(KFVS) - A simple screening.
Sometimes that's the difference between catching cancer and learning your fate a little too late.
But according to a study by the Journal of the American Medical Association, you're more likely to die of cancer in certain areas of the country.
The national cancer death rate has fallen nearly 20 percent over the past three decades.
Except in along the Mississippi River.
It's what researchers call cancer hot spots.
Doctors say it's largely due to a lack of screenings.
And Sandy Vaughn will tell you time matters when it comes to detection.
"It was honestly kind of a fluke."
Sandy Vaughn didn't look like she was sick.
She didn't feel sick either until one night about a year ago.
"I woke up in the middle of the night. Just nauseous, could not stop throwing up," recalled Sandy Vaughn. "Threw up for 5 hours. I woke my husband up. Said you have got to get me to the emergency room I think I'm having a gallbladder attack."
Her self-diagnosis could not have been more wrong.
"And he came back in and he said Sandy, you have Stage IV colon cancer."
Shock mixed with disbelief when doctors told her she had been living with cancer for more than six years.
"That was July 31st and, I mean, I was just shocked," Sandy said.
Doctors quickly got to work removing the tumor, but the cancer metastasized to her liver.
That's now what the chemo is fighting.
"It was very tough. My grandchildren, who I'm very close to, were so upset. The youngest one who was six at the time ran in and said did Mamaw die? And they said 'no honey but she's very sick.' 'Is grandma going to die?' But I love the doctor there looked at him and said not if I can help it."
A tone many doctors have to take in our part of the country because so often normally treatable cancers go undetected.
Doctor Mark Meadors is a medical oncologist at Saint Francis Medical Center.
"Southeast Missouri. The Bootheel. Arkansas. Northern Arkansas. These are hot spots. Kentucky. Certain counties are woefully….the death rates higher,: said Dr. Meadors.
Cancer hot spots.
Areas of the country where prevention efforts lag behind so death rates increase.
"You're seeing failure to screen appropriately and then upon symptoms not getting to the doctor early enough," Dr. Meadors explained.
Sandy will be the first to tell you she didn't follow recommended guidelines.
"No, you know they recommend [a colonoscopy] at 50 and not that I was afraid to have it, but I had no symptoms or hereditary cancers. You just put it off."
But now Dr. Meadors and Sandy have the same message to anyone thinking of skipping that all important screening.
"Early detection and early treatment. It's very treatable. Curable. If you get it early," Dr. Meadors said.
"I want people to know that they need that early detection," Sandy said.
Sandy didn't get an early diagnosis, but she's taking on cancer in her own unique way.
"I think one of the things that has kept everybody up, we decided we need a fight song. And we decided 'Earl has to Die' by the Dixie Chicks. So we have my Bye Earl bracelets," Sandy said with a laugh.
Earl isn't gone, but he's hopefully on his way out.
Sandy gets new scans in a few days and is ready for whatever comes next.
"Don't give up. Don't give up. You just gotta keep pushing through it and that's my advice."
Researchers say a higher prevalence of risk factors like smoking and obesity can also contribute to higher death rates.
Talk to your doctor about your family history and screenings you may need to have.