Kansas and Missouri are in the bottom half of the class in a new report from the American Cancer Society’s Cancer Action Network.

The report, “How Do You Measure Up,” judges states on a variety of policies related to cancer control and prevention. It uses a traffic signal color scheme to indicate state legislative progress: green for a positive trend, red for serious shortcomings and yellow for somewhere between.

Twenty-five states, including Kansas and Missouri, have reached benchmarks in only two or fewer of the 10 legislative priority areas measured in the report.

Kansas received a green rating for two measures: cancer pain control policies and a statewide ban on smoking in most public places, which has been in effect for five years.

Missouri fared worse, receiving no green ratings.

Kansas got a yellow rating for its tobacco taxes, even though lawmakers approved a 50-cent per-pack increase this year. That’s because the Kansas cigarette tax rate of $1.29 per pack is still below the national average of $1.59.

Missouri got a yellow rating for Medicaid coverage of tobacco cessation, pain policy and access to palliative care.

Kansas got a red rating for six other policy areas in the report: Medicaid coverage of tobacco cessation services; funding for tobacco control programs; indoor tanning restrictions; increased access to Medicaid (the state is one of 20 that have not expanded Medicaid eligibility under the Affordable Care Act); state funding for breast and cervical cancer screening; and access to palliative care.

Missouri likewise fell short in six policy areas: cigarette tax rates (it has the lowest in the nation, at 17 cents a pack); smoke-free laws; tobacco prevention funding; indoor tanning restrictions; breast and cervical cancer early detection; and increased access to Medicaid (Missouri, like Kansas, has not expanded Medicaid eligibility).

Reagan Cussimanio, government relations director in Kansas for the American Cancer Society Cancer Action Network, said Kansas has underfunded tobacco control and prevention for years.

“We are just under $1 million and have been at that level for a number of years,” she said. “The CDC recommends funding for a state such as Kansas be closer to the area of $27 million. Only when you tackle tobacco use through a comprehensive approach can we really effectively overcome the country’s tobacco epidemic.”

Cussimanio said lawmakers should not see funding for these programs as just an expense.

“This is a return on investment,” she said. “When you’re investing in prevention, you are ultimately reducing your expenditures on Medicaid. You’re reducing your expenditures in other areas.”

Another top priority for Cussimanio’s group is for Kansas to make tanning beds off-limits to anyone younger than 18. She said the number of young people using tanning beds has been rising for the last two decades. So has the number of Kansas diagnosed with melanoma, the most deadly form of skin cancer.

“People who use an indoor tanning device before the age of 35 actually end up increasing their risk for melanoma by 59 percent,” she said.

The report may not have a direct bearing on efforts to win National Cancer Institute comprehensive cancer cetner designation for the University of Kansas Cancer Center. However, Cussimanio said making progress on policies to reduce the use of tobacco in Kansas would help to demonstrate that the state is serious about attacking cancer.

An estimated 14,400 Kansas will be diagnosed with cancer this year and 5,510 will die from it, according to Cussimanio. Nearly half of all cancer deaths in the United States are preventable with cancer-fighting policies like those outlined in the report, she said.

Bryan Thompson is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.