November is Lung Cancer Awareness Month, and a newly released report
shows far too few Nebraskans at high risk for lung cancer are getting the recommended screening.

The American Lung Association's latest "State of Lung Cancer" report ranks Nebraska 33rd for lung cancer screening -- at less than 4% of those who are at risk.

Julia McCarville, executive director of the American Lung Association in Nebraska, said although lung cancer remains the leading cause of cancer deaths for both men and women, the nationwide outlook improved somewhat between 2015 and 2019.

"The five-year survival rate increased from 22% up to 26.6%, and additionally, we're seeing the survival rate increasing at a faster pace among communities of color, so it is no longer significantly lower compared to white individuals," McCarville said.

McCarville stressed that a low-dose CT scan can lead to an earlier diagnosis. And when lung cancer is caught at an early stage, it can increase one's chances of surviving five years by more than 60% . At Savedbythescan.org, people can assess their risk for lung cancer and their eligibility for a low-dose CT scan.

Some 10% to 20% of those diagnosed with lung cancer have never smoked, and McCarville said anyone with concerning symptoms -- such as a lingering cough, chest pain, shortness of breath or frequent lung infections - should talk with their doctor about getting a low-dose CT scan.

Dr. Sumit Mukherjee, medical director of thoracic oncology for Methodist Health System, calls it a "huge missed opportunity" that so few people who are eligible are getting screened. He explained that screening should be done with a low-dose CT scan, not a chest X-ray.

"Because you just don't see these little spots in the lungs on chest X-rays, and by the time you can see them on X-ray, lung cancer becomes more advanced generally at that time," Mukherjee said.

Mukherjee added that part of the explanation for lung cancer being the leading cause of cancer deaths is the fact that it is often diagnosed at a late stage.

He said there is a movement to help women, especially those at high risk, become as accepting of regular screening for lung cancer as they are for breast cancer. More non-smoking women than non-smoking men are diagnosed with lung cancer.

"We all focus so much with women and breast cancer, and there is great screening and education behind breast cancer awareness and screening, and really more women die of lung cancer than breast cancer and colon cancer combined," Mukherjee said.

For those who do receive a diagnosis of lung cancer, Mukherjee added there are a number of better technologies and medications available now than in the past. However, he stressed that lung cancer is still a very deadly form of cancer that can have a profound impact on people's lives.

La administración Biden finalizó una norma que ampliará la cobertura de atención médica a los beneficiarios de la Acción Diferida para Menores Migrantes, o DACA por sus siglas en inglés, que ahora entrarán en la categoría de "presencia legal".

En Wyoming, la economía turística de Jackson Hole atrae a inmigrantes que buscan trabajo. Es difícil precisar cuántas personas son, pero algunas estimaciones dicen que los inmigrantes constituyen una cuarta parte de la población regional, según Alin Yuriko Badillo Carrillo de Voices Jackson Hole, una organización que amplifica las voces de los inmigrantes. Ella agrega que los inmigrantes tienen muchos empleos vitales para los puntos turísticos.

"Industria de servicios y limpieza, servicios de restaurantes, construcción: mucho del trabajo pesado para garantizar que nuestra comunidad siga funcionando," insistió también la entrevistada.

Más de medio millón de beneficiarios de DACA se encuentran actualmente en los Estados Unidos, según losServicios de Inmigración, y tienen tres veces más probabilidades de no tener seguro que la población general.

El programa DACA, iniciado en 2012, brinda protección a ciertos inmigrantes indocumentados que llegaron a Estados Unidos cuando eran niños. Pero hasta ahora, esas protecciones no incluían el acceso a la cobertura médica a través del Affordable Care Act Marketplace o el Basic Health Program (Programa Básico de Salud).

La propia Badillo Carrillo es beneficiaria de DACA y explica que los beneficios de la cobertura médica son de gran alcance.

"No solo para mí, creo que es un beneficio comunitario. Si tengo acceso a atención preventiva y médica, podré estar más saludable y también ayudar a otros," enfatizó además Badillo Carrillo.

La norma entrará a en vigor el 1 de noviembre, al mismo tiempo que inicia el periodo de inscripción.


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The Biden administration has finalized a rule that will expand health care coverage to Deferred Action for Childhood Arrivals recipients, who will now fall into the "lawfully present" category.

In Wyoming, the tourist economy in Jackson Hole attracts immigrants looking for work.

It's hard to pin down how many of those people are in the DACA program, but some estimates say immigrants make up a quarter of the regional population - according to Alin Yuriko Badillo Carrillo, director of immigrant leadership with Voices Jackson Hole, an organization that amplifies immigrant voices.

She said immigrants work many jobs vital to tourist hotspots.

"Service industry and housekeeping, restaurant services, construction," said Badillo Carrillo, "a lot of the heavy lifting to ensure our community keeps on running."

More than a half-million DACA recipients are currently in the United States, according to Immigration Services, and they are three times more likely to be uninsured than the general population.

The DACA program, started in 2012, gives protections to certain undocumented immigrants arriving to the U.S. as children.

But before now, those protections haven't included access to health coverage through the Affordable Care Act Marketplace or the Basic Health Program.

Badillo Carrillo herself is a DACA recipient, and said the benefits of health coverage are far-reaching.

"Not just for me, but I think it's a communal benefit," said Badillo Carrillo. "If I have access to preventive care and access to medical care, then I'll be able to be healthier, and to help others also."

The rule goes into effect November 1, at the same time the enrollment period begins.

As outdoor activities ramp up, May is a good time to think about observing good skin-care practices.

More skin cancers are diagnosed than all other cancers combined and one in five Americans will have some type of skin cancer by age 70.

Nebraska is among the states with the second-highest melanoma diagnoses per 100,000 residents, according to the Centers for Disease Control and Prevention. And Dr. Adam Sutton, director of Moh's and Dermatologic Surgery at the University of Nebraska Medical Center, says many Nebraskans have at least one of the risk factors for skin cancer.

"We've got a number of people who are fair skinned, who are Caucasian, who spend a significant amount of time outside, have a history of sunburns and/or work outside," Sutton outlined. "Which are all significant risk factors for melanoma."

He pointed out that melanomas, like all skin cancers, are highly curable when caught early. So, it is important to be checked -- ideally by a board-certified dermatologist -- if you have anything "new, changing or growing" on your skin.

The more common types of skin cancer, basal cell and squamous cell, tend to grow on sun-exposed parts of the body, but melanomas can develop anywhere. Sutton noted they make up only about 1% of all skin cancers but account for the most skin-cancer deaths, about 10,000 per year. Although melanomas can develop independently of moles, Sutton emphasized having a large number of moles is also an indication of increased risk.

"An individual that has 50 or more moles on their body has about a fourfold increased risk for the development of melanoma," Sutton explained. "That's pretty significant. Even if we have really normal-looking moles, if we have a lot of them, we're at greater risk for the development of melanoma."

Although white Americans are much more likely to be diagnosed with melanoma, non-Hispanic Black Americans have a higher incidence of later-stage diagnoses. Overall, melanoma diagnoses are expected to grow by 50% by 2040.

As far as prevention, Sutton stressed there is no such thing as a "safe tan." He recommended using broad-spectrum sunblock with a sun protection factor, or SPF, of 30 or higher for all outdoor activities, rain or shine. He added tanning beds have been "definitively determined to be carcinogenic."

"We still see a number of young people who are actively using tanning beds or have used tanning beds," Sutton observed. "That risk for the development of skin cancer really comes after the use of tanning beds one time."

Although skin cancer risk increases with age, Sutton acknowledged every week he treats patients who are in their 20s.


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