There is actually evidence to show that while the coastal blue states and Texas have better (not great but better) survival outcomes, the ability to get diagnosed earlier is tied to access to preventative healthcare because if you have good health insurance and money you're more likely to go to the doctor if something doesn't seem severe, like most initial cancer symptoms, this causes patients to only go to the emergency room for health care which is often too late for a surgical option as the cancer has metastasized to your lymph nodes, which generally means it's in your other organs as well. This leaves chemotherapy and radiation as the resulting therapies, which while these can be effective, it's basically only life prolonging as radiation has a limit on how much you can due and damages other healthy tissue in the area and chemotherapy comes with side effects, organ damage, etc. and the cancer will eventually mutate, or the treatment could only slow the cancer or do nothing. Unfortunately doctors mostly don't know why the same treatment that works for the most patients doesn't work for all patients. Other treatments such as clinical trials can be either, unavailable for patients due to distance, trial rules, or a lack of expression of the marker that the medicine is hoping to exploit. While these are typically of no cost to the patient, it still means you have to be lucky enough to be near the location, be able to have the time off from work for the treatments which can take half a day at a time, and be able to have reliable transportation that isn't you driving yourself as the treatments can cause unpredictable side effects.