ATLANTA – About 66,000 Georgians will get cancer this year, and 19,000 of them will die.

That sobering estimate by the American Cancer Society explains why state lawmakers decided to study the disease this summer in an attempt to reduce the rate.

“We are above the average for the nation,” Dr. Jorge Cortes, director of the Georgia Cancer Center at Augusta University, told legislators assembled at his university Wednesday. Cortes said Georgians are getting – and dying from – lung, prostate, breast and colorectal cancer at rates exceeding the national average.

Cancer is the second leading cause of death in Georgia, according to testimony from the state Department of Community Health (DCH). It is the number one killer of people ages 1-19, said Dr. Doug Graham, chief of the Aflac Cancer and Blood Disorders Center at Children’s Healthcare of Atlanta.

What can lawmakers do about it?

For one thing, they can knock down barriers to cancer screening.

At prior hearings of the House Study Committee on Cancer Care Access in May and June, they learned that cancer care is hard to come by in rural areas, as the medical payments system squeezes smaller service providers. Rising costs and inadequate transportation contribute to lack of access to care.

The later cancer is detected, the deadlier it gets. It also becomes costlier to treat, driving up health-care costs for everyone.

Lawmakers heard repeatedly about how medical industry consolidation is exacerbating lack of access by forcing patients to drive farther to find a specialist.

Dr. Harsha Vyas, who has a small medical office in Dublin, asked study committee members to address what he sees as a systemic problem in the pharmaceutical and insurance industries: pharmacy benefit managers, or PBMs.

“They’re middlemen in the health-care system created by insurance companies,” Vyas said.  “They dictate all sorts of things they shouldn’t be dictating. … Just three PBMs control 80% of the drug market in the country. If that’s not monopoly, I don’t know what else is.”

Vyas said insurers have too much control over what doctors prescribe though a system called pre-authorization, and he said reimbursement rates for clinics like his are too low.

“We need to keep them accountable,” he said. “I can’t call them to the table. You guys can, and you’ve got to ask them the tough questions.”

No insurance companies were represented at Wednesday’s hearing, but a DCH staffer explained how Medicaid is managed in Georgia through contracts with management companies.

Graham, from Children’s Healthcare, said cancer in children is connected with genetic syndromes, birth defects and maternal age. But there are other correlations that are within parents’ control: breastfeeding and maternal vitamins are associated with reduced child cancer risk.

Rep. Lee Hawkins, R-Gainesville, the committee’s chairman, said he and other lawmakers are working on drug pricing and other issues. He wrapped up the committee’s listening tour by saying the General Assembly will continue to study cancer care access.

“I think we’re just at the beginning and scratching the surface of what we can do,” he said.