ATLANTA – Lack of access to cancer screening is costing Georgia heartache and money, especially in rural areas with fewer doctors and an aging population, state lawmakers learned Tuesday.

It was the second hearing of a study committee of the Georgia House of Representatives, which met in Albany at Phoebe Putney Memorial Hospital to hear from experts.

The members of the Study Committee on Cancer Care Access had already heard last week in Gainesville about the state’s relatively high rates of lung and colon cancer and the potential risk of exposure to polyfluoroalkyl substances, or PFAS, particularly in parts of North Georgia.

On Tuesday, they heard about the value of screening for cancer early enough to treat it successfully and at less cost. And they learned about the challenge of providing that screening within the U.S. health-care system in general and in rural Georgia in particular.

Fewer medical students are choosing primary care because of the low pay compared to specialty fields. Fewer primary care doctors means longer drives for patients, and these doctors serve as a key gateway to screening. Add the transportation challenges to inadequate insurance coverage, and many Georgians simply aren’t getting screened for cancer, said Robert Smith, senior vice president of Early Cancer Detection Science at the American Cancer Society.

Too often, patients get screened after experiencing symptoms and learn that they have advanced cancer. Then, they either suffer through distressing treatments or succumb to the disease, Smith said. The resulting pain, in human cost, ripples out to everyone around them, he added.

This inefficiency costs society a lot of money.

“Employers tell us that cancer is the top driver of their health-care costs,” Smith said, noting that two-thirds of cancer patients miss more than four weeks of work, and more than a third miss more than three months.

Smith said the U.S. health-care system relies on overworked primary care physicians and volunteer organizations to advocate for screening. He pointed to Europe, and Sweden in particular, as a model for establishing more deliberate screening systems. Georgia lawmakers could establish such a system, relieving primary care doctors of the responsibility, he said, when prompted for recommendations.

Nita Ham, executive director of the Georgia State Office of Rural Health in the Department of Community Health, painted what she called a “pretty bleak picture” of deteriorating conditions in rural Georgia.

That’s partly due to the flight of younger people, leaving an older and more cancer-prone population behind, Ham said. But the situation is compounded by inadequate insurance coverage and by hospital closures, forcing patients to drive farther for care, she said.

Eleven rural hospitals have closed since 2001, eight of them between 2013 and 2020, Ham said.

“We certainly are concerned that there may be one or two more in the near future,” she said.

Cancer costs hospitals a significant amount, said Caylee Noggle, president and CEO of the Georgia Hospital Association. She said hospitals lose tens of millions of dollars on uncompensated cancer care statewide.

Sarah Sessoms, chief operating officer of Community Health Works, which provides low-cost and mobile cancer screening, recommended that the legislature make nonprofit hospitals report the number of cancer screenings they do. She said lawmakers could establish a minimum number of indigent screenings as a condition of nonprofit status.