The North Carolina Department of Health and Human Services today released the NC Comprehensive Cancer Control Action Plan 2020-2025 to address the cancer challenges and issues that affect North Carolinians. The plan includes strategic actions to address disparities among historically marginalized and rural communities who experience a disproportionate burden of cancer disease, disability and death.
"The NC Cancer Action Plan is a statewide blueprint for everyone working to reduce the burden of cancer on North Carolinians,” said Dr. Susan Kansagra, NCDHHS Chronic Disease and Injury Section Chief. “Our focus for 2020-2025 is to build on successes from the previous cancer plan and increase our efforts toward achieving health equity for all.”
The action plan lists strategies to increase screening rates and prevention measures for priority cancers that are preventable through screening and/or vaccination. The six priority cancers include lung, female breast, colorectal and prostate cancers, which are the four most deadly cancers in North Carolina, as well as cervical and skin cancers. Each cancer section looks at risk factors, prevention, early detection, treatment and strategic actions to reduce mortality and incidence rates. The goals are:
- Reduce cancer risks by supporting health behavior change in North Carolinians.
- Increase cancer screening and early detection of cancer.
- Improve access to cancer care, enhanced care coordination and quality treatment.
- Improve the knowledge and understanding of cancer, cancer care and the relationship between cancer and other chronic diseases among health care professionals and the general public.
Cancer is the leading cause of death in North Carolina, but the NC Cancer Action Plan reaffirms that the burden of cancer is not even across all populations. Cancer disparities are driven by a complex interaction between social, lifestyle, environmental, biological and health system determinants of health, including a long history of implicit bias and structural racism embedded in the nation’s systems of health care.
For many cancers, African Americans are the most likely racial group to have cancer diagnosed at a late stage when the cancer is more deadly. For example, African American women have similar incidence rates of breast cancer to white women but much higher mortality rates as they are more likely to have their cancer discovered at a distant stage. African American men also shoulder the heaviest burden of prostate cancer with higher incidence and mortality rates than other racial groups.
North Carolinians have major differences in their health, their healthy lifestyle resources and medical care depending on their community and where they live. Factors that influence health disparities can include lack of employment, inadequate housing, food insecurity and education level, as well as limited access to health care, medications, transportation services and caregivers.
In response to these challenges, the NC Cancer Action Plan addresses the need for more prevention efforts, increased screening and treatment opportunities that are easily accessible and affordable. The unique nature of North Carolina’s rural and historically marginalized communities is reflected in the plan’s strategies, which are based on the Center for Disease Control and Prevention's recommended evidence-based interventions.
“We want all North Carolinians to have the opportunity for health. That means addressing upstream drivers of health, like food and housing. It also means access to quality and affordable preventive health care, like screenings and vaccination to protect against preventable diseases, including cancers,” said Dr. Elizabeth Cuervo Tilson, State Health Director and NCDHHS Chief Medical Officer. “While the NC Cancer Action Plan offers strategies to address this challenge, our state will not be doing everything we can to reduce the burden of cancer until Medicaid is expanded to all North Carolinians who need health care assistance.”
With the risk of COVID-19 causing people to postpone some routine medical procedures, national cancer screening rates for preventable cancers have declined significantly in 2020. In the midst of the pandemic, the NC Cancer Action Plan supports North Carolinians in having the education and access to preventive health care they need to stay well and protect themselves against preventable diseases.
The NC Cancer Action Plan was developed through the North Carolina Division of Public Health’s Comprehensive Cancer Control Program and Cancer Prevention and Control Branch in partnership with the North Carolina Advisory Committee on Cancer Coordination and Control and the NC Cancer Leadership Team.