Colon cancer deaths are on the decline nationwide, but remain frighteningly high in the Mississippi delta, Western Appalachia, and the borderland between Virginia and North Carolina, the American Cancer Society (ACS) reports. 
The ACS attributes the skyrocketing rates of the disease in those areas to obesity, lack of education and a lack of access to medical care.
“In the Mississippi delta, rates among black men are not declining at all,” said Rebecca Siegel of the American Cancer Society, who led the study.
Due partly to colonoscopies, colon cancer is one of the most easily prevented cancers. The procedure can spot and remove pre-cancerous growths known as polyps before they become malignant, or find tumors easily when they are still easy to treat. Colon cancers can be removed surgically, and treatment is available to fight this particular diagnosis.
Health insurers must pay for colonoscopies, but that doesn’t help people who don’t have insurance, and that’s a major hurdle facing many residents in these areas.
“Particularly in the lower Mississippi delta and Appalachia, there are longstanding challenges, with high poverty, unemployment which coincides with less insurance coverage,” Siegel said.
Besides the lack of health insurance, many people from these regions exist on a diet of red meat, a fat-filled diet, and low fiber. 
The Affordable Care Act which passed in 2010 helps subsidize health insurance for low-income individuals. In order for that to happen, however, states must expand their Medicaid programs, the joint state-federal health insurance plan for people living in poverty. But only half of the 12 states in these high-risk areas have expanded Medicaid, Siegel says, leaving people whose incomes are too low to qualify for subsidized insurance with few choices when it comes to paying for health care. 
Siegel and colleagues calculated death rates for colorectal cancer on a county-by-county basis using software. The scientists compared trends from 1970 to 2011 and found deaths from colon cancer were 40% higher in the Mississippi delta than in average areas across the country from 2009 to 2011. Their report was published in Cancer, Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR).
Colon cancer rates in the Mississippi delta were 18% lower than the average death rates in the rest of the country in the early 1970s. Those numbers rose by 3.5% a year for black men between 1970 and 1990, and haven’t moved since.
“These areas are low-hanging fruit for colorectal cancer screening interventions,” Siegel said.
“Although we’ve made great strides against colorectal cancer in a fairly short time period, there are a lot of vulnerable populations that aren’t benefiting. Now that these groups have been identified, there is a moral obligation to do something about it. Targeted interventions, like using people within the community to talk to their neighbors about screening, are likely to be effective.”
 NBC News