added.

“December looks to be a strong month; but our screenings, particularly the first eight to nine months of the year, were lower than what they have been in the past,” Baker said. “Patients just weren’t getting their screenings like they have in the past, but we weren’t the only hospital seeing those lower numbers.”

Acton said there are many reasons why people might choose to not get a particular screening, such as a mammogram, colonoscopy, CT lung screening or other cancer detecting test.

“We suspect that some of it might be that people want to wait until their (health insurance) deductibles are met before having any kind of screenings done,” she said.

Smoking a problem

But many insurance companies actually pay for the screenings now, Acton added. She believes people just aren’t aware of what their health insurance covers.

With more insurance companies paying for mammograms and other screenings, Baker said, hospital officials expected to perform more of them.

“We anticipated our volume to increase this year in screening mammography because of that,” she said.

Another factor that figures into lung cancer being the most diagnosed cancer in Jackson County is the number of smokers here, Acton said.

Although she’s surprised by the drop in the number of cases of breast cancer, she’s not shocked that lung cancer took its place.

“We have a huge smoking population,” Acton said. “Every single lung cancer diagnosed in 2013 was a smoker. Every single one of them.”

Some of those patients had quit smoking before they were diagnosed, she said. Quitting smoking reduces but doesn’t eliminate the risk of getting lung cancer, she added.

Also, early detection of lung cancer can lead to better outcomes and more successful treatment. Most lung cancer, however, isn’t diagnosed until it’s too late.

Of the lung cancer diagnosed and treated at Schneck, 47 percent were Stage 4, which means the cancer had spread outside the lungs and was not curable; 33 percent were Stage 3, and just 15 percent were caught early in stages 1 or 2.

Help available

According to Indiana State Department of Health statistics for 2010, 26 percent of Jackson County’s population were smokers. For the state, the figure was 21.2 percent; and for the country, it was 17.2 percent.

In 2013, the county smoking rate decreased a little to 23 percent, which was the same as the state’s level that year.

But the problem isn’t just with the adult population.

“When I go to schools and I ask how many of the kids smoke, I see a lot of hands go up. That’s because their parents smoke, and they see it as an acceptable thing to do too,” she said.

In the past, the hospital has treated some patients who were exposed to secondhand smoke and were diagnosed with lung cancer, but not very many.

“We’re not treating anyone like that right now that I’m aware of,” she said.

It’s not just lung cancer that is associated with tobacco use, however, as the hospital also sees cases of head and neck cancers and bladder cancer that are directly linked to tobacco use.

To help target the problem of smoking and help lower the number of cases of lung cancer in the future, the hospital’s respiratory department and the Jackson County Health Department continue to offer a smoking cessation program free to the public.

Schneck’s smoking cessation courses are from 6 to 7 p.m. Thursdays in classroom 1 at the hospital and from 1 to 2 p.m. at the health department. A four-week supply of nicotine patches are available free to those who attend six classes at either location.

Quitting not easy

Attendance at the classes hasn’t been very good, said Mona Fish with Schneck’s respiratory department.

“They want to quit, but it’s hard,” Fish said. “If they’ve been smoking 30 years, that’s part of their life. To give that up would be like giving up something that’s very important to them. It’s their security.”

Smoking is no different from any other addiction, she added.

“You have to want to give that up,” Fish said. “And that’s giving up some of your life. You might have to give up some of your friends or places you like to go.”

In another effort to curb smoking and reduce secondhand exposure, a new group, the Jackson County Tobacco Coalition, is working to propose a countywide smoking ban and tighten Seymour’s current smoking ordinance.

The new regulations, if approved by city and county councils,

would keep people from smoking inside all buildings, including private clubs and bars, and would require people to stand at least 20 feet away from the entrances to buildings when smoking.

Seymour’s ordinance bars smokers from lighting up in public buildings and restricts smoking within 8 feet of entrances.

Dr. Kenneth Bobb, health officer with the Jackson County Health Department, is leading the coalition, along with public health coordinator/educator Lin Montgomery.

Acton said Schneck’s annual cancer report “allows us to look for trends and to compare ourselves to state and national averages.”

She added, “Each case identified is not only a patient; it is a network of family, friends and co-workers who are each impacted by that patient’s cancer journey.”