By Bob Griffin
I’ve spent most of my life flying over Alaska— across vast stretches of tundra, over mountain ranges, and into communities where the nearest road does not exist. When you have seen this state from the air, you understand something most policymakers in the Lower 48 don’t: distance here is not an inconvenience, it is a defining reality.
And too often, it is a deadly one.
That is especially true when it comes to healthcare, and more specifically, colorectal cancer. Alaska ranks the sixth deadliest state for this disease. For Alaska Native communities, the situation is even more alarming. They face the highest colorectal cancer incidence and mortality rates in the world— two to three times higher than any other group in the United States.
Those are not just statistics. They are neighbors, friends, and families.
The problem is not a lack of awareness or even a lack of coverage. Colonoscopies are covered through the Alaska Tribal Health System, yet fewer than 70 percent of eligible Alaska Native patients are getting screened. The issue here is access.
In much of Alaska, getting a colonoscopy is not as simple as driving across town. It can mean booking a flight, taking time off work, arranging childcare, and paying for lodging— all for a preventive procedure. For many, that’s enough to delay screening. And with colorectal cancer, delay can be the difference between life and death.
This is upsetting because when colorectal cancer is caught early, the five-year survival rate is about 91 percent for patients with localized stages. When it is caught late, those odds drop dramatically. Early detection is not just necessary, it is lifesaving.
That is why innovation in screening matters so much for a state like ours.
New options, like Guardant Health’s Shield test, the first and only FDA-approved blood test as a primary screening option for colorectal cancer for adults 45 and older at average risk, offers an easier approach. Shield does not require specialized facilities, sedation, or travel. It is a quick and easy blood draw at a local clinic that can bring screening within reach for people who would otherwise put it off, and it is already covered by Medicare, VA Community Care and TRICARE for active-duty service members. For a place like rural Alaska where even routine care can require air travel, this is transformative.
We have the tools to close this gap. We have the data that shows early detection saves lives. And now, we have more accessible ways to make screening a reality for more Alaskans— whether they live in Anchorage or a remote village off the road system.
The question is whether we act on it.
Alaskans pride ourselves on resilience. We adapt, we endure, and we take care of one another. But resilience should not mean accepting preventable loss.
If you are 45 or older and haven’t been screened for colorectal cancer, talk to your healthcare provider. Ask about your options. And if you have already taken that step, encourage someone else to do the same. Because in a state defined by distance, access to lifesaving care should not depend on how far you have to travel to get it.
Bob Griffin is the Senior Education Research Fellow for Alaska Policy Forum and a member of its Board of Directors. He is a retired USAF fighter pilot and former Chair of the Budget Advisory Commission for the Municipality of Anchorage and the Anchorage School District and a former member of the Alaska State Board of Education and Early Childhood Development.
