MARIANNA, Ark. — In the home of the blues, amid dying towns, gravel backroads and endless Mississippi Delta farmland, cancer grows, spreads and kills mercilessly — even the types that can be caught or stopped with well-known screening tests.

Here, 73-year-old Ruby Huffman got her first colonoscopy only after passing blood, and it found a huge cancerous tumor. Sixty-one-year-old Rita Stiles went at least a decade without a mammogram. And 55-year-old Tina Williams has had only one Pap smear in her life.

The story is the same in many parts of America, USA TODAY has found, and experts say there’s no excuse. Screenings that have been around for decades can detect breast, colorectal and cervical cancers at early stages, and even find colon polyps and cervical lesions before they turn into cancer. But their promise is limited — the nation’s progress against cancer diminished — because poor, minority and rural residents are left behind.

USA TODAY analyzed state-by-state data on screenings, incidence and death for these three cancers. The newspaper worked with the North American Association of Central Cancer Registries to compare states’ incidence-to-mortality ratio to see where deaths exceed what’s expected based on how often cancer strikes. States faring worst include Arkansas, Mississippi and Alabama, largely because cancers were found late, causing untold suffering and pushing up health costs for everyone.

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