Rates Upstate are even worse than some other areas of New York, according to latest figures
By Deborah Jeanne Sergeant
A recent study by an organization affiliated with Columbia University indicates that compared with the rest of the nation, New York showed higher incidence rates for prevalent cancers, especially among those aged 25 to 49 for several cancers, including breast, colorectal, thyroid, kidney, renal pelvis and leukemia.
A few answers as to why were offered by Christopher P. Morley, Ph.D., chairman of the department of public health and preventive medicine and professor at Upstate Medical University.
“This is a complicated question because the broad mapping data combine all cancer types,” said Morley, who also serves as editor-in-chief of peer-reviewed Reports in Medical Education Research (PRiMER). “However, we know that disparities, in cancer incidence and in outcomes, exist between rural and urban populations. One issue is that we often see markers of health behavior that increase risk for cancer as higher in rural populations. In New York state, for example, you can simply visually compare the maps of where smoking rates are higher with the cancer incidence maps and you can visually discern the connection.”
Tobacco use has been implicated as a factor in causing numerous types of cancer. Morley added that areas where more people consume higher levels of red meat, fried foods and alcohol tend to have poorer health, as do those who have fewer food choices.
“Many health behaviors follow an educational and socio-economic gradient, with those who are less well-off having higher rates of tobacco and alcohol use and obesity,” Morley said.
It’s not that any one particular factor makes all the difference. It’s the stressors added up that can tip a person from reasonably good health into illness.
Morley explained that “people in lower socio-economic strata also tend to face higher levels of what some social scientists call ‘allostatic load’ or the overall levels of stress that impact health outcomes.”
Morley also blamed the poor access to preventive services in rural areas. Typically, cancer that is caught and treated later is more likely to become fatal.
In addition to avoiding tobacco, reducing consumption of alcohol, red meat and processed and sugary foods, Morley encourages people to maintain a healthy weight.
“That can mean engaging in intentional exercise, but people don’t need gym memberships,” he said. “You can increase physical activity, even if it means going for a walk, taking the stairs instead of an elevator or making other small choices throughout the day that improve your physical stamina.”
He added that it’s easier to make lasting change through small, achievable steps rather than trying to make sweeping changes in lifestyle habits that can affect health.
Physician Haider Khadim, an oncologist with St. Joseph’s Health, explains to his patients that there are some nonmodifiable risks such as age and genetics and some that are modifiable, such as lifestyle factors and preventive health measures for some types of cancer, such as screenings and tests.
“There are a few cancers we can screen for like prostate cancer and breast cancer,” Khadim said. “For prostate cancer, have a blood test after 50. There’s colonoscopy for colorectal cancer. It’s appearing more in younger people so we lowered the age to start screening at 45, not 50. Women should also get mammograms done at age 40 and sooner if a close family relative who had breast cancer. Young men should get screened if their mothers had cancer younger. There’s a perception that BRCA mutation perception that only women can get breast cancer, but men can get it as well. Families with BRCA positivity are prone to prostate cancer and pancreatic cancer. A family should consult with a geneticist.”
Physician Tarek Sousou, a medical oncologist and hematologist who is the board president of Hematology-Oncology Associates of CNY, said that genetic risk from hereditary mutations causes up to 10% of cancers.
“Through screening tests, these patients can undergo enhanced screening and other risk reductive strategies to avoid developing cancer or diagnose it at earlier stages when it can be more readily cured,” Sousou said. “Adjustment of controllable risk factors such as avoidance of tobacco, enhanced cancer screening and maintaining a healthy lifestyle and weight can help reduce genetic and age-related risk for cancer.”
Maintaining a healthy weight can be challenging in New York. In a CDC study from 2017 to 2020, New York ranked among states with a self-reported sedentary rate of 25% to 29%. A handful of Southern states ranked worse. However, New York ranked worst in the Northeast.
Long, cold winters may help explain the low rates of physical activity in the area. However, sedentary lifestyle should be avoided for many reasons, including the fact that it contributes to higher rates of obesity. Obesity is a risk factor for many diseases and illnesses, including cancer.
Choosing an activity that is enjoyable and also meets health goals can help people stick with it.